Healthcare Sticker Shock. Again.

Once again work is rolling up to Open Enrollment Time, everyone’s favorite time of year.  This is the period when you find out how much your insurance has gone up.  Note that I did not say whether or not it goes up: I said how much.

We have two plans from which to choose: Evil HMO A or Evil HMO B.  We can choose between the one that went up only ten percent or the one that only went up fifteen percent.

Overall impression:  I can no longer afford to work where I do.

Then there’s the little game that they play: “But it hasn’t gone up.”

No, the premium hasn’t, but the copays went from $25 to $40.

My head is spinning around and I’m cursing more than normal.

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Yes, it’s true: I can’t afford to work at my current job.  I make more than I ever have and it’s simply not enough.  If I didn’t have to worry about healthcare expenses, I could explore that mythical realm called Savings.  Or even Pizza every now and then.  Eating out is a luxury.

REACTIONS DIFFER

The left wants the government involved.

The right wants the opposite of whatever the left wants.

The libertarians want less government, like others claim but don’t follow through.

You don’t have to read the papers or even pay attention to know the above is true.  What really shocks me is the responses I am seeing from the benefits department.

TIME FOR A DIFFERENT SCAPEGOAT

I understand that the insurers see our data before quoting rates.  I understand that where I work we tend not to hire the healthiest segment of the population.  I used to refer to this as paying because we hire crack addicts and people who visit the emergency room for primary care.

All of the sudden people are coming out of the woodwork, including Benefits, and pointing the finger straight at the Fat.

Wow.

I am starting to see claims that this contention is accurate.  It would make sense but I need to study the facts a bit more.

I never thought I’d hear that we shouldn’t hire someone because they’re fat.  [NOTE: this is discrimination and illegal in the US.] I have always stuck by hiring for competence, which seems to have fallen out of favor (don’t even get me started on minority quotas over competence).  But I have had off-the-record conversations with people who tell me we shouldn’t hire the Fat.

Wow.

The very small part of me that’s a yahoo-whooping-revolutionary wants to cheer and FIRE THE FAT but the larger part of me doesn’t like that idea.  I’m not looking for a scapegoat now: I’d rather fix the problem.

Even taking into consideration that the Fat might be responsible to some degree, they’re not the sole category.  What of the insurers?  The providers?   What about behavioral (mental) healthcare?

This is not a one-sided affair, folks.  It needs to be fixed at all levels.  I am just not sure how to do it.  Although Benefits argues with me, I know government involvement is not the way to fix anything (although I do have readers who seem to think otherwise – and I’m sure they’re very nice people).

NOW WHAT?

I wonder what we will do if we discover the Fat are a serious issue.  Is there a difference between genetically large and overfed?  What causes fat?  Before you start, not all large people are that way by choice.

This would signal a humongous change in insurance.   Again, what about behavioral healthcare?  They didn’t make themselves crazy.  What about people with congenital heart issues?

Where is the line?  IS there a line?

Is this simply discrimination under random laws?  (I’m asking – I don’t know.)

Who decides what we cover and what we don’t?

Rationing looks like it’s going to be an even bigger issue than it is now.

Should insurers be required to take risk regardless?  Could they stay in business?

Here’s my favorite: Where is all the money going?

[Remember: the key to unraveling all mysteries is Follow The Money]

I welcome your thoughtful responses.