WHY IS HEALTHCARE SO FLIPPING EXPENSIVE AND WHAT CAN WE DO ABOUT IT?

This article may include partner links. If you click, visit or buy from these links, we will receive a fee or products from the companies mentioned in this post. Please read our disclosure policy for more details.

 

 

It’s open enrollment this month across all employers in the county. And for us who have full-time employment, it’s a chance to pick and choose what healthcare programs we’ll sign up and agree to pay for in the coming year 2018.

 

If you’ve already enrolled for 2018 coverage, have you checked the pricing?

 

Am I the only one who thinks medical insurance is ridiculously expensive?

 

I used to be a contractor up until a few months ago, and I paid a total of $9,840 for 8 months, which is broken down to $1,230 a month!!!! What the???

 

I apologize but I’m just so freaked out.

 

 

And to think that I paid that much I’d get decent coverage right? WRONG! The only thing that’s covered is preventive care, once a year, for the whole family and that’s it.

 

We have to pay my $40 co-pays for doctor’s visit, and around $20 for prescription if needed; and basically pay all that and all expenses we’ll incur up to $10,000 which is my  family’s deductible part, then and only then will the insurance pay out.

 

What???!!!!

 

Take a look at this example below.

 

 

Scary huh?

 

RELATED:

 

• 4 WAYS TO ENSURE YOUR FAMILY’S PEACE OF MIND

• 4 COMMON SENSE WAYS TO BE DEBT FREE

 

So back to my rant.

 

In 2016, I paid the insurance company $14,760/year and have to pay another $10,000 to cover my deductible and then the insurance kicks in? Is this a great deal? No wonder the healthcare system is screwed up? It screws us, the payers first!!!

 

Looking back on our doctor visits the past ten months, we’ve only spent about $1,200 so far, which is far below our $10,000 deductible; and we try to be healthy as a family so we don’t have to visit doctors or hospitals for that matter.

 

Fast forward to my new employer coverage.

 

Now that I’m being covered by my employer’s health plan I get a discount and a little subsidy since they also contribute $1K in wellness credit for me and my wife.

 

To make sure I pay the minimum premiums, I decided to enroll in a high deductible plan. I now pay a total of $6,860/year, which is half  of what I used to pay as a contractor, plus the deductible is at $8,000 instead of the $10,000 I previously had.

 

 

I’m now saving a little bit, and I don’t know about you but there’s gotta be a better way?

 

This is unsustainable in my opinion and a lot of people will end up not opting to sign up for healthcare insurance in the near future and just pay the $2,085 penalty to not get covered and just stay healthy.

 

That or not work at all and just go for the free ‘socialist’ insurance coverage Obamacare is providing.

 

No wonder people are fighting for a change.

 

What’s our incentive for staying healthy and not using these services? Isn’t there a pay per use option just like what we would have with any other service? It is still a service the last time I checked.

 

The following are what I’ve dug up as viable alternatives to the chaotic and expensive healthcare system that we are currently paying into.

 

 

ALTERNATIVES

 

 

1. MEDICAL CO-OPS

 

As early as 2012, Business Insider ran an article about Healthcare Co-ops, an arrangement where a group of doctors band together and charge a monthly membership fee for access to their services.

 

Fast forward 2017, a new generation of Co-ops has sprung up, called ‘Direct Primary Care’ . Similar to a co-op in that it charges a monthly membership of about $150/month to get access to the service, see chart below for a general idea.

 

 

I love the idea of not having to be tied to fixed monthly costs as in healthcare insurance when you won’t use it monthly, I’m better off with this low membership fee and only use it when I have to.

 

I believe this is going to be the future of how healthcare services will evolve in this county and won’t be surprised with the likes of Costco and Amazon if they start putting up their own medical subsidiaries and services as part of a membership plan.

 

It’s pay per use, instead of mandated pay and out of luck if you don’t use; which is what we currently have with the Affordable Care Act (ACA).

 

 

2. HEALTH COST SHARING SERVICES

 

 

A popular alternative is ‘health care sharing’ such as CHM, Medishare or Altrua Health Share.

 

In this system, aptly called ‘cost-sharing ministries’, you join to what amounts to like a cooperative of like-minded individuals sharing medical costs of its members.

 

Members pay a contribution fee, the plan pool the member’s money, and whenever there’s a medical event, the plan pays the cost of the medical bills subject to the plan guidelines.

 

For more detailed information, head on over to this YouTube video by luvtogrow2 who details her experience and the costs of her medical event and how CHM worked to her favor.

 

In the graphic below from Altrua, it essentially sums up what these plans do.

 

3. MEDICAL TOURISM

 

 

I know this is not for everyone but more and more people are seeking services overseas for routine and even extreme procedures.

