The annual medical insurance cringe

You just kind of stand there like a cowed dog, don’t you?

You know that pose? I do. I assume it every fall now. I know I’m going to get swatted; I’m just not quite sure how much. It looks like nearly a 20% bump in fixed medical insurance costs for me and my family next year.

We’ve been conditioned to think “well, thank God it’s not more!” Haven’t we? Isn’t that exactly what’s happening? That it’s a fathomable increase—one I can get my brain around—is supposed to be enough. That’s a victory.

Are anyone’s insurance costs going down next year? Are anyone’s even staying the same? If so, let me hear from you.

pjboyI have a bit more research to do this year, too, which was most of what was so offensive to me about Obamacare’s Pajama Boy. If you’ll recall, the directives were:

Wear pajamas. Drink hot chocolate. Talk about getting health insurance.

Well, no. I don’t want to. Health insurance is the sort of drudgery I want to be on vacation from over the Christmas holidays. I think it’s pretty damned bent to sit around and discuss federal mandates during leisure time with family and friends, and I think it’s unnerving and sick for my government to have a marketing campaign designed to persuade me to do so.

Despite ample promises to the contrary, Obamacare has done nothing to contain costs. In fact, it’s had exactly the opposite effect. The $10 Band-Aid, the $1,500 ambulance ride, the $10,000 baby delivery—they’ve all just settled into the narrative, haven’t they? Sheesh, these things are expensive. Thank God we have insurance! Thank God the government looks out for us!

Nothing Our Betters have done in the name of “protecting” us has fostered innovation or competition, so we’ll have no cost relief anytime soon. The law implicitly asks “how can we help a person pay for a $10 Band-Aid?” when the law should be asking “why is there such a thing as a $10 Band-Aid?”

I shouldn’t have to think about medical insurance to the degree that I do. None of us should. The proper vision is insurance companies competing for us, not us feeling relieved when we don’t get screwed quite as hard as we might have.

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5 thoughts on “The annual medical insurance cringe”

  1. My insurance costs have gone up slightly every year since I’ve been a working professional (including before the ACA). Somehow, my cringe time (I do cringe when I see that email every year) is always around May, even at my former company. My current company, as one of its benefits, pays a large percentage of our premiums, so I only see a small amount of cost increase. I honestly have no idea how much my actual premiums are, and I feel somewhat guilty for being ignorant of that fact.

    My coverage hasn’t changed much overtime though. It seems like the changes I’ve experienced every year are penny pinching, and not so much whole budgetary swings. Usually things like changing which name brands are covered vs requiring generics, maybe a couple dollars change in a deductible or copay for some specific type of service.

    My biggest beef has been that with my previous employer, I had an issue where right after the May policy change/update (which the company notified its employees of after the change went into affect), we had issue getting coverage on one of my wife’s regular monthly prescriptions. I’ll cut to the chase… it was birth control. The type she uses has no generic and was explicitly listed as covered on the name brand coverage list.

    The issue was, when she’d go to the pharmacy, they’d say the insurance system reports it isn’t covered. Then I’d call BCBSA’s rather infuriating support line and they’d say “Why yes, it is covered”. The problem is, when I pick up the phone and talk to BCBSA, I talk to different people than when the pharmacies pick up the phone and call BCBSA. Went through that cycle about 3 times.

    In the process of getting it resolved, they did two “review panels.” The first came back saying it should be covered, but the system at the pharmacy still said no, so they did another panel, determined it shouldn’t be covered, but then a day later, they changed their mind again.

    Somewhere in the middle of all the back and forth, someone at BCBSA said that it wasn’t covered because of the contract between BCBSA and my company. I asked if the “contract” can contain actual coverage information that the “policy” booklet doesn’t have, which they said it can/does. So I asked them for a copy. They said they couldn’t give it to me, only my company could. So I went to my HR and asked them for a copy. They also said no, even after I explained my problem. This absolutely infuriated me. I was (as far as I knew) stuck in some sort of contractual loophole on insurance coverage I was paying for (even if I don’t pay all of the premiums (which I don’t remember how that worked at that company), the overhead the company collects from the work I do covers it), and I’m not allowed to see the terms with which I’m operating within.

    That was bullshit. I actually started a stink about it too, b/c I didn’t think that was ethical and I knew other employees were having the same problem. And I’m sorry, but when head of HR in a small business is the one supposedly being unethical, you have to complain to people who’s titles start with the word “Chief”.

    They eventually figured out that the problem was BCBSA’s pharmacy systems hadn’t synced with all of the other policy systems correctly.

    You’d think they’d be a little more willing to cover a $60 monthly medication that’s literally saving them tens of thousands in costs of us having a kid.

    There was also my more infamous story of BCBSA denying us birth control right after we got married. It was because they had my wife marked down as my husband…. And even though the pharmacist is standing there staring at my wife, in person (and if you’ve ever met my wife, there’s no doubt as to her gender), they can’t actually give her the birth control, even at full price and let us to the refund later….

    I politely called them up and the conversation went like this:

    Me: Yes, now you are Blue Cross, Blue Shield of Alabama correct?
    Polite CSR: That’s correct.
    Me: So that means you only serve customers in Alabama correct?
    Polite CSR: That’s correct.
    Me: Now, is gay marriage legal in Alabama at this time?
    Polite CSR: No sir, it is not.
    Me: So I recently added my new spouse to my plan… does anything look funny about my spouse’s info?
    Polite CSR: OHHH!
    Me: Yes, my wife would like to get her birth control please.
    Polite CSR: I’ll get that fixed right now.
    Me: Thanks you Ma’am.

    For the record, all of those shenanigans were well before the ACA was ever in place (before it was even up for a vote I’m pretty sure). Fortunately, I haven’t had any issues to deal with since the ACA, though I don’t expect that BCBSA has gotten any better or worse because of it.

    Reply
    • I had heard the story, but thank you for sharing it for BoWilliams.com readers. 🙂

      What we have to get past is that there is any inherent reason prices for medical care should rise every year. What we have to get past is being unable to fathom medical care without insurance.

      Obamacare takes not the slightest interest in addressing root causes.

      Reply
      • I agree. I would think medical care costs would naturally become cheaper in a similar manner to computer hardware. It seems like medical procedures and equipment are getting simpler and cheaper to make, treatment times are much quicker, and yet costs go up some every year.

        I don’t have an answer to how to solve that problem. I’m definitely not a business or economics pro.

        On a side note, I did find out the share of my premiums that my company covers. The numbers are considered close hold within the company, but I’ll just say I greatly appreciate my company’s generosity and I wish more companies were so giving. I think we’d all be better off in so many ways.

        Reply

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