July 17, 2024

The Health

Your health, your choice

Guest View: Americans and a lifelong relationship with health insurance – SanBenito.com

Health insurance—can’t live with it, can’t live without it… or can you? These days, it seems the price we pay for health insurance is more than what it’s worth. 

When you tally up the monthly premiums, health care deductibles and copays, the average healthy American spends more on maintaining their title of being insured rather than what it’s worth. For those of us who reside in certain states, the stakes are higher. If we are found to be without insurance, we are financially penalized. 

Ironically enough, for some of us, it pays to be a cash paying patient. With doctors giving a reduced fee for cash patients and companies offering prescription discounts, it costs less to pay cash for a checkup or urgent care visit than it does to run it through insurance. 

For most of us using insurance, we pay the same cash price until we meet our deductible on top of the monthly premium we are charged. At the end of the day, are we just paying for the idea and title of being insured? 

I recently explored this option when a medical device with insurance was more than $400, and without insurance and with a coupon was $175. Have I been duped into thinking my insurance was working in my favor? Had I been so busy with the demands of life, I went along with believing this is how insurance works? It seems so. 

With the already high cost Americans face in health insurance and medical expenses, healthcare costs in 2024 are increasing higher than we have seen in the last decade. 

One would assume the increase in cost would yield some benefit to the insured. Alas, it does not. The wait times are longer, the declined authorizations have increased and the time it takes to get anything approved is months. 

I’m no stranger to the hurdles one has to overcome for basic healthcare. It took me four months to get a medically necessary surgery authorized by insurance (still waiting on that surgery). What I have come to realize is most Americans will settle for subpar healthcare rather than the healthcare they deserve out of fear of being uninsured. To top it off, most Americans are settling to avoid the difficulties and time required to advocate for themselves. 

According to CNN, individuals enrolled in group insurance paid “an average annual premium of $8,435 in 2023 (about $703 per month).” For families under group insurance, their annual premium payments were, “$23,968—or about $1,997 per month.” If you are an entrepreneur or involved in contract work, individual monthly health insurance premiums cost an average of $1,178. 

If that comes as a shock, you’re in for a rude awakening as CNN reports, “The average yearly deductible for an individual was $5,101.” For families they had an “average deductible of $10,310 per year.” On a yearly basis, combined health insurance expenses are costing Americans and their families $13,536-$34,278. 

The numbers don’t lie. For the average American who does not need to pay hefty amounts in prescription medication, visit the doctor’s office or see a specialist on a regular basis, being a cash paying patient saves money rather than having or even utilizing insurance. Instead of punishing those without insurance, maybe we should make insurance as affordable as it would be for those that opt to be cash paying patients?

By no means am I advocating for you to run out and drop your health insurance; however, I am urging you to spend some time on running the numbers and deciding if the health insurance you currently have is working in your favor. If your health insurance is working against you and not for you, let this be a reminder you are your own advocate and you deserve more. 

Your insurance probably can do more and should do more, but if you don’t ask, it’s a dirty little secret they will keep to your grave. 

Stephanie Scagliotti, born and raised in Hollister, worked in finance for a decade before changing her career to healthcare. Scagliotti currently works as a dispatcher for the 988 suicide lifeline while finishing her post-baccalaureate degree.