Better Vox mystery: How do you write about health insurance costs without mentioning the biggest government intervention in the markets in history? On Friday, Vox’s health-care analyst Sarah Kliff attempted to explain the rise in interest for single-payer health care by using this chart showing Americans having to pay far more of their costs out of pocket. Kliff gets this chart from the Kaiser Family Foundation showing deductibles skyrocketing over the last decade — but never quite explains why:
Let’s talk about a very important chart.
It came out earlier this week as part of the Kaiser Family Foundation’s annual look at employer-sponsored health insurance. And I think it does a lot to explain why Americans are frustrated with our health care system — and why they’re becoming more open to the idea of moving to single-payer.
This chart shows that, over the past decade, the size our insurance deductibles have skyrocketed. Deductibles have grown by 212 percent since 2008 — eight times faster than wage growth, and 12 times faster than inflation. … Just a decade ago, the average American with employer-sponsored coverage had a deductible of $303. Flash forward just one decade, and that number now sits at $1,350.
Let’s talk about it, Kliff writes … and then never really does. She writes correctly that this rapid expansion of deductibles means that people have to pay more out of pocket for their health care. Kliff offers an anecdote or two about what that means for families who have to access emergency care, also accurately. And she also concludes accurately that this has made health care “unaffordable” for many Americans.
What Kliff never “talks about” is why those deductibles suddenly became disconnected from inflation and wage growth over the last decade, and why health care became “unaffordable.” Kliff never uses the word “affordable” on its own, as in the Patient Protection and Affordable Care Act, better known as the ACA or ObamaCare. None of those terms ever come up in Kliff’s analysis.
And that’s pretty odd, since the real cause of skyrocketing deductibles is that same government intervention. ObamaCare limited premium hikes and forced insurers to add more costs while eliminating risk-based rates with its “community pricing” mandates. Even before passage, analysts and critics warned that insurers would have to raise deductibles on the individual markets in order to keep from going bankrupt. Even the Kaiser Family Foundation, which was nominally supportive of ObamaCare, noted that deductibles could go up by “thousands of dollars” along with premiums, a point they made again in 2011 and linked directly to the ACA:
The Kaiser study also indicates employers are switching plans and shifting costs onto employees. Half of workers in smaller firms now face “deductibles of at least $1,000, including 28 percent facing deductibles of $2,000 or more,” according to the study.
Ever since ObamaCare first passed, we have written nearly continuously on how it has created the worst of both worlds. Rather than encourage people to get low-cost competitive hospitalization coverage and use HSAs and FSAs for out-of-pocket expenses, ObamaCare forced insurers to sell only high-cost comprehensive plans with enormous deductibles in order to stay afloat. That means we pay a fortune for premiums to cover services most of us never will never use, while also paying cash for practically everything else.
The market distortion caused by government intervention in ObamaCare is directly responsible for the skyrocketing deductibles and personal costs. The last thing we need is more government intervention in these markets. It’s quite telling that Kliff never even mentions ObamaCare in attempting to make this outcome an argument for the competence of government in health care.