Daily Kos

We can't continue on like this: health insurance costs

Tue Nov 20, 2007 at 12:35:27 PM PDT

WHEN WILL IT STOP!?!

I've written about this every hear now for three years.

In 2005 our health insurance (for two adults and a child) went up 11.3% and I wrote a diary "Health Care is Killing Us"

In 2006 our health insurance went up 21% and I wrote a diary "It can't go on. It must stop. Health care is making us sick"

So yesterday, 2007, I get the news, our insurance premium is now up 18% to 1033 a month.

I am part owner of a small business. The business can not afford health care, so we buy our own. Since we have a daughter and another on the way (adoption) and I have a preexisting condition (hypertension since 18yo) and am over 45, we MUST have health insurance and it's not cheap.

5 years ago it was 428.

Today it's 1033, 2.4 TIMES what it was in 2002. I can assure you our family income has not gone up 2.4 times in that time. In those 5 years we haven't had any out-of-the-ordinary costs. There was my sleep apnea, but I paid for the 600 dollar machine (insurance didn't cover it) and it's made me healthier. That's it. No emergency trips, no health issues, no change in coverage. Nope, just rising costs.

In the past few years we've absorbed the extra cost of the insurance. This year we can't. So we have choices to make. We've spent time over the last couple years paring down our bills so we can keep them within our income means. We have one car, we've insulated the house, I've cut our food bills in half, we cut our phone/cable/internet bill in half, we've done a lot. Our income just barely covers our bills.

Don't get me wrong, we are doing well. We've made some choices for our family that affect that bottom line. We've decided to live in San Francisco (with it's high housing costs we have to absorb), we've decided to keep our daughter in her private school (though we do get a huge tuition break) because she thrives there.

Now though, for the first time, we can't absorb this new rise in health care cost and live with the choices we've made. Something must give.

At this point we've decided to stay in SF (for various reasons that deal with raising our daughter) and in the school she's in. We are also keeping the internet and phone (I work at home, virtually, not a choice), can't cut food costs any more (in fact, they are rising). We've got it down to one car and car pooling.

So health insurance is going to have to give.

My partner is leaving our health care plan and finding another with a high deductible . That will allow me (who has the health problem and needs expensive meds) and my daughter (who is young) to keep our good coverage. Jointly we'll get our costs back down to around 800.

Less coverage, same price. That's the choice we made.

Now, you might have made a different choice, you might have moved to Ohio :), or taken your daughter out of her school and placed her in public school. We are still viable, our life, in fact we are doing pretty good.

But this isn't my point. The point is, that this is NOT sustainable. It's just the warning shot.

Consider this: At this rate of cost changes, in 5 years, if prices continue to rise (in just health insurance) at the rate they have for us, they'll be 2,500 a month.  At that point, we'll have taken our daughter out of private school and we'll have to leave San Francisco. Not miserable, lots of people do it and are happy.

In 10 years, our insurance will be around 6,000/month. At that point, we'll have sold our home in whatever state we had moved to and be living in a one bedroom apartment. We'll have canceled our cable and our cell phones. We'll have sold any car we have. I'll probably start growing food on our meager plot to supplement our grocery budget.

In 15 years, well... you get the picture.

This doesn't take into account of course the price of gasoline. In 2002 it was about 1.68 a gallon (and that's adjusted for inflation). Today it is 3.60. So in 5 years?  7.20?  In ten years? 14?  

Don't get me talking about food prices.

There is of course that other choice some have had to make, just go without insurance (which is the road we are heading down in part I guess with lower coverage).

This diary isn't a "oh woe is me" diary. This diary is a wake up call. This affluent family who works hard and is living the American dream is starting to feel the pinch of health costs and we can foresee, in the near future, where we can't continue like this 5, 10 years in the future

There are going to millions NOW who can't do it and there will be millions, tens of millions, more who that line where they can't continue is just around the corner.

Something is about to break. Do you hear the cracking sound?

Tags: health insurance, health care, health, inflation (all tags) :: Previous Tag Versions

Permalink | 27 comments

  •  Damn, I'm such a pessimist lately (14+ / 0-)

    with oil prices, food prices, health care costs, global warming...

    we need solutions and we needed them yesterday. I just don't see them coming in the huge way they need to.

