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Pay more, get less! What’s going on?

Just when it looks as though you can make ends meet, health insurance costs go up again. A growing percentage of every paycheck is going on health and, for the most part, you’re getting less for your dollars. The result? Every month, more people give up on rising premiums and drop into the ranks of the uninsured. Worse, if big bills hit, people face personal bankruptcy. This was mostly affecting low-income working families and those with chronic conditions requiring more continuous treatment like diabetes or depression. Now, it’s starting to bite the middle class. Employers are also feeling the pinch and more companies are dropping medical cover or reducing the benefits packages, and introducing wellness programs with teeth. This combination is placing a growing burden on taxpayers who fund Medicaid and the Children’s Health Insurance Program. Why is this happening? Well, let’s come down to a short list. The economy is not in great shape. The population is ageing and, as people get older, more goes wrong with their bodies. New technology is producing new treatments but that is often more expensive. The pharmaceutical industry keeps raising prices to maintain its profitability. Put all the causes together and you have a broken system. The real problems start with the “entitlement” trap. Because people pay their health insurance premiums out of their own pockets, they feel they’re entitled to get all the medical care they like. This leads to a significant amount of waste as health providers supply expensive services on demand regardless whether those services are needed. Mostly, the providers are driven by the need to make profits to keep their investors happy, and not by the patients’ needs. This makes general medical care unaffordable and shifts ever more of the costs on to the insurance companies and the tax payers. Health insurance premiums therefore go up. The Republican approach is to reduce taxes which makes funding public health provision more difficult. If people are uninsured, they wait longer to see a physician or go to an emergency room when their conditions have worsened. What could have been treated early on for less money suddenly becomes a bigger bill as costs are higher in emergency rooms. Why are costs higher? Because a significant proportion of patients cannot pay. The hospitals costs therefore have to be recovered from those who have the money or still carry health insurance. The moral of this story is for political parties to have the will to fix the problems.

What kind of payment deals are on offer?

Sometimes, paying the whole premium up front is a real problem. Household budgets are really stretched these days - particularly as gas prices are going up so fast. Most of the auto insurance companies offer a range of payment options. They allow you to decide how often you want to pay. It can be monthly, quarterly or every six months. These offers always try to make it look convenient to you.

But there is a downside. When you spread your payments, the insurance company is actually giving you credit on the total bill. Some will charge you an arrangement fee - just a few extra dollars for agreeing to take your money in instalments, set up the payment schedule to monitor your account, and so on. Others will add in interest. Put the fee and the interest together and you can find yourself paying a lot more than you expected for that policy.

Use a calculator to multiply the instalments together to see what the total cost of the policy is. It can be surprising how the price has increased. It is often cheaper to put the full premium on your regular credit card than to pay monthly to an auto insurance company.