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Why Is Health Insurance So Expensive?
Posted by: | CommentsThe answer to this question is complex, but in general terms the high and rising costs of health care are the result of eight key drivers:
1. Medical technology is amazing…but it’s expensive
As new health care technologies prove to be more effective, expect utilization to increase; in turn driving costs up even more. Spending on health care technology accounts for two-thirds of the growth in spending.
2. Inflation and Economics
Inflation affects all aspects of life, health care included. However, medical inflation is dramatically outpacing general inflation. Why? It is simple economics. As demand for health care services increases, so do prices. An example of this problem: in the US we currently have 350,000 primary care doctors. It is expected that we will need approximately 400,000 primary care physicians to properly care for our aging population by 2020. What will happen to the cost of these physician’s services if we don’t address the supply issue? Costs will continue to outpace general inflation.
In a normal market, given these conditions, the invisible hand would get to work and natural incentives would avail themselves to medical students (i.e. they would make more money because supply/demand equation is out of balance). In reality, there are very few incentives to become a primary care physician right now given the uncertainty of US health care system. A primary source of this uncertainty is the Patient Protection and Affordable Care Act. Combine this uncertainty with burdensome regulations, excessive administrative and compliance costs, and virtually unlimited malpractice risks associated with running a primary care practice, and it is no wonder that a doctor-shortage is imminent.
3. Cost Shifting
The government brags about its ability to control costs by pointing to statistics that show how much less services cost under their Medicare program as compared to services covered by private insurers. The fact that Medicare and other government health care programs limit reimbursements (effectively instituting price controls) does not mean that the true costs of this care just disappears. These costs are simply shifted elsewhere in the system. Now let’s follow the trail. These unreimbursed costs get shifted to private insurers. Private insurers in turn tap their primary source of capital…their clients (i.e. you!). The lesson here is this – even if the government says that they are not going to raise your taxes to pay for government health care programs; you will, in fact, be paying for these programs in the form of higher insurance premiums.
4. Compliance Costs
Did you know that health care insurers spend over $340 billion every year to comply with government regulations. Approximately half of this cost is spent covering services that government mandates be covered by insurance (regardless of whether you, as the consumer, wants this additional coverage or not). The other half is spent on regulatory and reporting requirements.
5. Our Lifestyle Decisions
Spending on chronic diseases accounts for 75% of all health care spending. One way that we can help reduce these costs is to take better care of ourselves. Obesity, tobacco use, drug abuse, poor nutrition, and physical inactivity are all risk factors that can lead to chronic diseases…and all of these are controllable! If we, as a nation, are to have any chance of controlling the out of control health care inflation, then we need to look in the mirror and start taking personal responsibility for our own health.
6. Excessive Utilization
It is estimated that one third of all procedures performed in the US have questionable benefits and/or are outright inappropriate. The lesson here – more care does not always mean better care.
7. Health Care Fraud and Abuse
Conservative estimates suggest that health care fraud and abuse accounts for over 3% of the overall cost of health care. This amounts to $68 billion per year (or $180 Million per day).
8. Prescription Drug Costs
Here are some interesting facts about prescription drug use in the US:
- The rate of inflation for prescription is 2.5 times that of the general rate of inflation.
- Some cancer drugs can cost as much as $100,000 per patient for the course of the treatment.
- 50% of all adults in the US take at least one prescription drug per day and 7% take at least five drugs per day.
- Two thirds of patients that enter a physician’s office leave with a prescription.
These eight drivers account for most of the rate of increase in health care spending. You might be thinking to yourself, “but what about all those profits reaped by the health insurance companies? That must be a key driver too!”. This is a common misconception. In reality, insurance company profits amount to just 3% of your premium investment. To learn where the rest of your premiums go, check out this article.
Health care costs and health insurance premiums are closely correlated. By understanding the key drivers behind health care inflation, we can start making better decisions personally, and as a nation, in an effort to control these costs and to, hopefully, reduce the rate of premium inflation.
For a free review of you current health insurance options, please call Sage Benefit Advisors at (970) 484-1250. We are here to serve!
Where does your health insurance dollar go?
