Employee Medical Plans are also Slip-Sliding Away

In the Trump/GOP orgy of pro-business legislation – from massive deregulation at the expense of citizen-consumers to the massive tax cuts to the richest segments of American society – the focus has now shifted to decimate employer obligations to employees and governmental obligations to citizens in healthcare and other social benefits.

In my June 27^th, We Don’t Want to be A Loan, and my June 22^nd, Medicrisis, blogs, I point out how pressure from the lost revenues due to the above-noted tax cut has created a GOP call-to-arms to chisel away at (if not completely eliminate) social benefits every which way they can, with a particularly heartless priority to kill the remaining provisions of the Affordable Care Act (ACA, also known as Obamacare).

The Trump administration, focusing on the most expensive healthcare costs (preexisting  conditions, diseases and disorders with expensive treatments and aggregate caps on medical services), has granted “exemptions” to ACA mandates, allowing business and trade groups to offer so-called “skinny bundles” for healthcare coverage… allowing no coverage at all for those costly items and/or very high deductibles and co-pays. So employees who may think they have coverage often find out the hard way that their employer-provided plan either excludes their particular malady from any coverage at all or imposes deductibles and co-pays that are so high that even with insurance, employees cannot afford to access their healthcare plans. So they get sick, have serious healthcare problems, and even with insurance go untreated.

Writing for the June 28^th Los Angeles Times, John Tozzi and Zachary Tracer tell it like it is: “Today, 39% of large employers offer only high-deductible health plans from such firms as Anthem. Medical bills have driven some families into bankruptcy.

“When Carla Jordan and her husband were hit with a cascade of serious medical issues, she knew that at least her family had health insurance through her job. What she didn’t realize was that, even with that coverage, a constant stream of medical bills would soon push the family to the edge of financial collapse.

“The Jordans, both 40, were once solidly in the middle class, but ever since the 2008 financial crisis, money has been tight at best. Then calamity hit. In 2016, Carla needed a gallbladder operation. Her husband, John, suffered a seizure the same year, followed by an unrelated infection that sent him to the emergency room. Toward the end of the year, Carla was diagnosed with diabetes. Even after paying $501 a month for medical insurance, they ended the year owing $8,000 to 18 different providers, with creditors threatening to garnish John’s wages.

“Health plans similar to the Jordans’ that put patients on the hook for many thousands of dollars are widespread and growing, but some employers are beginning to have second thoughts. ‘Why did we design a health plan that has the ability to deliver a $1,000 surprise to employees?’ Shawn Leavitt, a senior human resources executive at Comcast Corp., said at a conference in May. ‘That’s kind of stupid.’ A handful of companies, including JPMorgan Chase & Co. and CVS Health Corp., have recently announced plans to reduce deductibles or cover more care before workers are exposed to the cost.

“Yet it’s still the reality for a growing share of Americans. Today, 39% of large employers offer only high-deductible plans, up from 7% in 2009, according to a survey by the National Business Group on Health. Half of all workers now have health insurance with a deductible of at least $1,000 for an individual, up from 22% in 2009, according to data from the Kaiser Family Foundation. About 41% say they can’t pay a $400 emergency expense without borrowing or selling something, according to the Federal Reserve. The bottom line: People like the Jordans simply can’t afford to get sick.

“The family had an Anthem Inc. insurance policy through Carla Jordan’s job as a public school teacher in Stafford County, Va. But the monthly premium barely covered any of their bills before they satisfied a $2,000 deductible. And by the end of 2016, the Jordans were deep in the hole to doctors, hospitals, an anesthesiologist, urgent care and various labs and testing centers. Their doctors sent collection notices. Some dropped them as patients until they paid up…. ‘I actually dreaded going to the mailbox,’ Carla Jordan recalled. ‘I feel like I’ve done everything I’m supposed to do.’ And yet, she said, sickness pushed the family ‘right over the brink.’

“Since the early 2000s, employers have mostly embraced high-deductible health plans. The thinking has been that requiring workers to shoulder more of the cost of care will also encourage them to cut back on unnecessary spending. But it didn’t work out that way. In the wake of the 2008 financial crisis, many families were hard-pressed to meet their soaring health insurance deductibles. At the same time, studies show that many put off routine care or skipped medication to save money. That can mean illnesses that might have been caught early can go undiagnosed, becoming potentially life-threatening and enormously costly for the medical system as well as the patient…

“The Jordans’ response to spiraling family medical costs is repeated in families across the country, studies suggest. When one large employer switched all its employees to high-deductible plans, medical spending dropped 12% to 14%, according to an analysis by economists at UC Berkeley and Harvard. But the workers weren’t learning to shop more effectively for healthcare. They simply reduced the amount of medical care they used, including preventive care. In high-deductible plans, women are more likely to delay follow-up tests after mammograms, including imaging, biopsies and early-stage diagnoses that could detect tumors when they’re easiest to treat, according to research in the Journal of Clinical Oncology.

“‘High-deductible plans do reduce healthcare costs, but they don’t seem to be doing it in smart ways,’ said Neeraj Sood, director of research at the Leonard D. Schaeffer Center for Health Policy and Economics at USC.” There are a lot of people, really sick people with life threatening ailments, who are untreated… inflicting even greater long-term social costs into the nation… who actually have healthcare insurance. They are living the Republican dream: minimal or no healthcare coverage unless you are wealthy enough to afford the coverage or the care. Dying but less affluent people simply eliminate those inconvenient lives from public concern.

So what?! Businesses, freed of heavy healthcare costs can generate even higher profits… as if those massive tax cuts were not enough.

While some companies are reacting and implementing a fix, there are too many employers who just won’t. Why? Because they can get away with it under this wondrous GOP/red state vision of pulling government out of any many parts of society as they can, all with an eye to increase profits and nothing else. The United States remains the only developed nation on earth that still has medical bankruptcies and hordes of people who simply cannot access necessary healthcare.

I’m Peter Dekom, and that our government can continue to let this situation worsen by the day should provoke outrage and shame… but in Trumpland, it is a bragging point!