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Who loses in a rigged game of high-deductible health plans? American workers, every time

A March 1 Forbes story on the rise of high-deductible health insurance plans compares insurers to street-corner grifters. Hear, hear!

We’ve all played three-card monte, right? Three cards face down; pick the queen and win the green. Why is this game so successful? Because the marks (the suckers who step up to play) believe they have a fair chance of winning. The naïve players never come out ahead—in fact, they rarely (if ever) break even.

Here at Un-covered, we feel like we’re having a mind-meld with the folks at Forbes. Their article posits that insurers got spooked that businesses might not be able to afford to pay high annual premium increases. So, according to the article, the insurers came up with a shady hustle to shift costs from employers to employees and preserving their own massive profits. In 2007, these high-deductible health plans (HDHPs) accounted for just 5% of all employer-based plans. Today, that number is at 51%.

The article breaks down the players in the so-called “con” of HDHPs, in which employees must pay off substantial annual deductibles before insurance will start paying for health expenses. It also explains how we got to a point where employers can transfer the soaring cost of insurance plans onto employees.

We thought Forbes’ comparison of card sharks on the street corner to executives in the boardrooms of large health insurance companies was very clever. Forbes says they share the same key roles: The dealer runs the scam (insurance companies). The marks fall for it (consumers). And the shills in on the scheme help make it look legit (employers).

As regular readers know, we don’t see insurers often losing when it comes to money. Whether it’s due to a delay in care, rolling back coverage for telehealth services, or refusing to cover emergency care, the house seems to always win in the end.

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