Imagine that shopping for a new car worked like this: If you really didn't need the auto and lived two blocks from work, any dealer would sell you a car for a song. If the commute was 50 miles, much too far to walk, no one would sell you a car at any price. You wouldn't get to see a full contract until you plunked down your cash. Your monthly car payment would go up 20 to 30 percent every year, and, by the way, the steering wheel might be extra. The auto industry doesn't work like that, of course, but the market for people who buy their own health insurance does.
The article reveals Consumer Reports' findings:
- 71% of those on individual plans had overall complaints with their coverage, compared to 53% for those on an employer plan.
- 55% of those on an individual plan said their insurance covered most costs, while 81% of those covered by their employer did.
- 52% covered by an individual plan said their premium was too high, compared with 29% on employer plans.
- 45% on individual plans said they postponed needed medical care due to costs, compared to 31% covered by employers.
In Arizona, 24,000 folks are in a state-sponsored, high risk pool called Healthcare Group. These are people who pay significant monthly premiums for their health insurance, are employed, and are not eligible for health insurance through their employer. What they do get through Healthcare Group that they do not get in the private individual market is coverage for their pre-existing conditions. As is always the case with a pool of high risk (sick) people, it costs a lot to insure their health. Healthcare Group has been operating in the red, and the legislature is still determining the future of the plan, and whether the 24,000 Arizonans served by it will continue to have coverage. While the plan is administered through our Medicaid agency, AHCCCS, Healthcare Group was told by the legislature to be financially independent and for several years did not receive taxpayer money. Enrollment in Healthcare Group has now been closed and premiums have been increased, which tends to create a further "death spiral," since no new (and younger) people may join the plan, while those on it will usually get older and sicker. There is not silver bullet, but when someone says everyone should just be responsible for going and buying their own health insurance, it simply is not that easy.
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