Costs of Costs
A recent study by the Commonwealth Fund shows that those who have “individual market” insurance pay more and are less happy than those with “employer based plans.” Well, gee whiz. If you’re the insurance company and you have two calls: one from a company with 300,000 employees and another from a single, self-employed individual. Guess who’s going to get the best deal on health insurance! Hardly surprising, and no one can blame the insurance company for managing risk.
Not surprising either that most who enquire about individual plans do not purchase. No value there. These are the folks who really need to consider a high deductible plan. Of course, those with high deductible plans are at a disadvantage in a market where insurance companies (including CMS) pay for most healthcare. With no price pressure, costs remain high, and individuals who pay suffer. Those who pay taxes (for Medicare) or premiums (for health insurance) also suffer, but not as directly.
Also not surprising is their finding that 43% of those who did purchase such a plan spent more than 10% of their income on premiums and care. With premiums alone over $3,000 a year, that’s not hard to do.
The CMWF stated that those in individual plans had access problems, but their data suggest that this was a matter of choice, not availability. Patients chose not to spend the money to see a specialist or obtain other recommended care. Some of this is a failure of the physician to convince the patient that such care was truly necessary. Perhaps it wasn’t necessary. Providers become accustomed to freely suggesting care when insurance is paying the bill.
The only suggestion proposed was state sponsored insurance pools to help individuals buy into the health insurance market. This of course does nothing to promote efficient care and perpetuates the high cost of services.
