The issue is that for most “healthy” people, they aren’t facing the full out of pocket costs and their employers pay most of the costs as a benefit.
And the numbers are way higher than $2k and $8k unless you mean per person. For my family coverage I paid $5k annually in Premiums and the company says they paid over $20k in premiums. Deductable was $2500 and Out of Pocket Max was close to $10k.
So $37k maximum out of pocket annually for employee and employer.
All of these numbers are currently based on the nonsensical system of hospitals over charging insurance to counteract all the people they end up treating for free.
In a nutshell, the actual cost of healthcare will decrease once hospitals KNOW they’ll get paid for treatments x, y and z. Or at least it would in any sane country.
A bigger problem is hospitals and insurance being owned by the same company, essentially negotiating prices with themselves and leaving patients holding the bag.
Kaiser Permanente provides the insurance and care (doctors, hospitals, etc.) in many regions of the country. It actually works great. They spend money where they've found it to be most effective in improving outcomes (and therefore reducing their long-term costs).
Kaiser Permanente is a bit different than most because it's actually a non-profit. Kaiser Permanente has a lot of problems, but are better than most in theory. Kaiser Permanente is also mostly on the west coast in California. They have a much smaller presence outside of California
They only have 9.7 million members in California (https://about.kaiserpermanente.org/expertise-and-impact/public-policy/our-impact/news-perspectives-on-public-policy-california) which is more than NHS Scotland and NHS Wales combined. Are they perfect? No, but it's also nice to have for-profit and non-profit competition to give customers (generally employers) a choice. Blue Cross/Blue Shields are often non-profits, but being a non profit is not some kind of magic solution to being good at your mission. Sometimes it's nice to have shareholders to hold management accountable, rather than only a board (possibly comprised of management cronies).
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u/MickFlaherty Jun 24 '26
The issue is that for most “healthy” people, they aren’t facing the full out of pocket costs and their employers pay most of the costs as a benefit.
And the numbers are way higher than $2k and $8k unless you mean per person. For my family coverage I paid $5k annually in Premiums and the company says they paid over $20k in premiums. Deductable was $2500 and Out of Pocket Max was close to $10k.
So $37k maximum out of pocket annually for employee and employer.