I place a high value on my health insurance.  In fact, it’s a Gold Card to health for my family and me because it provides access to care whenever I need it.  I don’t think twice about calling the pediatrician, internist, or specialist.  If we need a prescription refill we go to the pharmacy.  If my son needs more tests, we have them done.  If my husband needs an outpatient procedure, he schedules it.  And for all of this security, all we have to do is pay $1,200/month in premiums plus co-pays and deductibles.  I haven’t been keeping a running total for all of our bills this year, but in December I’ll probably pour myself a glass of wine and start tallying.  It will definitely amount to one or two new cars for the year.

The term affordable is a sliding scale depending on your financial situation, and the amount of care you need.  Unfortunately, premiums, services and products aren’t priced along a continuum like this.  If you’re part of a large risk pool and your company pays 80% of your premiums, your monthly bill can be low with great coverage.  If you’re self-employed like I am, or work for a smaller company that can’t pay the 80% of your premiums, then your monthly outlay for insurance can be high with less coverage.   However, many large companies are changing their plans to offload more of the premium costs to employees with higher deductibles so fewer and fewer Americans are actually feeling the effects of affordable insurance or healthcare.

I certainly like some of the consumer protection insurance reforms being talked about in Washington, D.C such as dissolving lifetime caps and mandating coverage for people with pre-existing conditions.  What’s hard to know is how any of the reforms are going to lower our premiums and help to reduce prices for services and products.  I certainly don’t want to count on insurance companies to solve this for me while they continue to post above-average corporate profits.

Maybe it would help to set out a few healthcare reform guidelines for keeping the insured insured:

• Develop menu-option health insurance coverage that can also be tiered to fit my affordability scale
• Bring transparency to pricing so I can evaluate cost and care for myself
• Mobilize market-driven buying groups to reduce prices for specific healthcare products
• Incentivize providers to develop innovative pricing models for care, and
• Motivate consumers to become savvy healthcare shoppers

I’m sure the policy wonks in Washington have many more ideas, but until someone actually starts talking to consumers about pricing options it’s too abstract to really consider the effect any of it will have on my family or yours.  All I know is that we need more affordable options for the care we need.

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