Health care & the blame game...

I read an interesting article this morning in the Times, discussing who is to blame for the rising costs of health care. The article hit home for me, because it discusses how hard small companies are getting hit with the costs.

I've worked at a small company for nearly 12 years. We've had between 8 & 15 employees during my tenure, and we're sitting at the low of 8 right now. Our costs for health insurance have gone up around 30% a year since I've started. I remember when I was hired, we basically had full coverage - $5 co-pays on prescriptions, and an incredibly low deductible ... it would be considered a "Cadillac" plan today. Every year, we've had to offset the rising cost by dropping benefits and increasing what we contribute. This year, we changed from an HMO plan to an HSA plan, which is terrifying to me.

In case you don't know, the HSA plan is a "Health Savings Account". We have no co-pays, and a $6000 deductible - after which we only have to pay 20% of costs. The only benefit is that we get to put up to $6000 a year into a savings account pre-tax to pay for health care costs, which is great if you can afford to contribute $115 a *week* towards your health care. It really makes me think back to the health care debates these past few years - where that sleazy schmuck Alan Grayson was railing on the Republicans for their health care plan: don't get sick - and if you get sick, die quickly. That's basically what our health care plan is now: the "Don't Get Sick" plan. My budget is tight enough as it is - and I can't really afford to be dropping way over 10% of my income on a kidney stone.

I like my job - as much as a job can be liked. I really like where I work, I like my co-workers and I've rarely thought about leaving, until now. This new health plan makes me think hard about where I am and where I'm going. If I knew that I could get another job with similar pay that just had a decent health program, I'd be re-building my resume instead of bitching to Blogger. Yeah, it's *that* scary for a single-income family of 4. Risking bankruptcy on a hard six is a tough bet to take for a man who doesn't gamble because there isn't a lucky bone in his body.

I'm not planning on packing up and leaving because there's no guarantee that I could even get another job, let alone another job that has a real insurance program. If I set aside my health worries, I'm still very happy where I'm at. But what really irks me is when my bosses call our new health program the Obama plan (yes - I have multiple boss at a company with only 8 employees). They blame "Obamacare" for this year's 30% increase in costs, citing the law's individual mandate and pre-existing conditions clauses - ignoring the fact that 30% a year increases has been the trend at least since I've been in the job market. It's also an interesting leap of logic to say that adding a few hundred million new paying customers is a bad thing to the insurance industry, even if a small percentage of them have some pre-existing conditions. The insurance industry runs on statistics, and the health market just got a few more decimal points.

In case you haven't guessed, my bosses are Republicans. I should forward this Times article to them, because it quotes experts in the health insurance industry saying that *maybe* 1-2% of the rate increase is due to Obama's Health Care Reform bill. And that those few percentage points are mostly attributable to "free coverage of preventive services". The vast majority of this year's increase is due to the same old shit that's been going on this past decade. Not that it would make a difference if they read the article anyhow - it'd be easier to pick up and move Mt. Everest than to change a Republican's mind with piddly little facts.

But wait - it gets better. I've done my fair share of research on the HSA/HDHP plan, and it turns out that our piece-of-shit plan is actually the Bush plan. Bush signed the law making HSAs available back in 2003, and it's been gaining popularity with employers ever since. It's easy to see why the "Don't Get Sick" plan is so popular with employers: it's the cheapest thing to offer, and still be able to claim a Health Plan on their benefits package. The Democrats railed on Bush in '03 about this plan, saying that it only caters to the young and healthy that don't have families, or really need health care for many years - or the super-rich who are just looking for a $6,000-a-year tax shelter. And you know what? They were right!

I have two young daughters: 4 & 5. Last year they each got pink-eye twice. With our HMO, each bout with pink-eye cost us $45: $30 co-pay to see the doctor, and $15 co-pay for the antibiotic eyedrops to cure them. Total cost under HMO for 2 kids, 2 rounds each: $180. A low car payment. It affected our budget, but we could manage. If that were to happen this year without co-pays? $150 is a low estimate for a pediatrician visit. $50 for antibiotic eyedrops. $200 per case X 2 children X 2 cases = $800. That's a house payment. If pink-eye revisits our house this year, we're screwed. And that's just pink-eye!! So to my loving daughters: DON'T GET SICK!!! Unfortunately, with both of my girls in school this year, telling them to not get sick is about as realistic as telling them to not want candy, or stop liking cartoons. It just ain't gonna happen.

It's even worse for one of my co-workers, who is an insulin-dependent diabetic. The poor guy needs $500 worth of medicine every month just to keep his heart beating. It wasn't so bad with a $30 co-pay at the pharmacy, but a jump to $500 a month is going to do a number to his bank account. His health care costs just jumped 1000%+!!! His only saving grace is that both he and his wife work full time, and they've only got a shared-custody teenager to worry about. If I had his health situation with my home situation, I'd be in full-blown panic mode right about now.