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When it comes to our health care “affordable”takes on unique meaning.
For many (most) people affordable then means $0. I have been aware of and thought about this conundrum for over sixty years when I first became involved with healthcare benefits. I have seen it in action more times than receiving HD down arrows.
Health insurance evolved from true insurance in the 1940s to covering virtually all spending from the first dollar and then we made gradual attempts – strongly resisted by individuals – to return to more patient cost sharing via high deductibles and copayments.
Generally speaking, people see healthcare out of pocket costs as punitive, as a scam by their insurance company and fail to make the connection between cost sharing at the point of service and the premiums they pay.
About 60% of American workers are covered by health benefits that are self-insured (large employers) or partially self-insured using stop loss (smaller employers). The premiums these workers pay only reflect the healthcare used by fellow workers and their families. The greater the portion paid by the employer, the greater the likely affect on the wages it can pay. And yet, the resistance to out of pocket costs is strong.
Connie and I receive flu, and COVID vaccinations each year, they are “free” – to us at least. Would we receive them if we were required to pay the full cost? Well, yes, but many people would not spend the $200 or so.
Last week we spent $253 on a special occasion dinner, but if we were required to spend the same amount on health care, it would be viewed entirely differently even though the healthcare spending may have far greater value.
If you think I occasionally rant, take a look at true ranting on social media about health insurance, the cost of health care and out of pocket costs. Much of it is irrational and most is not based on facts, but does reflect the view health care should be “free.”
People posting from other countries like to point out they receive free healthcare. Of course they don’t, but it feels like it to them when they need care and that is what matters. Their true cost is hidden in taxes, but who cares as there is no thought of spending money or is there a financial barrier when obtaining needed healthcare.
Spending $80 on a ticket to a ball game or concert is acceptable- even when purchased on credit – but ask the person to spend half that for a prescription co-pay and it becomes unaffordable.
Some people, including many of those in Washington, DC, believe we Americans should become healthcare consumers by paying more and thinking about spending at the time healthcare is obtained-shoppers if you will – and that will lead toward affordability. It won’t.
People shopping on Black Friday are consumers. People concerned about health care for themselves or a loved one are not and never will be nor should be consumers looking for the best bargain.
So, what is the solution? I believe I know, but these days it’s politically charged and can’t even be intelligently discussed. If you want to see my views you can find them here. No, it’s not socialized medicine, but I have friends who are perfectly happy with theirs.
I always find it bemusing that nearly everyone who complains about how expensive healthcare is almost certainly has family or close friends who are doctors, nurses, or other providers. But they don’t want those providers to be paid less.
I wonder if it ever think about how those squares can be circled?
I’m not sure that is true. There are a lot of people complaining. We need providers paid fairly not different fees from Medicaid, Medicare, and various health plans.
It would be nice if you would try to initiate an intelligent discussion of your ideas about how to improve our Healthcare instead of taking your usual approach of complaining about people’s misperceptions.
I would be happy to do that. That’s why I put the link in my post. I write quite a bit on the subject and that link is a place to start. I don’t think HD is the place such a discussion though.