First, the bad news – “The Choice: A Longer Life or More Stuff”

The average cost of a family insurance plan that Americans get through their jobs has risen another 7.7 percent this year, to $11,500, according to the Kaiser Family Foundation. In only seven years, the cost has doubled, while incomes and company revenue, which pay for health insurance, haven’t risen nearly as much.

The article took an unexpected turn, however, when it didn’t reflexively blame insurance companies, greedy doctors, and pharmaceuticals.

There is no question that the American medical system does suffer from a lot of waste, be it insurance industry bureaucracy or expensive procedures that haven’t been proven effective. But the No. 1 cause of the cost increases is still the one you can see at the hospital and in your medicine cabinet — defibrillators, chemotherapy, cholesterol drugs, neonatal care and other treatments that are both expensive and effective.

So the prices have gone up a great deal, and with each new advance in medical technology, the price will continue to go up. My family is an excellent example of the kind of tradeoffs we make. We have health insurance through my husband’s employer. It pays 100% of covered costs – after the $5,050 deductible has been met. In practice, this means that we get no real coverage, but we do enjoy the discounts that Blue Cross has negotiated with our providers. Small things we just “tough out.” Going to the doctor for the flu or anything self-limiting is unheard of. Over the counter medicine and good old fashioned common sense usually do the trick. When we do have to go to the doctor, we ask for samples, and when we need an ongoing prescription, we ask for something cheap. At my request, the doctor discontinued a medicine that even in it’s generic form was $60 a month, in favor of an older drug that did the same thing which cost $4 a month. When something major is wrong, we have it treated and make payments if necessary, so there’s no real lack of health care when it counts – we just don’t baby ourselves.

The bottom line is that it’s all about choices. There are a lot of ways that the average family could adjust their budgets to afford more health care. Just one example:

Fast food consumption now accounts for over 40 percent of an average family’s budget spent on food.

From the NYT article,

Somehow, going to the mall to buy clothes has come to be seen as a vaguely patriotic way to keep the economy humming, and taking out a risky mortgage is considered to be an investment in one’s future. But medical care? That’s just a cost.

The difference is, we have developed the idea that health care is an entitlement instead of a responsibility. I’m not suggesting that we defund health care for the poor and elderly. But as the article points out, the average middle class family that complains about the lack of affordable health care has unreasonable expectations about what health care should cost, and chooses not to make it a budget priority. You get what you pay for.