    Daddy, Papa & Me: Two dads, a daughter & the politics of it all.

    by wclathe on Tue Nov 20, 2007 at 12:36:28 PM PDT

  •  those high costs are in their last throes (3+ / 0-)

    Recommended by:
    wclathe, tmo, Sychotic1

    with the doctor malpractice anti-sue laws in place those savings can be enjoyed by you and your family.

    and the free market will take care of it all.

    /sadness

  •  You are not alone (7+ / 0-)

    Health-care reform is one of the pivotal issues in the 2008 campaign.  We simply cannot afford any more of the status quo.

    Injustice anywhere is a threat to justice everywhere. - Martin Luther King, Jr.

    by DWG on Tue Nov 20, 2007 at 12:49:37 PM PDT

    •  just color me skeptic (2+ / 0-)

      Recommended by:
      cookiesandmilk, Sychotic1

      Ok, so in my good days I think a Democratic president and a Democratic congress will make the HUGE changes we need in this country when it comes to energy policy, global warming, civil rights and health care...

      but the congress' capitulations and weakness right now isn't give me a lot of hope.

      I AM a pessimist today, ain't I?

      Daddy, Papa & Me: Two dads, a daughter & the politics of it all.

      by wclathe on Tue Nov 20, 2007 at 12:52:10 PM PDT

      [ Parent ]

      •  No, you are being pragmatic (1+ / 0-)

        Recommended by:
        wclathe

        I too expected to see some fundamental change with the blue sweep into congress.  After seeing our congresscritters in action, I am pretty disheartened and don't have a whole lot of faith in what a Democratic Presidency will actually get us.

        There are bagels in the fridge

        by Sychotic1 on Tue Nov 20, 2007 at 01:36:10 PM PDT

        [ Parent ]

  •  Wait till Hillary (2+ / 0-)

    Recommended by:
    wclathe, tmo

    mandates that everyone buy insurance
    thats the solution!

    A vote for Obama is a vote for the world : YES WE CAN!

    by oscarfrye on Tue Nov 20, 2007 at 01:09:09 PM PDT

  •  It's all about wage slavery (3+ / 0-)

    Recommended by:
    wclathe, debedb, Cassandra Waites

    How dare you start a small business or be self-employed?  Work for a big company that has a comfy benefits package.

    And you'll live in fear of losing your job so you'll work real hard and put up with whatever abuse the boss hands out.  

    And you won't complain because complainers get bad job evaluations and might just get fired.

    Yes, it's about insurance company profiteering, but it's also about keeping the workforce scared and quiet.

  •  Remember, inflation is only a few percent (4+ / 0-)

    Recommended by:
    wclathe, tmo, Cassandra Waites, artmartin

    And great news! Today's washing machines are more affordable and have better features than ever!

    Best of all, they come with a spiffy cardboard box that can be used for supplementary housing.

    It's a great economy, as long as you're not buying food, energy or healthcare, so rejoice!

    Fry, don't be a hero! It's not covered by our health plan!

    by elfling on Tue Nov 20, 2007 at 01:11:47 PM PDT

  •  Any plan that includes insurance is doomed (3+ / 0-)

    Recommended by:
    wclathe, loader2000, Cassandra Waites

    I've been "lucky" enough in the last year to work as a programmer for one of the major health care insurance providers in the country.  Our division actually administers different state's Medicare and Medicaid claims so we are not the worst of the worst.  Those programs are the most efficient and non-judgmental of all the ones out there.  

    Here's the problem though.  I work in an office where hundreds of people each day do nothing but try to make sense of a medical coding and diagnosis system that has gotten so convoluted and complicated that the costs to keep it going are huge.  You can tell it's one of those systems that just kept having rules added to it without ever trimming off the unnecessary mess that was already in place.  There are so many ways of paying for a procedure or reimbursing a provider for their work that no one person can explain it to you.  

    My job is to provide software tools for people to try to break through the crap and I find it nearly impossible to help them.  It's a very frustrating job.

    The only solution is to do away with this ridiculous system of claims and medical coding and to start over.  A person comes in, the care is provided no questions asked, and the doctor gets a salary based on their schooling, expertise, and patient load.  In the interest of free enterprise, if someone wants to work outside this system and charge piecework like some body shop, more power to them but their costs are going to be higher for the huge administrative staff they'll have to retain.  

