I just got my bill for the health insurance plan that Premera Blue Cross decided to provide for me in place of the plan that I signed up for a year ago. A few weeks ago I had received a glossy color sheet describing how my plan was changing, due to health care reform. My new plan would cover all health maintenance with no charge to me out of pocket, but would no longer have any coverage for various alternative medical services or eye care services. The overall deductible would be the same.
How much, you may ask, is this new plan that sucks marginally more than my previous plan? It is now about $630 bucks a month, a 30% increase over last year (with no dental coverage). As far as I could tell, there is no cheaper, crappier plan available to me. I will just have to suck it up and pay the extra nearly $2000 a year for my really truly catastrophic coverage. This will, of course, cover my deductibles on preventive services, which might have added up to as much as $200 a year with the previous plan. These figures are lower than many Americans’ since our family has no medical problems and our state has some of the cheapest medical costs in the country.
The Seattle Post Intelligencer reports that Regence has raised rates in the double digits for 4 years in a row, on average 91% since 2007. They have a nearly 1 billion dollar surplus, which increased 12% in the last year. Provisions of the health care reform bill will make health insurance more competitive, but not until 2014. That is plenty of time for insurance rates to double and then some.
Most people are in exactly the same situation that I am in, or worse, no matter whether they are insured by their employer, by the military or by the government through medicare or medicaid. To some extent, everyone has a bite taken out of their overall income due to the cost of insuring for health care. The cost of health care itself continues to rise, but much more steeply because health insurance companies continue to pay for these expenses, make the billing for them more difficult and therefore more costly, and hand all of those costs over to the consumers of health insurance with a hefty and increasing markup.
What shall we do, then? I do hope we all become uncomfortable enough with the status quo that we begin to calculate the true cost of a good health care system and re-evaluate what place our present third party payment system should have in it. Negotiating payment for the services that we as individuals or communities need and buying those services would take a great deal of cooperation between providers and consumers, but could radically reduce our dependence on health insurance companies.
An example of paying for expensive services in a proactive way is our local air ambulance service. We are a rural area and many serious injuries or cardiac emergencies are treated in our nearest big city which is 90 miles away. Sick patients are transported by Northwest Medstar to Spokane by helicopter or fixed wing plane, at a cost of over $20,000 per ride. Blue Cross will pay 30% of this if they even agree that the transport was necessary. For $59 a year, a person can buy a “membership” to Medstar which covers any air transportation needs. This is not charity, but simply a calculation by medstar of what it costs to support their services.
There are no other alternatives to our present insurance coverage that are available to me and my family at this point that are not either irresponsible or more expensive. I will continue to push for a community sponsored alternative to health insurance. Our hospital could make this happen if there was adequate cooperation from the doctor groups in town. Even without that, we could do a smaller pilot project to provide primary care, lab, hospital and imaging services. The incentive to do something like this will continue to increase as premiums rise. Interest in this has been high with our hospital’s administration and regardless of tomorrow’s election outcomes, I expect to see creative grass roots alternatives to our present third party payment system.