If today you worked for the company where I did for nearly fifty years and you wanted health care coverage for you and your spouse, the monthly premium is $2,517,27 for a plan with a $750 deductible plus out-of-pocket limit of $1,000 more per individual.
Outrageous premiums, right? Someone is making lots of money don’t you think?
But the thing is there is no insurance involved. This is a self-insured plan. The insurance company that processes claims does only that and receives a fixed monthly fee per covered person per month to do so. The claims administrator has no financial risk, no incentive to deny claims to make money.
The “premium” reflects the cost of the health care provided to the covered individuals and little else except the claim processing fixed fee.
This is how virtually all large employers operate. Such plans cover about 60 million Americans.
Still think the health care cost problem is an insurance problem?