If there’s a new year’s prediction that’s easy to make, it is that health insurance and health care prices will rise. The year 2017 was a hugely profitable one for large health insurers, and as predicted premium prices increased significantly in 2018. In 2018, health insurers again saw significant increases in quarterly profits and, you guessed it, monthly premiums increased in 2019. Annual health insurance premium increases are a trend with no end in sight because, why not. Medical care and pharmaceutical prices also rise each year in our anything goes health care system.

Meanwhile, people who have health insurance don’t want to use it because even with insurance, they may have to pay high medical bills when they receive care. Other people, especially in the individual health insurance market, are going without health insurance. After years of paying thousands of dollars each year in insurance premiums and deductibles, they have nothing else to give. Which makes me wonder: with all the frustration over ever-increasing health insurance and health care prices, will 2019 be the year the health care status quo loses its political and cultural support?

It’s On! (The Health Care Value Debate)

Maybe it's me trying to deal with the anger I feel about the 25% increase in health insurance premiums Cigna gifted me this year, but I’m starting to get a sense that 2019 won’t be business as usual for our greedy health insurance and health care industries. Or maybe it's a number of other signs I’m seeing in the health care reform policy debate:

• The new Democrat-led Congress elected to protect health care access, address health-insurance and health care costs, and explore universal health care options like Medicare-For-All or Buy-In, and Medicaid-For-All or Buy-
• The growing demand for real health care price data and all-payer claims databases by individuals and state governments, respectively
• The consistent reporting of and angry responses to outrageous medical care costs like the $629 Band-Aid, $4,000 surgical screw, and $52,000 per month prescription drug
• The study of health care value both nationally and internationally—what are we getting for the trillions we are spending, and what’s the real cost of innovation

Tags: health care , health insurance premiums

Steady, stable, slightly, slowly, low, relatively low, lower-than-usual, all words used in recent national articles to describe projected health insurance premium increases for employer-sponsored health plans. I'm sorry, but these words are way too upbeat for my me. Sure, we need to inform people that they can expect smaller health insurance premium increases than in prior years, but I can do without the cheerful tone extolling high but not as high health insurance premiums for some.

Still, you may be thinking that a slowdown in health insurance premium growth is good news or you may be thinking, what's the harm in saying things are better than usual. Where to start?

First, news of lower than usual health insurance premium increases applies mostly to large employers. Smaller employers will continue to see rate increases in or approaching double digits. Second, these "slight" rate increases are made possible by already overinflated health insurance rates. Individual premiums for some small group health plans can be as high as $700 to $1,000 per month, based on benefits covered and cost-sharing structures (e.g., deductibles, coinsurance and copays). These rates are higher than the exchange rates.

But the number one reason we should not celebrate lower than usual group health insurance premiums is that it gives a false impression that we are controlling health insurance and health care costs. That employer groups have finally figured out how to win at the health care negotiating table. That health insurance companies are more accurately predicting risks and passing on the savings to their employer groups. That workplace health insurance is a bargain and operates like a fine-tuned machine, not in need of reform. That health insurance prices are not something we need to address, at least not right now. Nothing could be further from the truth.

Steady Rates or A Red Flag

There is no reason to believe that health insurance costs are under control or are a minor issue in the whole health care reform debate. The cost of health insurance (and health care) is the debate. Health insurance prices are too high and individuals can't determine the value of their policies.

Also, if health insurance was becoming such a bargain, why don't health insurers share price and discount information with the public or employer groups? If insurers are paying providers four, five or six times the Medicare rate for medical services and receive a 50% discount on less, that's no bargain. And if insurers charge a little less to access these inflated, low discount rates, why give them a pat on the back? Continue Reading...

Tags: health insurance premiums, health insurance rate increases