    It's already broken.

    "I still say a church steeple with a lightning rod on top shows a lack of confidence" Doug McLeod

    by artmartin on Tue Nov 20, 2007 at 01:29:02 PM PDT

    •  good point (0+ / 0-)

      My post was not a response to yours.  I posted it without reading what you wrote.  I still think some of the latest, greatest, and most expensive proceedures will have to go in a universal health care system.  However, you make a good case for improving efficiency.  

      Chris

  •  Iron Triangle (0+ / 0-)

    Its an Iron Triangle.  What we want is 1. high-quality health care   2. For everyone  3. Less Expensive

    By high quality health care I mean this:  

    1.  Generally speaking, an american citizen on a good plan has immediate access to emergancy room care no matter what the problem is (I once stupidly went to the emergancy room a week after I broke my arm.  Even though I had already gone a whole week and it was only a hairline fracture, they took me immediately and didn't tell me to make an appointment with a doctor).  
    1.  He also has access to the most advanced medical technology in the world.  For example, people fly from all over the world to the Cleveland Clinic for serious heart problems.  They don't go to Cuba or the UK for this.
    1.  He doesn't have to wait on a standby list because of the limited availability of healthcare professionals.  
    1.  If he has a serious problem, it is taken care of almost immediately (I have a friend in England who needs a hip replacement so badly she can barely walk.  However, she was told she would have to wait years before she can have it replaced because that kind of surgery is only allowed for people over 50).  
    1.  His doctor's are the best trained in the world (The only way the UK has managed to maintain a population of servicable doctors at the low rate doctors are paid over there is by importing doctors trained in third world countries - like Pakistan).  
    1.  There are always random and infrequent exceptions this high quality in the sense that some people do have negative experiences.  Certain documentaries like to portray these exceptions to the rule AS the rule, but most people aren't gullible enough believe everything they see in a politically motivated documentary.  

    We can't have High-quality, for everyone, and less expensive.  You can cut out some inefficiency but the idea that eliminating most of this inefficiency by turning healthcare over to the government is ridiculous to anyone that has every worked for any bueacracy in D.C.  The horror stories I hear from my friend (who lived in D.C.) of people in all kinds of government agencies working 3 days a week and doing the minimum work required to not get fired send a shiver down my spine.  

    Therefore, at least some of the solution is going to have to come from lower quality health care, perhaps with an emphsis on preventative care, espeically for children.  

    I can live with this if it means every kid in America has access to health care.  The problem is, most Americans, liberal and conservative do not accept this.  They believe that there is some magic formula, whereby nearly all inefficiency can be eliminated from the health care system and we can get everything we want.  Politicians play to this idea, telling people that it is true and they will bring it about if only they are elected.  

    What we can get is a system like England or Canada.  Don't kid yourself that the health care in those places are equal to good plans over here.  People in England or Canada are fairly content with the health care they receive (at least according to polls) for three reasons:

    1.  They have never experienced anything better.  So what if they don't have access to the latest and greatest cancer busting surgery, no else in Canada does either and most of them have never heard of it anyway.  Cancer recovery rantes in the US are higher than in both these countries.  
    1.  Having free and undeniable coverage, even if you have to wait 3 weeks to see a doctor, provides people with a feeling of security.  They know that they will eventually be taken care of, no matter what.  This is unlike the American system where you never know what the insurance company make try to make you pay for.  Often times, insurance companies deliberately tell you that you have to pay for something that you don't, expecting you to figure this out and petition.  In these situations, the insurancee usually wins, but it is still a big hassle and very stressfull.            
    1.  At least in Canada, the price of drugs is restricted by federal law.  Drug companies still sell the drugs in Canada because they still make a small profit over there.  However, the Americans are the ones footing to bill for all the advertising, research and development.  Essentially, US citizens are paying for Canadian health care so that they have plentifull access to the latest drugs at low cost (this one really pisses me off).

    I can deal with lower quality healthcare.  The last time Americans were told they had to deal with it (in the form of managed care in the early 90's) they freaked out, rebelled, and we have the system we have now.  I hope their attitudes have changed or we are in serious trouble.  

