stable, slightly, slowly, low, relatively low, lower-than-usual, all words used in recent national articles to describe projected health insurance premium increases for employer-sponsored health plans. I'm sorry, but these words are way too upbeat for my me. Sure, we need to inform people that they can expect smaller health insurance premium increases than in prior years, but I can do without the cheerful tone extolling high but not as high health insurance premiums for some.
Still, you may be thinking that a slowdown in health insurance premium growth is good news or you may be thinking, what's the harm in saying things are better than usual. Where to start?
First, news of lower than usual health insurance premium increases applies mostly to large employers. Smaller employers will continue to see rate increases in or approaching double digits. Second, these "slight" rate increases are made possible by already overinflated health insurance rates. Individual premiums for some small group health plans can be as high as $700 to $1,000 per month, based on benefits covered and cost-sharing structures (e.g., deductibles, coinsurance and copays). These rates are higher than the exchange rates.
But the number one reason we should not celebrate lower than usual group health insurance premiums is that it gives a false impression that we are controlling health insurance and health care costs. That employer groups have finally figured out how to win at the health care negotiating table. That health insurance companies are more accurately predicting risks and passing on the savings to their employer groups. That workplace health insurance is a bargain and operates like a fine-tuned machine, not in need of reform. That health insurance prices are not something we need to address, at least not right now. Nothing could be further from the truth.
Steady Rates or A Red Flag
There is no reason to believe that health insurance costs are under control or are a minor issue in the whole health care reform debate. The cost of health insurance (and health care) is the debate. Health insurance prices are too high and individuals can't determine the value of their policies.
Also, if health insurance was becoming such a bargain, why don't health insurers share price and discount information with the public or employer groups? If insurers are paying providers four, five or six times the Medicare rate for medical services and receive a 50% discount on less, that's no bargain. And if insurers charge a little less to access these inflated, low discount rates, why give them a pat on the back? Continue Reading...
Bernie Sanders revealed his Medicare for all plan, and Republican Senators renewed efforts to repeal and replace Obamacare with a plan (Graham-Cassidy-Heller-Johnson (GCHJ) plan) that will leave tens of millions without health insurance. If it seems like American health care reform continues on the road to nowhere, it's because it does.
After weeks of silence, followed by news of Obamacare sabotage, health care reform policy returns to center stage. Last week,
The Sanders plan is long on moralizing (yes, health care should be a right) and short on concrete ideas to address health care costs. The plan includes all of the usual policy proposals to lower health care costs: administrative simplicity, enhanced negotiating power with prescription drug makers, federal subsidies for health care worker training, incentives for doctors to provide better care, and making rich people and employers pay more of the costs for national health care. The only thing new about the Sanders Medicare for all plan is that now it is official.
The Graham-Cassidy et al plan put out by Republican Senators Bill Cassidy (a doctor), and Lindsey Graham is a lot like other Republican health care reform proposals of late in that it looks to reduce federal funding of health care by replacing current subsidies with smaller block grants. The bill would also reduce the amount of money the federal government gives to states to fund their Medicaid programs. But mostly the bill, if passed, will unabashedly, take health care away from millions who currently have it with no pretense of offering them anything in return. There's more awfulness to read in Cassidy-Graham, but the overarching message is that Americans do not have a right to federally funded health care.
So here we are, again, with two opposing policies on American health care reform. Meanwhile, big pharmaceutical companies continue to introduce drugs approaching or surpassing the half a million-dollar cost mark. Employers persist in maintaining health plans whose costs they cannot manage. Workers' keep on watching health care premiums eat up their small wage increases. Politicians continue to move money around from one powerful health care interest group to another. And Americans continue to fall for the you-can't-put-a-value-on-your-health and the importance of American innovation cons to justify uniquely high-priced American health care.
No Shame In the Health Care Price Game
No one disputes that America has the highest medical care prices in the world. But in typical American fashion, some of us like being at the top of even this list. Defenders of high-cost American health care claim the costs are high because we as a country can afford it, and that that's the price tag for medical and drug innovation. But neither of these claims is necessarily true or right. Tens of millions of Americans cannot afford to pay for health care, and the high price of medical innovation shouldn't go unchallenged.
Last week there was a report about a new cancer drug with a $475,000 price tag. And it seems like just last year we in awe about a new Hepatitis C drugs that cost about $80,000 per patient. Also, just two weeks ago, Texas Medical Center was bragging about its $50 million worth of floodgates protecting it from Hurricane Harvey. Yes, America obviously has a lot of money to invest in medical care, but is it investing it wisely, is the greatest number of people helped by these investments and who gets to make these decisions. Continue Reading...