Most Americans get their health insurance through their jobs, and that coverage continues to increase in cost with the average annual premiums in 2021 exceeding $22,200 for families and $7,700 for individuals — a 4% rise from 2020.
The price increases affecting 155 million non-elderly people with employer-provided coverage, as detailed in the annual Kaiser Family Foundation surve, may seem modest, year over year, especially given that conventional wisdom saw all health care costs hit hard by the coronavirus pandemic.
But the foundation notes that overall health coverage costs, borne by employers and their workers, have not spiked due to the coronavirus, though they have risen relentlessly over a decade (see figure, above).
And while it is true that workers pay only a percentage of the total cost of their insurance ($6,000, for example, of the $22,200 for a family plan with companies picking up the other $16,600), employers have shoved an increasing share on employees.
Companies have presented them with the conundrum of lower premiums and monthly payments, provided they take on higher deductibles — out of pocket costs that must be paid before their insurance kicks in. The foundation found that the deductibles on average stayed high and static: $1,669 for single coverage.
The problem: Half of the adults surveyed by the Federal Reserve reported in late 2020 that they would face difficulty paying a $400 emergency expense, with 1 in 5 saying they could not afford that sum at all.
Experts have reported that increasing numbers of families and individuals, even if they have employer health coverage, postpone, or forego medical services and imperil their health because they cannot afford their care. Families also see their finances savaged by, say, a child’s costly trip to the ER for a child’s arm broken in a fall from a slide or a teen’s concussion caused in an athletic contest.
Craig Garthwaite, a health economist at Northwestern University’s Kellogg School of Management, described to the Washington Post the shift-and-shaft of the U.S. health care system and its reliance on employers providing health care, saying of this benefit:
“I think we lose the fact that this [expense] is coming out of the pockets of Americans. It’s not some largesse from your employer.”
When companies see the expense of health coverage soar, they budget and scrimp accordingly — not only cost-sharing with their workers but also slashing in other areas, including pay, to compensate, experts say.
The Washington Post news article carried two other, pertinent, and powerful expert quotes on employer health coverage and the Kaiser foundation information:
- “I think that this data still shows you that over the long term, the system is unsustainable,” said James Gelfand, an executive vice president of the ERISA Industry Committee, which represents large employers.
- “The biggest No. 1 driver is provider prices, hospital prices, drug prices, the prices of ambulatory services,” said Sabrina Corlette, a co-director at Georgetown University’s Center on Health Insurance Reforms. “We just have what is essentially market dysfunction.”
In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent health care. This has become an ordeal due to the cost, complexity, and uncertainty of treatments and prescription medications, too many of which turn out to be dangerous drugs.
Health insurance is a necessity for people to protect not only their well-being but also to protect their financial health. Coverage allows patients — all of us who are one devastating illness or injury from calamity — to share bankrupting costs and risks in a welcome and collective altruism.
Alas, the national political conversation has been dominated by a religious fervor by partisans (yes, the Republicans) who deny any federal role in the U.S. health care system. They cannot embrace the common sense idea that, in the wealthiest nation in the world, health care should be a privilege but a right, with a bulwark in safe, affordable, and accessible health coverage.
The Kaiser Foundation reported that employers mostly played it safe with health insurance funding and programs, albeit with small cost increases. More workers got slight increases in their access to mental health services during the hugely stressful coronavirus pandemic times. Companies allowed for more remote care, aka telehealth.
But we have a lot of work to do to bolster Americans’ health insurance, not only through the Affordable Care Act but also in figuring how to significantly improve employer coverage, too.