Karl Douglass: Moment of truth

September 29, 2013 

Without taking your hands off the paper, tablet or smartphone on which you are reading this column, tell me how much you pay for health insurance each month.

I am willing to wager that most people don't know. After we complain about the premium increases during the company's open enrollment period, we put the benefits brochure in the junk drawer and pay no real attention to the healthcare costs that are deducted from our monthly paychecks for the rest of the year.

What else do you buy like that? Nothing.

We pay close attention to every other major purchase we make. When someone buys a new car, they can tell you exactly how much it costs, how much was paid in taxes and even the interest rate on the loan. If I asked you how much you pay on your mortgage each month, you could quote the amount down to the cent and tell me how much of the total is allocated to escrow. Ask a parent how much college for his child costs and he will give you a detailed breakdown of course costs, housing costs, meal costs and student fees.

These purchase prices are seared in our minds because they are direct. We comparison shop for these items, and other things, because the pain of paying is real.

But when it comes to healthcare costs, we are disconnected from much of the pain. We look at the monthly premiums that are deducted from our paychecks as the cost of being a grown up. We say, "It is what it is" and focus on the net number in the bottom right hand corner of the pay advice. We mumble about the $30 copay when we take our kids to the doctor, but pay no attention to the EOB when it arrives in the mail and says the insurance company we pay every month paid an additional $120 for that same visit. With the stark exception of those families who have experienced grave illnesses or catastrophic accidents, average Americans don't have a handle on what they pay for healthcare because they don't really have to deal with it. Much of the structural burden of the costs is borne by someone else.

That will start to change on Tuesday.

On Tuesday, if nothing else, the launch of public healthcare exchanges will give every citizen an opportunity to examine the costs of healthcare up close and in person. Some will do the review and find that their employers are extremely generous when it comes to healthcare benefits. Others may find that they can free up some money each month by changing the way they buy their health insurance. Yet others may discover that they can afford health insurance because it is not as expensive as they thought.

Regardless of where you fall on the spectrum, the relationship between healthcare consumer and healthcare product will become a lot more direct this week. And the free market economist in me believes that, over time, it will prove to be a good thing.

Karl Douglass, Columbus native and resident, is a frequent commenter on local, state and federal politics. Follow him on Twitter@KarlDouglass or facebook.com/karldouglass.

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