I thought I had an easy task when my wife asked me to find our family a health insurance policy before she left her full-time job to start her own business. After all, I've spent the last 16 years writing about health insurance for readers of Kiplinger's, Reuters, various AARP publications and others.
I envisioned reviewing stories I'd written on the subject, calling a couple of carriers to compare rates and submitting an application, the entire process informed by the subtle understandings of the field I'd developed over the years. A three-hour task, tops.
(Illustration by Randy Mays - The Washington Post)
Health Savings Accounts: Three Scenarios
Transcript: Cara Jareb, senior benefits consultant for Watson Wyatt Worldwide, will be online to answer questions about health savings accounts and health insurance open season.
Selection Time (The Washington Post, Oct 26, 2004)
Early Users of Health Savings Accounts Say So Far, So-So (The Washington Post, Oct 26, 2004)
The ABCs of Health Insurance (The Washington Post, Oct 26, 2004)
Options for Individual Coverage (The Washington Post, Oct 26, 2004)
In the end, I spent some 30 hours poring over insurance literature and policies, questioning insurance company customer service reps and Maryland regulators, calculating all the angles with brokers and other experts, talking to my accountant and calling the IRS.
While my family now has what some like to call "affordable" health coverage, I still lie awake some nights thinking about the gaps in the policy, the costs we may incur and what would happen should my wife, one of our two kids or I get sick or hurt.
Only now do I truly appreciate the formidable, costly, baffling task facing the millions of people who try to find health coverage when they lose a job, retire early, start their own business or work in a job without health insurance.
Self-employment is an exciting proposition. But it can mean paying full freight for health insurance, a figure most people never encounter since their employers often pay a large portion of their premiums. Policies can cost as little as $1,000 to more than $10,000 per person a year. And that's for healthy individuals.
"If you're young and healthy and don't need much care, this is a market for you," says Karen Pollitz, project director of the Georgetown University Health Policy Institute. "But most people who try to buy individual health insurance have difficulty getting coverage because of availability, affordability and adequacy of coverage."
Buying health insurance in the individual market can be risky. ("Individual" policies can cover more than one person; the term merely indicates that the buyer is not part of a group whose health risks are being pooled.) Double-digit annual premium increases are the norm, policyholders lack many protections enjoyed by those who are covered through employers, and the coverage pales in comparison with group insurance. If you're sick, either before you enroll or when it's time to renew your coverage, the individual market is even harder on your wallet and your options are severely limited.
"The current system is discriminatory in my view for individuals who are self-employed, on their own or in a small group," says Lawrence Mirel, the District's insurance commissioner. "That's got to be fixed. It's just not right."
Our family had been enrolled in group health insurance through the University of Maryland School of Medicine, where my wife was a member of the full-time faculty. We paid about $2,000 a year for a CareFirst BlueCross BlueShield plan allowing us to see any doctor we desired. We knew that was a far better deal than I, a self-employed writer, could get.