Health insurance … and what you can do about it

On Halloween, I wrote about one big fat financial trick—companies sowing confusion and uncertainty around our choices. Best example ever? Health insurance. OK, I said I wasn’t scared. That isn’t totally true. Health insurance—buying it, paying for it, even being allowed to buy it—is terrifying … and infuriating. If you ever want to delve into why our system is as broken as it is, I would recommend an excellent book An American Sickness by Elisabeth Rosenthal, but it will give you high blood pressure. So … never mind.

If you work at a big company that provides benefits, it’s likely open enrollment season. Same if you get your health insurance through the Marketplace set up by the Affordable Care Act. Even though I spent most of my adult professional life in the relatively cushy cradle of huge-company employer-provided health insurance, it got noticeably more challenging over time to figure out what the “right” benefit choices were, all the more so when I was choosing for three, then four, then five people.

By the way, do you know why Costco is so popular? Because if you want almond butter, you have one choice. It’s a big jar, but you don’t leave with the nagging sense that you made the wrong decision. Also, free samples.

I figured that to make the right benefit elections during open enrollment, I basically needed to be a combination physician / actuary / psychic. Actually, just a psychic. How many times would someone need to see a primary care doctor? How about a specialist? Will you require maternity care? (you should probably be able to make an educated guess with this one … *sigh* … that’s a blog post for another day) Is orthodontia needed? Will I die while traveling on behalf of the company? 😑

One of my lovely, well-meaning colleagues once attempted to help the staff and created an Excel model that compared the cost of different health plans depending on levels of healthcare needed. This is an image of his actual spreadsheet:

Forgive him, friends. He worked at McKinsey. Seriously, though, if this is what the Harvard grad who worked at McKinsey needs, what hope is there for the rest of us?

And the worst part of all this? We can’t opt out. Health insurance is terrifying because not having it adds unlimited downside risk to your finances, and most likely, to the finances of those who love you. If you do not have car insurance, the most you can lose is the value of your car. Think for a moment. If someone you loved—a child—became seriously ill, what would you spend to make them well?  

One of my challenges writing at LBYM is knowing that there is only so much impact you can have on your financial situation by buying lots of toilet paper at a time. Most of us have big costs we have to cover—health insurance, student loan payments—and it seems we’re always fighting an uphill battle … alone. Against forces that are much larger and more powerful than ourselves.

You would be right. I stand by what I said on Halloween. Educate yourself. Ask lots of questions. Demand satisfaction. Vote.