Some place back in the 1980s I read an interesting article regarding the cost of health insurance and the impact it had on wages for those employees that enjoyed employer sponsored health insurance. Accoring to that article, wages would be 85 percent higher if industrial employers were not forced, by the evil unions, to provide health insurance.
As a result of that article I started tracking our family’s annual health care costs and continued to do so for a 10 years period. We were an average middle labor class family at that time – two adults in basically good health, and four children prone to the usual broken bones, sprains, viruses, dental and vision needs, etc. During that ten year period my husband’s employer paid an average of $2,500 per year per employee to provide health, dental and vision insurance. My husband’s portion of that coverage was about $1,100 per year at the very most.
Now take at look at the rest of the equation. For nine of those ten years our household’s total medical, dental, and vision costs never exceeded $1,900 and for most of those ten years our “out of pocket, excluded and deductible” costs were $1,500 or more. The only exception was the year when one of our sons was involved in a very serious car accident.
Now, let me tell you how that went …
The ambulance and a separate rescue unit arrived at the scene, evaluated my son’s injuries and determined there was high risk of serious internal injuries due to the nature of the accident and his initial vital signs. He was, immediately transported to the nearest hospital. He was again evaluated and the medical staff there determined that his injuries were too severe to be treated locally. He was again transported, by ambulance with a nurse on board to the nearest trauma center.
At the trauma center a specialist determined that my son had several broken bones that would normally require surgery to implant a steel rod and/or pins to secure the bones. However, do to the presence of possible internal injuries the specialist decided to take a non-surgical approach to the broken bones. The specialist believed that with traction and movement restrictions, my sons broken bones would mend themselves without the invasive surgical procedures.
For the next 24 hours my son was in an intensive care unit. Then, confident that the unstable vital signs were the result of pain and emotional trauma, rather than internal injury, my son was moved into a regular room. Within a matter of days x-rays showed that the non-traditional, non-invasive approach to treating my sons broken bones was working. He was young, and his body was healing itself without extreme or invasive practices.
But, five days later the specialist called to advise us that our insurance company would not authorize addition days in the hospital. And the doctor would not authorize our son’s release.
Many telephone calls later we (the specialist, the insurance company, and my husband and I) came to an agreement. The doctor would sign a release if we provided a hospital environment here at home including special medical transport, a hospital bed and a ton of other equipment, plus 24/7 care.
Our health insurance company did not cover one dime of those expenses! In fact, we ended up paying for the ambulance transport from our local hospital to the regional trauma center. (Our insurance covered only one ambulance transport per incident).
That year our total health care costs exceeded $6,000, but the portion covered by insurance was about $3,000. So, even with that incident, the insurance company made a real profit year after year with our family.
And, it is the profit factor that causes me to oppose employer sponsored insurance. Health insurance is NOT health care. Usually, health insurance is nothing more than a third party payer system. And if it is an employer sponsored program, it is definitely a FOR PROFIT THIRD PARTY PAYER SYSTEM.
The monster here is not the employer or the employee or the labor union that bargains on behalf of the employee. It is a for profit industry that has played on the employer/employee vulnerabilities.
We all fear the major health care incident that breaks the personal bank and sends us into bankruptcy. But, employer sponsored health insurance will not provide protection.
The employer that provided my husband and I with moderately decent, relatively affordable health care insurance for most of our married life closed all of it’s Wisconsin plants in 2002/2003. The two hundred jobs lost at that time were among more than 27,000 industrial jobs to leave Wisconsin in search of lower personnel costs, usually outside of the United States.
It took my husband 18 months to find a new job. His new jobs pays 30 percent less per hour than his former job and my husband’s share of the employer sponsored health insurance has gone from $45 per month to $267 per month. And the deductible portion has increase from $250 to $2,000.
With that kind of deductible, we can’t afford to see our doctor except in extreme situations. I used to have annual exams, but I don’t anymore because the $25 co-pay for an office visit after paying our weekly share of insurance premiums is no longer affordable, not with our now much lower household income.
The answer to our nation’s health care woes does NOT lie in employer sponsored health insurance. Employer sponsored health insurance will only give the for profit insurance industry more power and more control over decisions that should be made between a doctor and a patient.