Free Market Health Insurance Not Working

Our national health insurance discussion correctly focuses on documenting the industry's failures with sick people. Yet even the lucky people with good health have great difficulty with purchasing private health insurance. Our family is the classic case of health insurance not working. We have had a perfectly healthy family, and yet we still can only afford to take high deductible insurance, basically only catastophic insurance. We pay $7434 this year in premiums. We could end up paying $16434, before we see even one 80% payment from the insurance company.

So what would happen if we actually needed the insurance? How much would we pay then, and would our insurance company just drop us? The McCain $5000-for-health-care-insurance plan was totally out of touch with what really is available privately.

My family has two adults (early 50s) and one teenager, all blessed with good health. We have to buy private health insurance, and got a major medical policy. Our annual claim is the office visit for my mammogram and Pap smear. Our premiums have tripled in nine years, because the rates increased an average of 11% each year, in addition to the higher rates as we got older. This year's premium is $7434 with a $3000 deductible, up from a $2000 deductible.

I realize that this is nothing to complain about, compared to anyone who has a larger family size, a lower deductible, or special health issues. I also know that health risks increase at ages 50, 55, 60, and 65+, and insurance premiums have to increase as well. We get frustrated knowing that we have to pay at least $10434 this year (up to $16434 if we each get sick or injured) before our insurance company will make a payment for us. (And that is not guaranteed.) $10434 is a lot of money to spend, and not get a return on the investment. Think of all the things we could buy with that. Think of the vacations we could take.

Right now, it would be a stretch for our family to pay that $7434 in taxes if we had a national health care premium (or whatever you want to call it), but we'd try, if my annual mammogram and Pap smear were included in our coverage. Anything is better than the nothing we currently get. We'd also appreciate a few routine preventive medical procedures, nothing fancy or expensive.

We pay good money for our insurance company to print and mail documents, and increase our premiums. None of those directly improve or maintain our family's health. We also pay for the promise of our insurance company paying our claims, up until our next premium is due. If we're lucky, by the time we're eligible for Medicare, we'll probably have paid close to $200,000 for private health insurance, and never be reimbursed for a claim. If we miss a premium payment, we'll lose our coverage and all our premiums. One option is to go without health insurance, save the premium money and invest it, to pay for later medical costs. That seemed like a good idea until two months ago.

I have no patience with people who claim that our health insurance crisis can be solved by making sure everyone owns a private insurance policy. That is plainly not working.

The important questions are:

What will these private policies do to maintain and improve people's actual health, and prevent illness?

What kind of private insurance policies are available, and who is eligible for them?

What do they actually pay for?

What do the premiums currently cost, and what is the expected annual increase?

If insurance companies don't do anything to maintain or improve the actual health of real people, then the insurance companies and their private policies are one cause of our national crisis.