Dealing with shrinking benefits
Most of us get our health benefits from our employers, who are struggling with ever-escalating costs
Idaho workers’ health-insurance premiums nearly doubled in six years, fewer employers are offering medical benefits, and the current trend nationwide is toward skimpier, even costlier coverage.
"We are the first ones to note that the system is broken," said Mike Tatko, spokesman for Regence BlueShield of Idaho. "We want to be part of the solution." Part of the solution gaining steam nationwide is medical "transparency," giving patients information on price, quality and treatment outcomes. The feds, backed by a growing body of research, say smart patients will shop for the best care at the best price, leading to improvements in the health care system. "Providing reliable cost and quality information empowers consumer choice," the federal Department of Health and Human Services says on its Web site. "Consumer choice creates incentives at all levels and motivates the entire system to provide better care for less money."
Idaho workers and employers alike could use the help. Workers paid an average of $1,444 out of their paychecks for employer-sponsored family coverage in 2000. That nearly doubled, to $2,726, in 2005. In 2006, the nonprofit Kaiser Family Foundation found that employees paid about $600 less out of their paychecks, but the numbers for that year were not statistically significant because of the margin of error, said Hannah Yang Moore, senior policy analyst for the foundation.
Nationwide, more middle-class families are joining the ranks of underinsured Americans, those with high deductibles or co-insurance or with limits that fail to protect them from high medical bills, the Kaiser Foundation says.
Enough is enough, says Yvette Sedlewicz of Boise, whose husband, Eugene, 79, had a knee replacement in April 2008 at St. Luke’s Boise Medical Center. The hospital bill alone came to at least $21,303. That didn’t include doctor charges. The couple was uncertain what the total bill came to, but Sedlewicz, who has a nursing background, was angry about the markups on everything from the intravenous fluid commonly given to patients after surgery to the cost of her husband’s hospital room.
The IVs cost $195, compared with less than $40 for the same solution for sale over the Internet. The operating room Eugene occupied for one hour and 45 minutes cost $4,893, or $699 for every 15 minutes he occupied it. Hospital room No. 5010, where he recovered for three days, cost $705 a day. "We could have stayed in a hotel," she said.
Sedlewicz and her husband have traveled in Europe, where everyone gets health care through some form of government funding. In Scotland, her husband broke his nose and went to a hospital emergency room for treatment. The cost for the tourists? No charge.
"I don’t care if I go to the hospital and I have to sleep in an old, iron bed," Sedlewicz said. "It doesn’t have to be the Ritz," she said. "You can still get good health care." The couple has good health insurance, but she knows other people don’t. "I don’t think the taxpayers should have to pay for an exceptionally high markup," she said. "It’s predatory, I would call it."
St. Luke’s officials couldn’t comment on Eugene Sedlewicz’ bill because of confidentiality rules, but spokesman Ken Dey said the hospital has to make enough money to meet the needs of the growing, and aging, population of the Treasure Valley.
None of that gets to the heart of the problem, said Bret Noble, health care organizer for Idaho Community Action Network. The poor don’t get fair treatment in the current health care system, he said.
"We believe the answer is national health care reform that guarantees quality health care for all," he said. Sedlewicz agrees. Taxpayers would pay higher taxes, but such a system would help employers, who now bear a large share of the burden of health insurance, Noble said.
Health care should be a right in the same way public safety is, he said. "Everybody pays for the fire department, even though your house may not burn down in your entire life," Noble said.
