Is There A Way to Make Health Care More Affordable?

By Becca T., Pinellas County

The increasing cost of health care is a constant concern for me and my family. I realize that we are fortunate to have insurance because there are so many people living without access to health care. At the same, I have to say that the outrageous cost of health care stands in the way of my family’s ability to become more financially stable and secure. Our health care expenses get worse each year. Now, COVID-19 has placed us all in a difficult and uncharted situation. As a family we are trying our very best to be as fiscally responsible as possible. The cost of our health care makes it hard.

My husband and I have two children. We both work for ourselves which means that we do not have access to insurance through our employers. Luckily, we were able to go through the Marketplace to purchase a health insurance family plan. Our monthly premium has gone from $100.00 a month to nearly $1500 a month, which is nearly the same amount as our monthly mortgage payment. The family deductible is $15,400 for in network providers. Our total out of pocket expenses is $16,300 which includes the deductible and copay's, but not the premium. So, between the premium and deductible, we have paid out $21,300 this year. There are still four months to go before the clock resets in January.

A few weeks ago, I went to the Emergency Room for treatment. My insurance covered $38.76, and I received a bill in the mail for $4,700. That’s right! My insurance covered less than 1% of my total hospital bill. The remaining 99% was applied to my deductible. Our insurance plan provides coverage for basic health care and very little more. The bright side of the situation is that, thanks to the Affordable Care Act, our regular checkups are covered. However, we see the opposite side of the coin when there is a catastrophic issue. That’s where the financial hardship sets in.

Despite the high cost (or perhaps, because of the high cost), I have to say that the providers I’ve seen have been really great. When anyone in my family needs care, I find that I can get my needs met fairly quickly, but it’s pretty intense because the variables that determine my cost are out of my control. The hospital system is very complex, and most people don’t realize how it all works. When you go to your assigned “network” hospital you have to remember that hospitals are now like malls. There’s a landlord, but the ER doctors and specialists are all like stores inside the mall. They have their own products and prices, and there’s not always a sign posted on the door that tells you if your insurance will cover what they’re selling. You may not know until you get a $4,700 bill in the mail and by then, you’re out of luck.

Again, getting a $5,000 bill in the mail is not ideal. I’m fortunate that I can cover the cost. And I received excellent medical care. It was some of the best care, concern, and efficiency I’ve ever experienced. While I was in the ER, there was another patient being treated. From the conversation I could tell that he was an addict and needed drugs for withdrawal symptoms. The hospital staff treated him with such dignity, kindness, and grace. I’m not used to seeing that kind of compassion, which is sad, but true. So, I don’t want to take away from the professionalism and care I received. My frustration is with the insurance company. While I am deeply unhappy about the costs that come my way, I also know that the hospital negotiates prices with the insurance companies.

At the end of the day, the skyrocketing costs are an economic issue. I believe they should be reviewed legislatively, especially during this pandemic. Florida’s economy is being pummeled as each day goes by. We will need small businesses to keep the state moving and growing. What if small business owners starting new businesses were able to buy into a state insurance program? This would drastically reduce their costs. If new business is the heartbeat of the economy, why wouldn’t we develop a system to incentivize people to follow their dreams and invest in themselves? I would be happy to participate in the state plan and commit the cost difference to investing in our local economy.

For me, the bottom line is that special interests often have too much influence into how we care for people in Florida and the nation at large. Elected officials have never known what it’s like to navigate the complex health insurance system. While I appreciate their service, their pockets and bank accounts don’t have to feel the effects of rising health care costs. There’s no negative impact to their families when prices inch up year by year. They simply don’t have the same jarring experiences with health care costs as everyday Floridians. It’s so hard to advocate for what you haven’t lived. Perhaps the crushing impact of COVID-19 will inspire meaningful change to our health care options in Florida.