Medical Care is Expensive and Inaccessible to Many in the USA and in Alaska it is worse

As we approach the new year most people in Alaska are going through “Open Enrollment” where they choose what “Medical Insurance” they will have for 2022. This includes people with private insurance, meaning it is provided by employers, even when that employer may be a government entity. People who are buying insurance via the ACA /ObamaCare exchange and those on Medicare.

Insurance premiums have come down for a few getting subsidized insurance via the ACA Exchange but deductibles, prescription costs, doctor visits, and maximum out of pocket expenses have gone up. I have spoken with many people who have insurance from private employers. Every one of those people told me their premiums were going up with most of them saying deductibles were going up as well.

Medical Insurance DOES NOT GUARANTEE YOU CAN GET MEDICAL CARE!

People cannot afford the deductibles (the amount of money individual and /or family must spend prior to “Insurance” paying anything.) A few years ago, I saw a plan with an individual $10,000 deductible. More common are deductibles of between $2,000 and $5,000. Family deductibles are commonly $3,500 to $12,000.

Many, if not most people in Anchorage, have a challenging time affording the premiums, they pay for Medical Coverage let alone the deductibles and co-pays when medical care is needed. (See my 24 November 2021 article about why people are not going back to work) So, what happens? They simply go without care, not treating conditions that will cause more problems later in life.

People who receive Medicaid and Medicare do not have an easy time getting care either. In preparing this article I found three primary care clinics and twelve specialist offices that are not taking Medicaid or Medicare patients because those programs pay significantly less. Medicaid patients also have the highest percentage of no-show appointments. Providers do not get paid when someone does not show up for an appointment. The lower amount Medicaid would have paid them would have better than zero. Other major clinics in Anchorage are limiting the number of Medicaid and Medicare patients they will serve.

A 2020 study done for The Alaska Policy Form APF High Medical Costs shows some reasons for the high costs in Alaska and offers a few solutions.

The State of Alaska is the largest purchaser of Medical Care in the State. These costs include coverage for employees and those on Medicaid.

As such the State has power to reduce costs for everyone. This would not be a mandate or ‘socialized medicine.’ Its negotiations and competitive bidding for medical services would reduce the costs. Over the last 6 years a plan to do just that, complete with a trial version to prove the plan will work was presented to various legislators and members of the Administration’s including multiple Commissioners. No one chose to act on this plan or any other. If we want to reduce the dtate budget, we must control healthcare costs WITHOUT reducing choice or the quality of care. This approach could save anywhere from $10 million to $100 million per year, a non-trivial amount of money. Once the State negotiates lower costs private insurance companies will demand the same lower prices.

Next week my column will cover other ways to reduce medical costs.