Common sense for insurance, medical care

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At a time when the county doesn’t need any extra expenses, we were disappointed to learn that the cost of county employees’ health insurance is going up significantly. Unless the employees are asked to contribute more than $30 of the nearly $650-per-month premium the county pays for each of them per month, the total will go up at least $325,000, and possibly a half-million dollars more per year.

The reason? Because more people than expected had to use the product they purchased. That’s right. A total of eight employees are suffering through major medical events, and that’s more than the one or two per year that’s expected. The result was a loss for United Healthcare this year, so the company is tacking on a 12 percent increase. 

And that’s one of the tacky things about the insurance business. The agent told the Board of Supervisors that there had been no increases in premiums over the last four years because the number of major claims stayed within that expected number. So now they go up one year, and the company won’t absorb that loss and consider it the cost of doing business? If that’s the way things are done, why didn’t the company offer a discount on the years the county employees’ claims were under expectations?

Look, we aren’t trying to beat up the insurance companies. We understand that they have to make money to stay in business. Having payouts consistently exceeding premiums isn’t a formula for staying in business. But insurers take their customers’ money to invest. And one of the first rules of investing is to leave your money alone. Let it ride for the long haul, and history shows that there will be a dividend eventually.

Making changes to an agreement based on what happened one year — and only after the “house” lost money — doesn’t do anything to change people’s perception of insurance companies. The county didn’t do anything to cause any of its employees to get injured or sick. It’s just bad luck. A rough year. 

To turn around and tell everybody to pony up more because of that just doesn’t sit well. It sniffs of opportunism. United officials know that other insurance carriers aren’t going to sign up a group of employees in which more than a half-dozen of them are battling ongoing illnesses. They know they can hold them hostage. We’re fortunate that it’s only a 12 percent increase.

We wish that we could return to the days of what health insurance was created for — to cover the costs of care for catastrophic illnesses — and the rest of our routine medical care was affordable enough that we could just write a check for it. It would be even better if a network could be created for those of us who have common sense and are reasonable. We would all sign something swearing not to sue unless there was truly gross negligence on the part of a doctor so that they wouldn’t have to practice defensive medicine.

But those days are long past, unfortunately. It’s interesting that insurance was created to help people with catastrophic illnesses … and now those who are using it for the purpose it was intended for are being penalized for it.