Today's Beef

I am fortunate that Hank allows me to post here without censorship. After today, that may change.

There is plenty that is wrong with the health care delivery system, and the risk management side, but all in all it works better than it should and much better than socialized systems in our country and others as well. Most of the complaints about health insurance can be summed up in the immortal words of Pogo.

We have met the enemy and he is us.

We, as consumers, are truly our own worse enemy. We fail to understand the dynamics of health care and health insurance pricing and then complain when we can’t get what we want. We make demands on health insurance that would, in other situations, be considered foolish and then complain that the price is too high.

When it comes to health insurance, consumers want doctor visit insurance, prescription drug insurance, and yearly physical exam insurance. We have been conditioned to believe a doctor visit really only costs $20 and medicine is $30. We also want our annual exams covered under a copay, even though females are the only ones in the family who go regularly.

We believe nothing bad will ever happen to us, but if it does we have comfort in knowing we only have to satisfy a $500 deductible.

All of this luxury comes at a price. A price few can afford and even those who can afford it are unwilling to make the sacrifice. A family of four in Atlanta will pay about $1000 per month for the plan described above. For many, that is a house payment.

That is $1000 per month for a plan that will rarely be used, even for minor ailments and will still cost you around $3,000 in out of pocket expenses on a major claim.

That is $12,000 per year in premiums plus incidentals in a “good” year; over $15,000 in a bad year.

Contrast that with a catastrophic plan that will discount your doctor visits by 40 – 50%, discount your prescription meds by around 30% and limit your out of pocket in a calendar year to $5,000 if you have a really bad year from a health standpoint. The premium for this plan is about $250 per month, or $3,000 per year. In a “good” year you save almost $9,000 and in a bad year you still save about $7,000.

Now will someone please explain why most people would rather have the $12,000 plan over the $3,000 plan?