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Why Are Healthcare Costs So High?

If you are like most Americans, you are probably happy that you have health insurance. Whether you get it through your employer, the government or one of the Obamacare health insurance exchanges, it is a great comfort to know that a large portion of your medical expenses will be covered by your health plan.

The problem is that how much is covered by your insurance may not be as much as you think. In a time when health care costs are rising at a spectacular rate every year, companies and insurers are desperately looking to pare away costs. Unfortunately, this often leaves policyholders with a larger portion of expenses.

How Your Employer Is Shirking Their Responsibility

A Broken Health Care System

In order to understand why your health care responsibilities are climbing so rapidly, you need to understand how the U.S. health care system works. Health care in the U.S. is a very flawed system despite being the largest in the world. In 2016, the U.S. spent $3.3 trillion on health care, or almost 17.9 percent of the entire national economic output. That equates to more than $10,300 per American.

Despite the enormous expenditure on health care, the U.S. ranks at or near the bottom among Western nations in terms of health care quality. Not only do Americans get poor medical care, but they get this care at overpriced rates. One study by the Commonwealth Fund placed the U.S. last among 11 wealthy nations in terms of care quality and performance per unit spent.

One of the primary reasons why quality is declining is that there is a limited supply of it. There are a number of bottlenecks in the medical education system that are limiting the number of physicians. Although medical schools have enlarged the number of students—this grew 27 percent from 2002 to 2016—but the number of training residency spots has remained static. This cap on residency spots is due to a limited amount of federal funding; this $10 billion federal funding limit has been in place for more than two decades.

The Association of American Medical Colleges predicts that there will be a shortage of 40,800 to 105,000 doctors in the U.S. by 2030. This means that more people—primarily older and sicker Americans—will demand more care from a dwindling number of providers. As the number of medical professionals shrink, the remaining doctors, physician assistants and nurse practitioners must take on a heavier caseload, often providing less quality care as a result.

Rising Health Care Costs

Rising Health Care Costs

It is as simple as supply and demand. There is a limited supply of health care in the U.S., and there is a growing population of consumers. Not only is the Baby Boomer generation entering retirement, a period when they will require more medical care, but the government is subsidizing more consumers through Medicare, Medicaid and Obamacare. This growing demand is adding a premium to health care prices, allowing medical providers to continuously raise prices without any pushback from the market.

In addition to the fact that there are more health care consumers, these consumers also require more care. Almost half of all Americans suffer from a chronic health condition like diabetes or heart disease. Almost 85 percent of all health care expenses are related to the treatment of these long-term health issues. Most of these chronic conditions are difficult to treat and are quite expensive.

How Your Employer Is Shirking Their Responsibility

In general, health care costs are rising at an alarming rate every year due to a number of systemic issues, but the amount you are paying may also be related to actions taken by your employer. In the past, most employers shouldered a larger portion of health expenses by subsidizing the premiums of their employee health plans. However, in recent years, more employers have opted for high-deductible health plans (HDHP) that have lower premiums but put more of a financial burden on employees.
A high-deductible health plan is considered any plan with an annual deductible of $1,300 for single policyholder or $2,600 for a family. This dollar amount is the total amount you must pay in the calendar year before your insurer will start making payouts. As the premium lowers, inevitably, the annual deductible rises.

For many people with serious or long-term health issues, a HDHP provides only limited financial protection. Following 2014, there has been a 50 percent increase in the number of employers offering only high-deductible health plans. In 2005, only one million Americans were enrolled in high-deductible health plans, but by 2014, almost 17.4 million were enrolled in such plans. That is why almost 1 in 5 Americans has a high-deductible health plan. That is also the primary reason why the average individual annual deductible has grown from $584 in 2006 to $1,217 in 2014.

How to Keep Your Medical Expenses Low

If you have a high-deductible health plan, there are still some things you can do to lower your medical bills. First of all, sit down and analyze your current plan. Know how much you are responsible for annually, if you must make copayments or coinsurance payments, and what providers are in your insurance network. If you don’t understand the details of your policy, ask your insurer or your employer’s insurance administrator.

You may find yourself on the hook for surprise medical bills. If you don’t think you should be responsible for them, don’t be afraid to dispute them with your insurer or medical service provider. If you need help disputing a charge, you can hire a claims expert to represent you in the dispute.

If you realize you need more insurance, you may want to consider a supplemental health policy. These come in many varieties of cost and coverage, but some may cost you only a few dollars a month. Many supplemental plans can help pay for out-of-pocket fees that your primary plan doesn’t cover. To find out more about supplemental health plans in your area, please visit Boost Health Insurance.

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