    Chris

    •  Disagree, (0+ / 0-)

      Health care is Germany is just as good here, if not better. We lived there for 4 years under their system. The wait times to get appointments and the wait times at the office were much lower than we have now at Kaiser (the best HMO in the state supposedly), the doctors were as well or better educated, the drugs for my hypertension were the best available (my HMO wouldn't pay for one I got in Germany because it was too expensive), etc, etc.

      Our health care experience was by far better in Germany than here.

      And per capita it was cheaper than here.

      It might be anectodal, but several here at DK have posted quite a good series debunking the thought that we can't make our health care cheaper and keep it good.

      Daddy, Papa & Me: Two dads, a daughter & the politics of it all.

      by wclathe on Tue Nov 20, 2007 at 01:59:18 PM PDT

      [ Parent ]

      •  Interesting (0+ / 0-)

        It sounds like the German system works pretty well for the things you described.  I would be very interested to know what cancer recovery rates were in Germany compared to the US.  For example, I know Breat Cancer recovery rates in the US are among the best in the world, but is possible the recovery rates in Germany are just as good if not better.  I don't know and am having a hard time finding info about it on the internet.  

        If they were just as good, it would imply Germany had a system that was better (or equal) for run of the mill problems as well as serious problems.  If that were the case, we should be studying the German system very carefully.

        Chris  

    •  As to drug costs (0+ / 0-)

      US citizens are not "paying for Canadian health care"

      Drug costs are less than 10% of the total health care bill and have been rising at a much slower rate than other health care costs this decade.

      At worst, Americans are helping with a small part of 1% of Canadian health costs (given that drug costs are less than 10% of the cost of health and that the R&D for drugs American companies pay is only a percentage of that), but even then I don't see the evidence for that.

      Daddy, Papa & Me: Two dads, a daughter & the politics of it all.

      by wclathe on Tue Nov 20, 2007 at 02:10:05 PM PDT

      [ Parent ]

      •  perhaps (0+ / 0-)

        "Drug costs are less than 10% of the total health care bill and have been rising at a much slower rate than other health care costs this decade."

        Good point there.  The rising costs are due to a lot more than what we pay for Canadian drug R&D.

        "At worst, Americans are helping with a small part of 1% of Canadian health costs (given that drug costs are less than 10% of the cost of health and that the R&D for drugs American companies pay is only a percentage of that), but even then I don't see the evidence for that."

        I spent the last year working for a drug company.  I can tell you that R&D accounted for a huge percentage of the budget.  I'd say that about half the employees worked in R&D and that it probably accounted for 30%-40% of the budget.  However, this only revises the amoun we pay for Canadian health care to 3 or 4 percent (assuming prescription drugs do only account for 10% of healthcare).  

  •  mine went up 33% BCBS NC (1+ / 0-)

    Recommended by:
    wclathe

    My husband has a small business and insures our family. I am on a separate policy from he and our son, and he just got a notice that my premium was going up by a third. Last year it went up about 24%, he told me.

    At this rate, it will be more than our mortgage. For an addition to our home we are in the middle of right now. Okay, we are putting on solar panels, so that will help with the electricity, but we don't have money to burn.

    I am not a particularly high intensity user of medical services. I am 55, so I have some prescriptions and my big problem is seasonal allergies and upper respiratory infections. They claim the increases of all users mean I have to pay this whopping increase.

    The pump don't work 'cause a vandal took the handle.

    by Chun Yang on Tue Nov 20, 2007 at 01:59:01 PM PDT

  •  We cancelled our BCBS health insurance (0+ / 0-)

    in 2002 or 2003, when it was $1,000 per month for just us, a married hetero couple in our early 50's. The only pre-existing condition required a Synthroid prescription (no big deal). The policy was through the farm bureau. BCBS refused to pay for an outpatient colonoscopy which was only billed at $600 (the 'good old days'). This was despite a family history of colon cancer, which means that they'd rather I get colon cancer later and cost whoever my insurer happens to be then a huge bundle, than take the risk of shelling out for my colonoscopy (which prevents ever getting colon cancer as long as I continue having them routinely) now. Clearly they expected me to be some other insurance company's problem by the time I actually might have been diagnosed with cancer.

    There can be no more-salient case for universal health care than the attitude displayed here.

    When Republiconservatives talk about health care being a free market they really mean economic genocide. Alternatively they see health insurance, in the form of mandates, as a cash cow.

Permalink | 27 comments