How much your family’s health care costs in 2020: $23,842

Sooner or later health care reform will have to something to address out-of-control costs? Right? Right?

The rapid rise in health insurance premiums has severely strained U.S. families and employers in recent years. This analysis of federal data finds that if premiums for employer-sponsored insurance grow in each state at the projected national rate of increase, then the average premium for family coverage would rise from $12,298 (the 2008 average) to $23,842 by 2020—a 94 percent increase. (The Commonwealth Fund)

1,000,000 health reform articles later…

About 1,000,000 health care/insurance reform articles ago, someone wrote that President Obama should be “selling” reform with a “because of explosive cost growth, if you want to keep your current insurance, we need reform” not a “with reform you will be able to keep your current insurance” tactic. (I searched to no avail, the keywords “Obama” and “health reform” return just a few possibilities, if you have a link to the article leave it in the comments)

Opinions on all of this are numerous.  It’s overwhelming.  (I even considered going on a health reform posting strike simply because its domination of my daily life has put me over capacity.  But then I realized that would be a complete cop out and akin to leaving a Rolling Stones concert before they play Satisfaction or leaving a July 4th celebration in Washington DC at 4:30 in the afternoon or walking out on Game 7 of the World Series after the sixth inning of a tight ballgame…just can’t do it.  So instead I continue my efforts to ingest, comprehend, and explain this crazy system and its intended fixes.  But maybe a posting strike would work if we could gain critical mass?  Let me know…)

Back to the topic at hand.  The mesmerizing costs of health care.  In an Atlantic article by David Goldhill currently making the internet rounds he puts the lifetime costs of insuring your family into perspective:

Let’s say you’re a 22-year-old single employee at my company today, starting out at a $30,000 annual salary. Let’s assume you’ll get married in six years, support two children for 20 years, retire at 65, and die at 80. Now let’s make a crazy assumption: insurance premiums, Medicare taxes and premiums, and out-of-pocket costs will grow no faster than your earnings—say, 3 percent a year. By the end of your working days, your annual salary will be up to $107,000. And over your lifetime, you and your employer together will have paid $1.77 million for your family’s health care. $1.77 million! And that’s only after assuming the taming of costs! In recent years, health-care costs have actually grown 2 to 3 percent faster than the economy. If that continues, your 22-year-old self is looking at an additional $2 million or so in expenses over your lifetime—roughly $4 million in total.


Rational arguments are probably the worst to use because this issue is a very emotional one.  But if there’s anything that could snap emotional folks out of their daze, it’s dollar bills.  Anyway, read the article.  It’s a bit of an investment of time but it succinctly lays out the issues we’re facing in a way that’s escaped most of the millions of articles written on the topic thus far.

Models of success

So simple. Hoping there’s more:

Yet in studying communities all over America, not just a few unusual corners, we have found evidence that more effective, lower-cost care is possible.

To find models of success, we searched among our country’s 306 Hospital Referral Regions, as defined by the Dartmouth Atlas of Health Care, for “positive outliers.” Our criteria were simple: find regions with per capita Medicare costs that are low or markedly declining in rank and where federal measures of quality are above average. In the end, 74 regions passed our test.

Updated: Back-of-the-napkining health care

Dan Roam and Tony Jones recently got together to visualize health care reform.  It’s good and easy to understand.  That’s Dan’s default—he’s the author of “The Back of the Napkin.”


Part one: Health care in America is a business (that it is, with the patient increasingly mattering less…aside from $$ brought to the system)

Part two: It’s not health care reform—it’s insurance reform (and that’s a big problem, paying attention primarily to the insurance side does little to rectify our growing problem)

Part three: What proposals are actually on the table?

Part four: Impacts and conclusions

Winning…or losing?

Gosh, there’s a special place in my heart for civil, constructive, advance-the-discussion discourse. David Frum:

What would it mean to “win” the healthcare fight?

For some, the answer is obvious: beat back the president’s proposals, defeat the House bill, stand back and wait for 1994 to repeat itself.

The problem is that if we do that… we’ll still have the present healthcare system. Meaning that we’ll have (1) flat-lining wages, (2) exploding Medicaid and Medicare costs and thus immense pressure for future tax increases, (3) small businesses and self-employed individuals priced out of the insurance market, and (4) a lot of uninsured or underinsured people imposing costs on hospitals and local governments.

We’ll have entrenched and perpetuated some of the most irrational features of a hugely costly and under-performing system, at the expense of entrepreneurs and risk-takers, exactly the people the Republican party exists to champion.

Stop your screaming…

This is embarrassing.  Whatever your allegiances and opinions politically, this is no way to go about a debate.  Screams and chants and physicality in a public forum is irresponsible. This lack of civility is doing nothing for our need to have constructive discussion surrounding the issue.  There’s a real chance that a health care bill will get through Congress no matter how loud some people scream.  And when people start screaming, it’s difficult and uncomfortable for others to listen.  So if there is an actual point to your impassioned tantrum the people who need to hear it (the fence sitters), won’t (aren’t).

If you don’t think that the current reform proposal will solve these problems, then fine.  I’m not convinced myself.  But can we at least go about this in a constructive manner?  Please?

(Maybe I should reassess my naiveté…)

The snail’s route

Well isn’t this just flipped convention, Daniel Gross at Slate writes, “Simply by doing nothing, we’re slowly nationalizing health care.”

The system of employer-provided health care coverage is crumbling before our eyes, and for more Americans—and for more American insurance companies—government-funded health care is all that separates them from financial disaster. A Gallup poll found that the percentage of Americans who say they get their health insurance from an employer has fallen from 58.9 percent in January 2008 to 56.5 percent in May 2009, while the percentage who get it from the government (Medicare, Medicaid, VA benefits) has jumped from 26.5 percent to 29 percent. (The rest purchase it on their own.) But this poll understates the case. About 17 percent of payroll jobs today are government jobs. Crunch the numbers, and it’s more like 39 percent getting insurance from government sources (public programs and public-sector jobs) and about 47 percent from private-sector jobs.