Health care is always unaffordable – not really

Let’s say you have $50, $100, $200 and $500. 

I’m quite certain from time to time the average American would find spending those amounts affordable – on say a manicure, a round of golf, a tattoo, a couples night on the town or even attending a sporting event. For many people this would be true even if they charged the expense. 

It’s quite natural we receive pleasure from spending money, depending on what it is spent on. But there is difference. The same amount that is affordable on one item can easily be made “unaffordable.”

It’s true, take those amounts above and apply them to health care and everything changes. How do I know? Decades of managing health benefits and working with the people using them has clearly demonstrated the phenomenon to me. 

Walk into your pharmacy and find the Rx co-pay is $50 and a financial crisis occurs. That’s the same $50 spent on a manicure the week before, just a routine expense. 

But it gets curiouser. A test of some kind is denied by insurance, you are appealing the denial, but your doctor says you need the test now.  It costs $500. What do you do? 

I had many people tell me their health was in jeopardy by delaying a test, but paying for it themselves while fighting over payment was rarely considered. It was like the test was only life threatening if someone else paid. 

Trust me, I am not exaggerating or cherry picking. $50 is not always $50. Spending OUR money on health care is always unaffordable.

This basic quirk in logic is why we can’t fix health care, why people in other countries feel their health care is “free” because at the point of service costs are hidden in taxes and premiums and people like it that way. 

Except in the United States, we tend to think we should have no OOP costs, but also want minimum taxes or premiums offsetting that spending.