Wednesday, December 04, 2013

The Unhealthy Side of Capitalism

I have health insurance and I am grateful for it.  Like most Americans who have health insurance, mine is via my employer.  Like many people whose employer is a small non-profit, I pay a significant share of my benefits.  In my case, that's 40% of the premium.  To insure JT and me, I pay an amount that is a shade more than $550 a month; more than $6500 a year.  My employer adds another chunk of change, nearly $10,000 a year.  The total to ensure JT and I exceeds $16, 500 per year.  That's a significant amount of money, though I wouldn't consider going without health insurance.

Most years, the company who provides my insurance is making money.  It's a for-profit corporation and that's what for-profit corporations do: make money.  It's clear that most Americans actually forget that fact when they think about health insurance.  But it is important to remember that most health insurance companies are in the business of making money.  They collect a premium from their customers and place a bet that we won't get sick.  The customers pay that premium, hedging against the prospect of illness.  No one actually wants to be sick, of course, and we quickly lose sight of the basic nature of this arrangement.

I mention this because in the current hand-wringing about Obamacare and changing insurance plans, we've once again lost sight of the fact that in choosing an insurance-based for-profit model of healthcare, we've signed ourselves up for a very costly enterprise.  Obamacare's regulations require insurance companies to pay for a host of treatments, treatments that Americans want to be included in their healthcare: maternity care, birth control, vaccinations, regular check-ups, preventative measure tests like mammography and colonoscopies, and host more.  Those things are expensive.  Of course our rates will go up.  This is a significant burden for the people who pay for insurance: employers and employees.

If you work for the government or a large employer with a stash of cash, you likely pay a very modest share of your insurance premium.  For example, state employees in New Jersey typically pay less than 15% of the cost of their premiums, while their employer pays significantly more.  This is not unusual and it creates a challenging political climate.

I am frustrated by this increasingly unequal arrangement and would cheerfully support a single-payer system of government-managed hospitals and physician clinics.  It would be less costly, a fact born out by the current New York Times series about the cost of healthcare, "Paying Till it Hurts."  I've linked to the most recent article in the series here.  A single-payer system would also be accessible to every one of us and significantly better than the system we have today. 

Until then, I've received word that my insurance will cost at least 20% more next year.  My monthly outlay will therefore increase to $610 a month.  That's 610 dollars that will not go into the economy for other goods and services.  If I am lucky and we remain healthy, it will go into the coffers of a private corporation whose profits will pay stockholders.

It could be me, but that seems like an unhealthy arrangement.

No comments: