The Schrug

The Obama administration and Congress are facing some difficult decisions as they tackle health care and health care financing reform. Meanwhile, I have to make some pretty important decisions for myself.

I would probably be considered one of the lucky ones when it comes to finding health insurance. My insurance is provided by my employer: SCHRAG Inc. And although SCHRAG is a very small business, it has access to group rates through a larger business organization. So all I have to do is pick the right plan.

To keep things simple, for the sake of discussion I’m going to assume that I can only choose from one health insurer. In fact, the business organization offers plans from five different insurers. But since I’ve narrowed it down to one insurer right off the bat, this shouldn’t be much of a burden, right? In fact, you can probably do it for me. Just check the right box:

What’s that, you say? You don’t know if I should choose the plan that costs $3,395 a year or the one that costs $7,440 a year? Or one of the 23 plans in between? It’s quite simple, really. All I have to do is come up with an accurate prediction of how often I will:

• see my primary care physician
• see a specialist
• go to the emergency room
• get admitted to the hospital
• have outpatient surgery
• need prescription medication (in each of three different price categories)

Oh, and because some of the plans have deductibles and coinsurance, I should have a pretty good idea of what each of the above items will cost. No sweat.

To make things even easier, I only have to figure out what’s best for me! Good thing I don’t have any employees. If I did, I’d be making this decision for all of them and their families. On the other hand, how hard would that be? All I’d have to do is give them this chart, and then we could all have a quick discussion about which plan the company should choose.

At the moment, I’ve got the $581.96 plan. But I’m leaning toward one for $359.90. I’d save almost $2,700 a year in premiums in exchange for a $2,000 deductible and slightly higher payments for office visits, ER visits, and prescription drugs. Is that the right call? Who knows? I might end up simply pasting this chart to a wall and throwing a dart at it. As long as I don’t hurt myself with the dart in the process, I’ll probably be OK.