Thursday, February 2, 2012

Medical Insurance: I'm Mad as Hell and I Don't Want to Take it Anymore!

These figures are based on our actual salary and insurance premium figures.Each bar shows the rate of increase compared to 2004.

     Every year about this time we have "Open Enrollment" for health and medical benefits at my husband's employer. And every year about this time I become outraged over the state of our health system and I shake my fist at the whole insurance industry. My outcry begins at line item one where it shows the premium for our plan. It will cost us $84.00 more each month for the same insurance we had last year, bringing our total cost to $462 per month for family coverage. The company adds something to this and I don't know that amount but, I would guess it's double. The company used to offer three plans to choose from; a low, middle and high cost plan. Each year they eliminated one of the plan options. Now we are offered an all-or-nothing deal. In addition to this, we contribute to a Medical Spending Account which provides us with pre-tax dollars deducted from husband's salary to use on all the expenses the insurance doesn't cover like deductibles, co-pays, etc. I am all for MSA's and this really isn't part of the problem.
     I'm appalled at this huge increase in medical insurance premiums when we are in an economy where salaries have certainly not gone up. Most employees are not receiving cost of living increases let alone annual raises of any type and many have had to take pay cuts just to stay employed. Last year the premium increase was just as large and I vented on facebook. It was met with apathy. And there's the rub. No one really takes up the torch for this cause and rallies against the insanity of it all. Yes, some will say Obama's health care initiative is addressing this problem, but it actually doesn't. His plan is to provide coverage for all citizens, but I don't believe it addresses the rising cost of medical care and health insurance. As a matter of fact, since he took office our premiums have  increased the most. I realize his plan hasn't gone into effect, and perhaps it was a knee-jerk reaction from the industry when he started talking health care, I don't know. But I want to stand out in the middle of the field and scream for someone to listen! This is how helpless I feel.
     My gut reaction (which is total nonsense) is that we all need to cancel our insurance and everyone needs to take a stand against being screwed. If the entire country bought no insurance... can you imagine? The question is, am I willing to take the gamble. Because that's what insurance is, a gamble. We are protecting ourselves against the "what-if". What if I get hit by a car and land in the hospital? What if my child needs an operation? The fear of it all has me running to hedge my bets and buy the insurance. It's called fear-mongering. If I wasn't so afraid of a massive hospital bill which would in turn cause financial ruin to my family, I wouldn't buy the insurance.
     All insurance operates this way, but most have smaller increases in premiums each year. We can shop around for the levels of coverage we want and who might offer the best plan. Some of the control lies within our own hands. Homeowners, auto, and life insurance all charge minimal premiums compared to the cost of medical.
     I don't see this type of free-market enterprise working well in the system as it stands now. Has anyone tried calling around for a price on a medical procedure? Or a radiology procedure? I have. It's next to impossible to get a straight answer from a provider on what the cost will be. The system does not enable us to shop around for the best provider at the best cost. The insurance companies take charge of this. It's what a Preferred Provider Organization (PPO) is all about. A network of providers agrees to sign on with the insurance company, providing their services to all plan members for a locked in rate. Basically, they make a deal. We are left out of the wheeling and dealing. Yes we are given free reign to choose our provider from the network of providers the insurance company says we can use. But if you want some other professional, the insurance is going to cover less of the bill or perhaps none at all.
      On the two opposing ends of the spectrum, millionaires can afford not to carry medical insurance. Low-income families are forced to use Medicaid with even less providers available for them to choose from. The elderly have Medicare. But, both Medicaid and Medicare strain our government in ways that can bankrupt  the tax system. I suppose this is a whole 'nother fish to fry.
     So where does that leave us? I would like to see the system open to free enterprise. I would like doctors and hospitals to compete to provide excellent service at reasonable costs. I would like the free choice to choose any doctor I want, to call ahead and know what he/she charges, and to be able to pay my bill. As it stands now, I have no idea what our family physician charges for an office visit. I never see a bill. I pay my $25 co-pay and that's the end of it. All nice and tidy and cheap it seems. But that's the problem! I'm left out of the equation. Who knows what she charges and how that amount drives up the cost of medical insurance. (By the way, I like our doctor a lot.) We had a "specialist" "run some tests" last year. I would never have known what tests he ran or how much the bill was had I not phoned the hospital and asked for an itemized bill. It was $3000. That's exactly why my insurance premiums are what they are.
     I realize this problem is far too big and far too long in the making for any simple solution. I just wish a dialogue would open up among the experts to address the rising cost of health care, the rising cost of insurance and the very real inability for any American citizen to be able to afford it. I do not think the government should assign themselves this task. It should be left to the medical and financial experts to rack their brains and formulate a solution which would benefit all.
     My personal solution is to kick around the idea of purchasing a catastrophic health plan. We would cancel our medical insurance and pay as we go for any and all medical expenses. The insurance would be there only in the case of a real medical emergency or very high hospital bill. I need to look into this type of plan and the cost of premiums. I would genuinely like to know of anyone who insures their family this way and how it has worked out for you. I simply want to get off this crazy ride and take some control for ourselves.

Disclaimer : ) I'm no expert. I'm your average American citizen who is frustrated beyond measure.