Posted by: | CommentsVia: America’s Health Insurance Plans
Small Business Health Care Tax Credit Calculator
Posted by: | CommentsEver since the health care reform bill passed, we have been fielding tons of questions from our clients about how this bill was going to affect them. Three of the most frequent questions that we get from our small business / group health insurance clients are:
1. Does my small business qualify for the “Small Business Health Care Tax Credit”?
2. How much can I expect to get back as a result of the “Small Business Health Care Tax Credit”?
3. How do I calculate the “Small Business Health Insurance Tax Credit”?
If all you read was the news articles about this tax credit, it sounded pretty simple. In fact, I had many clients excitedly calling me saying that they heard about this 35% tax credit…and that this was just what the doctor ordered. Well, not so fast — there are about 13 steps to the calculation to determine if you qualify and, if you do, the percentage is not always a flat 35% of employer paid premiums.
So, in an effort to answer these three questions and to clear up much of the confusion surrounding the “Small Business Health Insurance Coverage Tax Credit”, we have developed this simple and easy to use Small Business Health Insurance Tax Credit Calculator. Just answer 4 simple questions (rows A-D) and then click “UPDATE”.
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Still have questions about the Small Business Health Insurance Reform Tax Credit?
Check out these additional resources:
Small Business Health Care Tax Credit: Frequently Asked Questions >>
Why Smart People Are Buying Health Savings Accounts
Posted by: | CommentsNo doubt about it, Colorado health insurance can get pretty expensive. In these difficult economic times, it’s hard to fit insurance premiums into the family budget. Which is why instead of getting traditional health insurance, more and more Colorado residents are turning to health savings accounts (HSA). The reason: instead of paying insurance companies for a service that they may not use, they create a stable asset that grows year-over-year, and acts as a standby fund for emergency medical needs when they occur. In short, health savings accounts combine health insurance and investment.
There are two parts to obtaining an HSA. The first part is a high-deductible Colorado health insurance policy. As of 2009, the IRS defines as high-deductible any health insurance plan with a minimum deductible of $1,150 for single-coverage and $2,300 for a family, as well as a maximum out-of-pocket of $5,800 for single-coverage and $11,600 for family coverage. To get such an insurance plan, just approach a qualified agent or get an online quote from a health insurance website.
Once you have an HSA-qualified policy, you’re eligible for the second part: a health savings account for covering present and future medical expenses. Anyone under 65 may open one with an accredited Colorado health insurance company that offers HSAs.
An HSA can be funded by an employee, an employer, or both. As of 2010, the maximum contribution is $3,050 for single-coverage and $6,150 for families. For seniors 55 years and above, they are allowed to pay “catch up” contributions of up to $1,000 to their accounts. HSAs are open to anyone with a qualified high-deductible plan, including employers of any size, employees, and the self-employed.
You can get a high-deductible health insurance plan without getting an HSA, but as you will see, HSAs have significant advantages that will appeal to the smart buyer:
Numerous tax advantages. First off, all the deposits you make to your HSA are tax-deductible – that is, you can exclude them from your gross taxable income. Second, any interest you earn from your HSA is tax-exempt. Third, when you use your funds to pay HSA-qualified expenses, like doctor’s fees, prescription medicines, and so on, those too are tax-exempt. Lastly, in the event of death, your remaining funds are transferred to your designated beneficiary-tax-free.
Your HSA is a permanent plan. A health savings account endures even when you change your employment status. That is, you get to keep the funds you’ve accumulated even after you leave your job. This applies even if your employer has contributed to your fund.
Your funds may be used as savings. Because of the tax benefit on the interest, you can let your cash grow over the years. Moreover, unlike with a flexible savings account (FSA), any unused funds in your HSA is rolled over to the next year. By the time you reach the age of 65, you can withdraw your funds without penalty and use it however you want. This makes your HSA an excellent means of augmenting your retirement fund, so long as you stay healthy.
Note:You are allowed to withdraw for non-qualified reasons before the age of 65, but this will incur a 10% penalty.
An HSA provides flexibility on the medical services it covers. With HSAs, it’s you, not an insurance company, who decide what you pay for. Your HSA can accomodate medical expenses not covered by the usual health insurance plan, including vision and dental care, medical equipment, related transportation costs, and non-traditional treatments like acupuncture, massage, and chiropractic care. Many kinds of HSA plans also cover prescription medicines.
An HSA is a lucrative option to a traditional Colorado health plan. Rather than paying premiums to an insurance company, your money goes to your own savings account. But not just any account-you’re investing in your own health, which is the wisest investment there is.
