As 2015 comes to an end, I'm examining my expenditures for the year. I plan to spend a full day going through my accounts to see where I overspent on non-essentials so that I don't make the same mistakes next year. But I already know how much I spent on health insurance and I know that I'll spend slightly more on it in 2016. I've used all of the health plan price comparison tools and I know I can't get a lower monthly premium than the plan I selected. And that annoys me because I haven't needed medical care services since I was a child.

I pay about $3,500 in annual health insurance premiums and that's considered relatively inexpensive. It is inexpensive compared to the $9,600 in annual premiums an acquaintance of mine pays. Before the Affordable Care Act (aka Obamacare) she was paying twice that as a freelancer. Still $3,500 is a lot of money to pay for nothing. And if I needed to use my plan, I'd have to meet a $6,000 deductible. But I'm okay with paying that deductible if I actually received medical care (aside from the unsubstantiated markup prices for that care).

What I'm struggling with in this American health insurance market is that I have no real options to cut my health care expenses. I can't negotiate my insurance rate with the insurance company. I'm just stuck paying what they demand I pay. I can't design a health plan that suits my lifestyle. I'm stuck with plans designed for sick people.


My ideal health plan would be a $0 premium, high deductible health plan (HDHP) with a health savings account (HSA). This is how it would work:

• I would choose from a menu of covered services: prescription drugs, inpatient and outpatient services and one dental cleaning would be standard
• I would have a narrow network of participating providers, with no out-of-network option except for emergencies
• I would have access to medical care price estimates and negotiate costs with medical providers and hospitals
• I would fund my investable HSA with $1,000 and then contribute a monthly amount until I reached the legal annual contribution amount - (2016 = $3,350, single coverage and $6,750, family coverage)
• I would fund my HSA annually via monthly contributions. What I don’t spend would carry over to the next year
• I would get an estimate of my claims for the year (using a reliable health care price tool). This would be based on my age, gender and geographic location. Even though my claims are typically 10% or less of most estimates, I'm willing to use this number as a base of anticipated expenses
• I would pay an annual federal health insurance tax of $500
• I would have some control over my health care spending while still paying into a system that supports others
• My annual deductible would be $6,000, with 20% coinsurance
• My annual out of pocket maximum would be $6,500

Tags: health insurance