 

According to Patients Beyond Borders ‘medical tourism’ is a growing trend.

 

What are the top destinations?

 

Costa Rica, India, Israel, Malaysia, Mexico, Singapore, South Korea, Taiwan, Thailand, Turkey

Why these destinations?

 

The making of a world-class healthcare destination is complex. We consider a variety of factors, including:

• Government and private sector investment in healthcare infrastructure
• Demonstrable commitment to international accreditation, quality assurance, and transparency of outcomes
• International patient flow
• Potential for cost savings on medical procedures
• Political transparency and social stability
• Excellent tourism infrastructure
• Sustained reputation for clinical excellence
• History of healthcare innovation and achievement
• Successful adoption of best practices and state-of-the-art medical technology
• Availability of internationally-trained, experienced medical staff

What are the top specialties for medical travelers?

 

• Cosmetic surgery
• Dentistry (general, restorative, cosmetic)
• Cardiovascular (angioplasty, CABG, transplants)
• Orthopedics (joint and spine; sports medicine)
• Cancer (often high-acuity or last resort)
• Reproductive (fertility, IVF, women’s health)
• Weight loss (LAP-BAND, gastric bypass)
• Scans, tests, health screenings and second opinions.

 

One way patients make this work is to also enroll in an HSA account

What is a ‘Health Savings Account – HSA

 

A Health Savings Account (HSA) is a tax-advantaged account created for individuals who are covered under high-deductible health plans (HDHPs) to save for medical expenses that HDHPs do not cover. Contributions are made into the account by the individual or the individual’s employer and are limited to a maximum amount each year. The contributions are invested over time and can be used to pay for qualified medical expenses, which include most medical care such as dental, vision and over-the-counter drugs.  Source: Investopedia

 

 

4. SINGLE PAYER SYSTEM

 

0ne alternative making its rounds in California and in other states is the so-called ‘Single Payer System’ .

What Is Single Payer?

 

A single-payer system is a way of financing and administering health care so that equal, comprehensive, quality care is possible for everyone. A public agency organizes the financing, while delivery of care remains largely private. The public agency—the single payer—defines wide-ranging benefits, pools contributions, negotiates reasonable costs for care, and pays all medical bills.

Key features of a single-payer system include:

 

• Streamlined, not-for-profit administration
• Maximized purchasing power through negotiated prices of all services, including doctors and other health professionals, medical supplies and equipment, laboratories, hospitals, and pharmaceuticals, etc.
• Financing from individuals paying a percentage of income, employers paying a percentage of payroll, and government funding such as Medicare, Medicaid and other safety-net health care programs
• Uninterrupted comprehensive benefits for everyone, with coverage unaffected by changes in employment, marital status, age, income, or health condition
• Efficient and timely payment for services and supplies

 

Single-payer systems, with variations, exist today in Canada, Taiwan, and the U.S. (Medicare). Most successful universal health care systems that use multiple payers (e.g. France and Germany) share the key features of single-payer, that is, no profit taken on administration for basic health care, negotiated prices, and the same comprehensive benefits for all.

 

IN CONCLUSION

 

 

The current healthcare system in the US is troubled to say the least.

 

The Affordable Care Act is not living up to its expectations. In fact, a recent study done by the Kaiser Foundation state that non-elderly middle class families who do not qualify for subsidies under the Act are uninsured due to the high cost of premiums. Essentially making it seem like the ACA was only meant to cover lower income individuals and families to the detriment of the middle class.  I know this is a controversial statement but the study shows exactly that;

 

“Coverage gains from 2013 to 2016 were particularly large among groups targeted by the ACA, including adults and poor and low-income individuals. The uninsured rate among nonelderly adults, who are more likely than children to be uninsured, dropped from 20.4% in 2013 to 12.4% in 2015, a 39% decline. In addition, between 2013 and 2016, the uninsured rate declined substantially for poor and near-poor nonelderly individuals” Source: The Kaiser Foundation

 

To that end, something has to change, and soon.

 

In this day and age of technology where everyone can be connected to anyone at a click of the mouse, services like Teladoc, an online medical service provider where members can connect to a doctor within minutes, be diagnosed and dispensed a prescription; should be able to work hand in hand, in cases where hospitalization is required, with a medical network that is equally accessible and can be technically leveraged when needed.

 

There is definitely a gap, the technology is available all that’s needed is the willpower to work through the layers of the system and bring a win-win solution to the millions and future generations that will need to access the US healthcare system.

 

Do you have other alternatives that I haven’t covered? Are there options or recommendations that all of us can benefit from? Please do share by commenting below.

 

Thanks for your time and until the next post.

 

Peace and Blessings to you All.