Choice. It's What's for Dinner

Not to make this healthcare week here at Reverse Pyromania, but I want to follow up on something Mister mix wrote this morning.

In figuring out his ACA plan for the coming year, MM wrote, “The other part of the horrible experience I had yesterday is that the Colorado exchange gave me a “choice” of like 93 different policies, each with slightly different terms. It was all fuckery.”

Choice. It’s a great thing, right? Not so fast.

The problem with choosing a health insurance plan is there’s too much choice, which makes the whole thing a crapshoot. Here are decision points one must consider when looking at which healthcare insurance plan to opt into:

• insurance company (if there is even more than one provider in your location)

• premium amount

• deductible

  • Individual deductible

  • family deductible

• co-pay

  • lower co-pay for urgent care visits or not

  • how many urgent care visits are included at fixed cost vs. part of deductible

  • lower cost for lab tests for chronic illnesses or not

• out of pocket maximum

  • individual

  • family

• drug coverage:

  • fixed dollar co-pay or part of deductible

  • low/no cost for certain chronic illness drugs or not

  • generic drug coverage (fixed dollar co-pay or part of deductible)

  • non-generic drug coverage (fixed dollar co-pay or part of deductible)

  • preferred drug coverage (fixed dollar co-pay or part of deductible)

  • specialty drug coverage (fixed dollar co-pay or part of deductible)

• in network vs. out of network (how the heck do I figure out who is “in network” and who isn’t)

• does it include vision or not

• does it include kids coverage or not

  • Kids vision, kids dental, only one or both

• Health Savings Account (“HSA”) eligible or not

Basically, someone looking to choose a plan has to take swag guesses at what may happen to them healthwise (and/or their family if they have one) in the coming year:

• how often will I or my family get sick

• Will little Johnny get injured playing sports or in school

• Will little Jane get the flu and then also have croup in a separate instance

• Will anyone on my plan come down with a chronic or major illness

• What drugs will we need

• Will we get sick/injured somewhere “out of network”

• On and on and on and on - you get the picture

You know who doesn’t have to make these ridiculous choices? Every resident of every other developed country in the world.