In the 1980s while negotiating a union contract I was trying to make the case for raising the deductible and coinsurance in the health benefits plan. As part of my pitch I made an analogy with other forms of insurance. What I said was that if you look at auto insurance, it doesn’t pay for an oil change or new tires. One union representative said his wife had just had surgery and did I expect him to pay for that. The point was that not everything is insurable and some cost sharing is fair and desirable. What I got back from the other side of the table was, “Are you comparing my wife to a car?”
Actually, I was comparing spending $20 on an oil change and $20 on an office visit coinsurance, but that didn’t matter. That “Are you comparing my wife to a car?” syndrome is not unusual because we cannot get past the attitude that paying for health care is not the top priority for spending our money.
Here is another way to look at this.
Georgia residents spent an average $470.73 on the lottery in 2010, or 1 percent of their personal income. Only Massachusetts (STOMA1) had higher spending, $860.70 per adult, more than three times the U.S. average. Georgia had per capita income of $34,800 in 2010, below the national average of $39,945, while Massachusetts’s was higher at $51,302, according to data compiled by Bloomberg.
In fact, in Georgia the median household income 2006-2010 was $49,347 and 15.7% of the population is below the poverty level. Under the Affordable Care Act a family with an income of $50,000 will receive a premium subsidy a little over $12,000 per year plus cost-sharing subsidies up to an additional $3,600 per year.
Clearly spending several hundred dollars on the lottery is not equal to the cost of health insurance, but the lottery is not the only non-necessity people spend money on. In other words, what is unaffordable is a lot more than health care, but we tend to reset our priorities so that the $80 office visit is unaffordable, but the lottery ticket is not. Go figure.
Logically our priorities would be more like this:
- Health care
- Other stuff
Exactly where are our priorities? What is affordable?
- Insure Against Disaster, Pay for Wants Out of Pocket, Save for the End Game: (brothersjuddblog.com)