'Taking it in the shorts': The cost of health care and what nobody talks about

Was it any coincidence that the day the Senate introduced its bill replacing the Affordable Care Act—the first of a few, way back in June, that is—was the same day I received the bill for my six-month health insurance premium?

Of course it was!

However, it was a welcome concurrence since I have been meaning to write about our national conversation/debate regarding health care—or at least what is missing from it—for a long time. Having started this post way back in June, it’s about time I finish it, especially since another (doomed) proposal was considered by the Senate, and I received unfortunate news from my insurer last week.

To get started, and because I can’t think of a better segue, here is some fun, personal health-care info (some of which I’ve probably posted in the past) to put things into perspective:

• I am a single, childless, 34-year old man who does not visit the doctor very often, does not have any prescriptions, and takes only over-the-counter pain relievers and cold medications when necessary. I don’t smoke, don’t drink soda, and don’t eat fast food. I run, bike, walk, and drink six to 10 beers on the weekend. Though I am considered overweight, I suppose I am in decent health.

• I am among the small number of Americans and Iowans who buy private health insurance. In the state, I read last week, there are only 72,000 of us; across the country, I think around 14 million people purchase their own health insurance.

• The bill I received in June for my six-month health insurance premium was for $2,551.32. I paid the same amount when I switched to my current plan—a high-deductible HSA—in December, meaning I have paid $5,102.64 to have health insurance in 2017. That will likely be over 12 percent of my income for the year. The six-month premium for my current plan is a little less than what my previous plan would have cost ($2,816.88), but it is $1,000 more than what I paid for six months of coverage in the first half of 2011 ($1,529.10).

Keep in mind that my plan covers only myself, does not include dental or vision coverage, and is not subsidized. Yes, I probably qualify for a government-subsidized ACA plan, but I choose not to get one. After considering all the unneeded welfare doled out to multinational corporations, I do regret not getting a subsidized plan. If our many layers of government all bend over backward to appease the most profitable companies in the world with all sorts of tax breaks and preferential treatment, it seems only right that they pitch in a couple hundred bucks for my health insurance.

• Speaking about my current plan, I received a notice last week from Wellmark, my insurer, that it is terminating its ACA-compliant plans—including mine—for 2018. It has been known for a while that Wellmark would stop selling private health plans in Iowa at the end of the year, but I assumed it would continue to insure those already with a plan. Nope. That means I will need to get health insurance from the only other company in Iowa’s private health insurance market, Medica—which has asked for permission to increase premiums by 56 percent. (Iowa is working on what it calls a “stopgap” measure to keep the state’s private health insurance market alive. If the measure is approved by the federal government, Wellmark has stated that it will remain in the marketplace. If not, Medica will be the only option.) Needless to say, it’s a good thing I never opened an HSA.

Ah, such is life on the private insurance market. Fun, fun, fun!

It may not have been a hassle getting a plan (until now, it seems), but it’s never been cheap. Why? I’m not 100 percent sure and should look into it. However, I have a feeling that a major factor is being overlooked and/or ignored in our national debate/discussion about health care: our collective health.

The debate/discussion about health care focuses a lot on care and treatment. However, as best as I can tell, little is mentioned about Americans’ health and everything that affects it, including our diets and lifestyles. (I could be wrong. Perhaps the talking heads on the cable news networks talk about it, but I wouldn’t know because I don’t watch cable news.)

The U.S. is not a healthy nation. The U.S. Department of Health and Human Services has a trove of sad statistics here. (Of course, I would like to see similar statistics for other Western nations to see how we compare.) None of those numbers paint a pretty picture, and all of it contributes to figures like this:

• “Projections estimate that by 2018, obesity will cost the U.S. 21 percent of our total healthcare costs - $344 billion annually.”

Statistics like that make it clear that the way we take care of ourselves (or not) is a major factor in the cost of health care.

Is Obamacare to blame for the increases in health care costs and insurance premiums? In certain ways, yes. Better plans that cover more and the addition of millions of people who were previously uninsured—both healthy and very unhealthy—no doubt are contributing factors. But despite how high premiums continue to grow, they are apparently not high enough to cover all the costs of the health care we use as a nation—likely because we are a sorry bunch of unhealthy couch potatoes. That’s why a number of insurers have left Iowa’s private health insurance market: They paid more to cover their customers’ health care than they collected from premiums. One gets the sense that Americans feel like they can do whatever they want to themselves, consequences be damned, and surgery and pharmaceuticals will solve any problems that arise. That costs a ton of money.

Would health care in the U.S. be cheaper if we were healthier as a nation? If we ate less and moved more? I assume so. It might not be much cheaper since there seem to be a number of compounding factors, but I think it’s safe to assume it would not cost as much as it does now.