The Health-Care Crisis Has Spread to Employer Plans

America continues to have the most expensive, least efficient healthcare system - if one can even call it a system, given its fragmented nature - where people pay vastly more for the same procedures than people in Canada or Europe.  Add to that the ungodly high prescription drug costs that allow pharmaceutical companies in the USA to price gouge consumers, and it is a recipe for financial hardship for many who find themselves deferring care because they cannot pay policy deductibles.  While the focus of the Affordable Health Care Act was to bring insurance to the uninsured, a growing crisis is developing under employer based plans that are using ever increasing deductibles and prescription limitations as a means to cope with soaring costs.  It's little wonder that life expectancy is falling in the USA.  A piece in New York Magazine looks at the growing crisis.  Here are article excerpts:  

For most of this century, the big U.S. health-care policy issue has been providing insurance to the uninsured, including the uninsurable people with expensive health conditions. Yes, the majority of non-elderly Americans covered by employer-based insurance were affected by this debate insofar as sharing the costs of more universal coverage would increase their premiums and/or taxes. But for the most part, Americans were relatively happy with the insurance they got at work.

That’s changing, as is graphically illustrated by a major new survey conducted by the Los Angeles Times and the Kaiser Family Foundation that shows insurance deductibles, co-pays, and other “cost sharing” requirements by insurers are putting the squeeze on affected policyholders in a big way.

As the Times’ Noam Levy explains, the rise of deductibles has been dramatic:

In the last 12 years, annual deductibles in job-based health plans have nearly quadrupled and now average more than $1,300 [family coverage deductibles are far higher].

Yet Americans’ savings are not keeping pace, data show. And more than four in 10 workers enrolled in a high-deductible plan report they don’t have enough savings to cover the deductible.

One in six Americans who get insurance through their jobs say they’ve had to make “difficult sacrifices” to pay for healthcare in the last year, including cutting back on food, moving in with friends or family, or taking extra jobs. And one in five say healthcare costs have eaten up all or most of their savings.

And that’s not even counting those who skip care they need because they cannot afford to pay their “share” of steadily rising medical bills.  When people don’t get essential care, of course, insurance has failed everyone other than the insurer itself. And while everyone was aware cost-sharing requirements were steadily increasing, it did sneak up on policy-makers whose attention was elsewhere:

The 2010 healthcare law — often called Obamacare — provided landmark protections to Americans once shut out of health coverage. But as Democrats and Republicans fought over the law, Altman said, neither focused on the rapid run-up in costs for people covered through work.

But this was by no means accidental. High-deductible insurance plans were promoted both by the industry and by conservative politicians: . . . . Backers of the high-deductible strategy nevertheless argued that patients, given “skin in the game,” would become active consumers who would force drugmakers, hospitals and other medical providers to rein in prices.

If that sounds familiar to consumers of political rhetoric, it’s because Republicans have long promoted patient-driven competition as a health-care cost panacea, usually through a combination of high-deductible insurance plans and tax-preferred health savings accounts designed to help consumers save for out-of-pocket costs.

Guess who got left holding the bag? That’s right, the employees, who were essentially victims of a bait and switch.  Now, suddenly, people with employer-sponsored health insurance have more to worry about than fighting managed care and/or maintaining the right to choose doctors

This shift in sentiment also helps explain why Medicare for All is so popular an idea. Yes, seamless universal coverage is attractive, but getting rid of deductible, co-pays, and even (in the more generous proposals) premiums could be an even bigger deal. It’s enough to make proponents of “skin in the game” nervous:

Even former Utah Gov. Mike Leavitt, a Republican who supported the move to higher deductibles as Health and Human Services secretary in the George W. Bush administration, acknowledged that adjustments may be needed, even if returning to the days of no-deductible coverage is not the solution.

“There needs to be a way to relieve the pressure,” Leavitt said. “Otherwise, people will feel like they have no insurance at all.”

Exactly.