If businesses and politicians think the 45 million uninsured are not their problem, they are wrong. Really wrong. The uninsured get health care, they just don’t pay for it – taxpayers, employers, and those of us with health insurance do. And they get a lot of care – around $100 billion worth.
Out of that $100 billion, three-quarters is covered by cost-shifting to those patients with insurance, and one-quarter is self-paid. And because upwards of 30% of the uninsured who are admitted to hospitals are there for avoidable conditions and 18,000 die prematurely each year, the economic costs in terms of excess care and forgone productivity are immense.
There are overt taxes and hidden taxes – and the uninsured represent a $100 billion hidden tax, borne by employers who offer health insurance, employees who pay part of their premiums, and taxpayers.
The next time someone says we can’t afford to cover the uninsured, tell them we already are, and we are paying way more than we would if they had insurance.
What does this mean for you?
Higher taxes and premiums due to lack of political will.

Yes, there are ways for employers to keep health care inflation under control. And yes, some insurers are better positioned to help manage expense over the long term. Some employers have been able to hold health care cost increases under 3% for two years or more. That is an amazing result, especially in a period where many employers have seen double-digit premium jumps. How do they do it? Do they fire sick employees? Only hire Olympic athletes? Are they the early adopters of consumer-directed health plans (CDHPs)?
No no and no. Rather, these employers are not the ones relying largely on CDHPs, engaging in significant cost-shifting to employees, slashing benefits or limiting eligibility. According to one of the sponsors of a study on high-performing employee health plans:
“merely increasing employee accountability or sharing costs with employees does not reduce overall cost increases. In fact, the degree to which organizations have adopted programs that share more costs and financial risks with employees was found to be almost completely unrelated to performance.
“Employers should not focus on employee accountability alone,” said (Helen) Darling. “When used in combination with promoting quality care, health management, use of data and appropriate use of care, companies are able to achieve significantly lower cost trends.”
Of all the health plans, managed care firms, and insurers out there, Aetna looks to be the best positioned to provide employers with the tools they need to identify the right docs, pay them fairly (although this is, at best, a work in progress), and educate consumers about appropriate health benefit, and health care, decisions.

Continue reading How companies reduce health care inflation

Alcoa, one of the nation’s leading industrial companies and a giant in the aluminum sector, is entering union negotiations that look to feature, you guessed it, health care costs as the key issue. The company is now paying the entire health care bill for hourly workers, a practice that is fast going the way of the dinosaur.
No surprises so far – old industrial firm overpays thru rich benefits, now struggling, asks for givebacks…
What’s different about this story is the union leader is asking Alcoa to work with the union to push for national health care, noting that all the other countries in which Alcoa operates have some form of national system.
Labor is starting to get it.

Kate Steadman at HealthyPolicy highlights the recent news that Wendy’s has terminated its traditional health plans, adopted an HSA-only program, and seen its health care costs increase.
There are also several insightful comments following the post.