Employer health plans now cost a gigantic $20,576 a year for family coverage, according to the Kaiser Family Foundation. Technically the employer pays most of it, but labor costs are labor costs. The more spent on benefits, the less on wages.
That’s $20,000 out of a worker’s pocket. Money that could have bought a small car or upgraded a kitchen. It’s a big problem. A staggering 156 million people — half the nation — get covered through workplace plans, compared with 11 million enrolled in ObamaCare.
This huge insurance cost is a key issue in the United Auto Workers strike against General Motors.
From an employee’s point of view, giving up $20,000 or more in wages for health coverage is bad enough. Worse, few workers and their families actually use that much health care in a year.
A tiny 5% of the population consumes 50% of the health care. Charging everyone the same is a rip-off for the healthy.
Here’s another raw deal. The No. 1 reason health costs are soaring is obesity and the diseases it causes. When overweight people need huge amounts of health care, their extra costs are shifted to you.
The reality is that health spending is soaring all across the developed world, even in countries with socialized medicine. Please take note, Sen. Liz Warren and other proponents of Medicare for All. The causes of these skyrocketing health bills are the same everywhere, according to the Journal of the American Medical Association: obesity, diseases related to it and aging. Nothing will tame costs that doesn’t address these issues.
The disease that’s busting the health care piggy bank in America is type 2 diabetes.
Diabetes costs shot up from $21 billion to $90 billion in the last 20 years. Heart disease still costs more, but diabetes will soon overtake it. Unless Americans change their behavior.
Meanwhile, generally healthy people who take care of themselves are getting overcharged to pay for coworkers or their family members with high health costs.
The way to correct this injustice without abandoning the obese and chronically ill is called reinsurance. The government reimburses insurers or employers for the highest-cost patients.
Reinsurance is already driving down ObamaCare premiums. ObamaCare became unaffordable mostly because the law forced all consumers to pay the same, regardless of their health. For the healthy, it’s sheer extortion.
The Trump administration stepped in to help states fix that unfairness and reduce ObamaCare premiums using reinsurance. Seven states — Alaska, Maryland, Maine, Minnesota, New Jersey, Oregon and Wisconsin — have lowered premiums by 20% the first year, on average, according to Avalere consultants. So much for the crazy claims that Trump is sabotaging ObamaCare.
People with pre-existing conditions are still covered, but their costs are not borne by premium payers. Four more states are launching reinsurance now. It is being embraced in states led by Democrats as well as Republicans. And it works.
Paying directly for high-cost patients is smarter than subsidizing the healthy majority to overpay for insurance. The same reinsurance model can be used nationwide to rescue workers from the exploding cost of on-the-job coverage.
Premiums will come down, resulting in more take-home-pay and fairness.
Reinsurance costs money. But it can be funded by capping the deductibility of employer coverage. Workers will still come out ahead because reinsurance will lower their premiums.
That’s the legislative fix. In the long run, Americans need to take better care of themselves.
On Thursday in Florida, President Trump will discuss his health-care agenda. Americans need to see him solving their problems, not allowing the Democrats’ impeachment obsession to drive the agenda. Trump will critique the Democrats’ Medicare for All scheme. But he can also stress what works — and point to his success in lowering ObamaCare premiums and making health insurance fairer.
It’s a roadmap for the future.
Betsy McCaughey is a former lieutenant governor of New York.