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Michael Miller


By Michael Miller
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Health Insurance Crisis Still Here

If you are in the market for health insurance coverage in Nassau County and are merely an individual, not part of a business or organization that helps pay for your policy, you don’t have a lot of attractive options. The largest health insurance company in this state, covering more than 5.5 million New Yorkers, offers two comprehensive insurance options. They will cost, depending on how much choice you want in what care providers you see, between $1,533.76 and $1,916.32 per month.

We haven’t added in your spouse or your kids, dental or vision, or the many copayments. You will have to wait nine to 11 months to be covered for pre-existing conditions, so if you have a chronic illness and some prescriptions, you may well have to pay tens of thousands of dollars before your insurance policy kicks in.

Group policies typically cost half these amounts, or a little less (Long Island school districts average about $747 a month for individual coverage, and that’s roughly what most of our local governments pay). School district health insurance premiums rose by a statewide average of 7.4 percent for this school year, and are expected to rise about the same amount for 2013-2014. As a group, Long Island school districts are budgeting for 10.4 percent premium increases.

Health insurance costs some of us more than rent or property taxes. For some, health insurance is a tax on life.

Politicians and the media decided for us that all discussion regarding health care revolves around this: Are you “for” the Affordable Care Act or “against” it?

Let’s be clear. There are very good things about that law. For example, the ACA’s closing of the prescription “donut hole” in Medicare Part D has already saved about 6.1 million elderly and disabled Americans some $5.7 billion on drugs so far. But while the federal reforms will certainly help some people, they aren’t going to help enough.

Only 45 percent of American adults were covered by employer-sponsored insurance in 2012, continuing a five-year decline. The biggest losses were among people earning less than $90,000. Workers age 45 and older make up a disproportionate share of the long-term unemployed, who are losing insurance at the time they’ll be starting to need it. In 2011, just over 17 percent of working-age Americans were without coverage for a year or more.

Over the past decade, the cost of medical insurance has gone up two times more than the cost of actual medical care, and three times more than wage growth. Between 2003 and 2011, the five largest for-profit health insurance companies spent $67 billion to buy back their own stock. In 2011, three companies alone paid over $1 billion in dividends to investors. Many other countries have private health insurers, but only in the U.S. are those businesses designed to make a profit off certain basic core health services.

There is inefficiency throughout the system. The $2.8 trillion health care industry has added more jobs than any other industry in America since 2000. Subtract health care from the employment statistics and there would be fewer jobs in the American economy than in 2000. But we’re not adding health care providers; we have five clerks and other administrative support staff for every doctor, mostly filling out insurance paperwork. Long Island hospital systems are buying independent providers by the hundreds, but every attempt to consolidate and standardize only seems to increase paperwork, frustrating everyone.

Millions of Americans are realizing they will likely never be able to retire, that the road ahead is going to be harder for them — maybe impossible.

We cannot sustain this health care system and a thriving, dynamic middle class at the same time.

Michael Miller is a freelance writer, designer and strategic consultant who has worked in state and local government. Email: