Fewer Health Care Choices for Employees

‘Tis the season for open enrollment for group health insurance plans. Although the high cost of health insurance has been increasingly passed along by employers to their employees, most open enrollment periods have given employees the choice between two or three options. According to the New York Times, those choices may be on the verge of becoming a thing of the past.

Employers like Nissan and Delta Airlines are giving employees one choice this year: a plan that calls for a high annual deductible before the insurance coverage kicks in. The premium for this insurance may be lower than (or, at least, even with) last year, but obviously, the employee will have to pay more out of pocket medical expenses before the insurance benefits become effective.

Employers moving in this direction argue that this kind of plan requires an employee to focus more specifically on her own health and will result in healthier living. Thus, there will be fewer doctor charges, emergency room visits, and expensive diagnostic tests. The contrary view is that such a plan will force employees not to go to the doctor or hospital when they need to, because they’ll have to spend their own money. Thus, employees’ minor health problems will become more serious because they’re not treated.

Some of the one-choice plans provide positive benefits to offset the high deductible. For example, annual physicals, well-child care and immunizations, and cancer screenings are covered irrespective of whether an employee has reached his deductible. In addition, some employees can put money into tax-sheltered health savings accounts whose balances can grow year after year. Some employers still make contributions to the health savings accounts established by their employees.

The choices are nonetheless getting harder for employers and employees as the cost of health care continues to increase. President-elect Obama promised health care reform that would move in a different direction from that of employers like Nissan and Delta. One of the first questions his administration must face is whether any type of health care reform is possible, given our present economic crisis and the enormous federal deficit that may make spending money on anything of significance difficult, if not impossible.