Whining About Health Insurance
When I made the transition in 1999 from employee to entrepreneur, one of the company sponsored benefits that I left behind was health insurance. It was necessary to replace my family’s health insurance coverage with a private policy.
We first opted for a fairly traditional health plan from a major provider (let’s call them “A”). After several years of double-digit rate increases, we switched to a high deductible policy from a different provider (“B”) and coupled this with a health savings account (HSA) option. The HSA is a tax-deferred savings account that can be used to pay medical expenses not covered by insurance, such as the deductible, vision checks, dentist, orthodontics, etc. This high deductible policy essentially provides coverage for the big ticket items: surgery, hospitalization, etc. This kind of medical coverage is more compatible with my medical care philosophy: the consumer is responsible for the small things and the insurance provides coverage for the big things.
However, while I am philosophically happy with my coverage, it is not without problems. One glaring issue is that rate at which the premiums have increased. We just started our fourth year with company B, and the premiums for coverage have nearly doubled in those 3 years.
Year Provider Rate Increase 1999 “A” n/a 2000 “A” ?? 2001 “A” 20% 2002 “A” 35% 2003 “B” n/a 2004 “B” 22% 2005 “B” 19% 2006 “B” 30%
Another problem with private coverage is pre-existing conditions. We have some broad categories of health coverage that just aren’t covered at all due to a pre-existing treatment in that category. As an example (and I’m making this up but it’s similar to a real situation): “You have had a kidney stone and are taking medication to prevent the formation of kidney stones. We will not cover any future kidney stone treatment or other health issues related to the kidney.” Losing coverage in a broad category due to a very specific condition is particularly frustrating.
An additional frustration is that every visit to the doctor makes it more difficult to switch health insurance providers due to the pre-existing condition clauses. Switching to a more price competitive provider could result in less coverage due to the pre-existing conditions.
It’s like being caught in a clever trap: “This customer cannot jump to one of our competitors without losing coverage; thus, we don’t need to be as competitive.” Now, I’m not suggesting that such decisions are made on a customer-by-customer basis. However, I wouldn’t be surprised to learn that one rational for increasing premiums for current customers is that many just can’t afford to change providers due to pre-existing conditions.
There are some alternatives to health insurance. For instance, two Christian alternatives are Medi-Share and Samaritan Ministries. These are not insurance companies. Instead, they are organized ways for Christians to help pay for the qualified medical needs of other Christians, knowing that other Christians will help pay your needs when they occur. It is a non-guaranteed method of risk-sharing.
It’s common for Christian risk-sharing organizations (ministries?) to quote Galatians 6:2 as a guiding principle.
Carry each other’s burdens, and in this way you will fulfill the law of Christ.
(Galatians 6:2 NIV)
Like the HSA, I like the philisophy of these alternatives. I like the concept of people being responsible for their health care, and Christians working together to help with the larger expenses that sometimes come along. A healthy lifestyle is encouraged, and members are to be under the teaching and care of a local church.
Unfortunately, a little investigation into these ministries reveals that pre-existing conditions are again a problem. While the concept of burden-sharing is biblical, the realities of life (that is, money) results in this principle:
Carry each other’s (future) burdens (and not those that they are already carrying), and in this way you will (partially) fulfill (a part of) the law of Christ.
(Galatians 6:2 RLV [*])
Again, I understand why this is necessary. However, doesn’t it seem just a little inconsistent?
I’m not sure what the solution to any of this is, but I hope it involves both personal responsibility and compassion. Let me know if you have any thoughts.
[*] RLV = Real Life Version
