We're Going to Need a Bigger Band-Aid

The dire health insurance situation that I outlined last week just got direr. The already-stratospheric price of our COBRA coverage has attained orbit – it’s going up by $96 a month, retroactive to Sept. 1. Our deductible is doubling, from $250 to $500 per person. Generic drugs are going from $10 to $15. Name-brand drugs were already out of reach, so that price hike doesn’t affect us -- we simply can’t fill prescriptions that don’t have generic versions.

If worse comes to worst and I can’t find something better than our COBRA Blue Cross/Blue Shield insurance, I can step down to a lower-quality BCBS policy that carries a $750 deductible and pays a lower percentage of medical charges, but costs $150 per month less. Since we can’t actually afford to get health care under either plan, we might as well go with the cheaper monthly payment. ("Cheaper" being a decidedly relative term).

Naturally, this gets dumped on me just as I’m ramping up for Christmas. I’ve already placed $1400 worth of orders so far this month, two of them with new vendors (take a look at Funkeyboards. Nifty, huh?). I've got a few hundred dollars left that I need to deploy quickly and intelligently. These things take time and at least a little brainpower -- I'm not filing TPS reports here. Last week’s sales were the strongest since last March. Although this week's business fell off again, I’m too fracking busy for this idiotic distraction. Seriously, who wants to shop for health insurance?

Well. It’s not like I have a choice. My wife just came back from CVS shell-shocked by the 50% increase in her prescription copays -- the crisis is happening now. I need to explore Commonwealth Care and find out what’s available through the Massachusetts Business Council or Small Business Association or some other similarly-named organization. I'm sure that Kraken Enterprises would have to pay a membership fee to access those.

In case last week’s post gave you the impression that I’m anti-capitalist, let me say clearly that I appreciate the power of the market economy. Letting individuals pursue their own best interest is the most powerful social force there is to maximize wealth and happiness. When the aggregate of self-interest contradicts our collective interest, though, government has a duty to step in. Sometimes that just means nudging the market with tweaks to the tax code. Sometimes it means setting firm rules through legislation. When the market fails to deliver a vital service at all, or bungles it badly enough, government must fill the gap directly. Who else can?

Our medical payment system breakdown is waaaaay beyond tax tweaks. Congress's will to impose new rules on the existing market system appears to be weakening by the day (unless Obama’s speech this week revives it). So I had to conclude that the for-profit health insurance system should be replaced with a nonprofit payment mechanism. I don’t care whether that’s directly government-run or administered through government-chartered private coops. I am not an ideologue. I only care about what works. Show me a for-profit medical payment system – anywhere in the world -- that works better than a nonprofit monopoly, and I’ll reconsider.

Maybe Congress will buy us some time by extending the COBRA subsidy for another nine months, but I don’t think that that’s even on the table right now. We can't hope for a last-minute saving throw. Unfortunately, this saga will continue in future posts.