I’ve been writing about employee benefits for the last couple of weeks. Of course, one of the most common and basic ones is health insurance.
As an employed physician, just out of fellowship, I had very little understanding of how medical insurance worked. Most of my premiums were paid for by my employer and depending on the bells and whistles I wanted, I could contribute more towards it. I am pretty healthy, and thankfully, so are my husband and children. So I cared very little about deductibles, copays, hospital coverage. I chose the lowest premium, highest deductible, with a health savings plan, to which my employer matched my contributions up to a couple of thousand dollars. It was great.
To add to my blissful ignorance, whenever patients tried talking to me about costs, I would tell them to call the billing department. If the billing department came back and said, "Mrs. So-and-so can’t/won’t pay," I’d tell them to write it off.
As a private practitioner, I have a much better (although not great) grasp of what patients mean when they say they can’t do this or that because of their high deductible. I understand that some of them have $50 copays while others have $5 ones. I know that some will cover everything and some practically nothing.
So as an employer, and a self-employed physician, I have to take all of that into consideration. I have to balance business expense and employee satisfaction. I could get the cheapest possible policy and save money for the practice, i.e. me. This could mean that my staff (and I) gets lousy coverage; that nearby physicians can’t see them because they don’t participate in the plan; and that they can’t get the meds or procedures they need. I could get the best plan out there, ensuring all our medical needs are covered with little out of pocket. Well, little out of their pocket. I, on the other hand, would be paying through the nose for premiums. Or I could only pay a portion of the premium and stick them with the rest.
I opted for something in the middle: decent coverage, moderate premium. I pick up most of the tab. I’m sure like everything else, this will evolve over time. Who knows where the healthcare system will be in a few years anyway?
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