Healthcare Cost Inflation Receding?

The Kaiser Family Foundation, who conducts one of the largest annual surveys of healthcare costs, released its latest study this week. It said that health insurance premiums increased "just" 5 percent in 2008 (very low by healthcare inflation standards). The 5 percent increase was comparable but somewhat lower than 2007's increase.

Despite the lower levels of healthcare inflation (after several successive years double-digit percentage increases), premiums have still more than doubled over the past decade. Overall, premiums for family coverage are now up to $12,680 and premiums for single coverage increased to $4,704. Employers pay, on average, about three-quarters of that cost according to the Kaiser study.

The annual cost of family health coverage has more than doubled since 1999, and employees are paying an average of $3,354 toward it in 2008. While employee co-insurance and co-pays continue to increase, employees are also are concurrently dealing with rising deductibles. About 18% are facing deductibles of at least $1,000, up from 12% in 2007.

The Kaiser study noted that rising health costs are most troubling for those employees working at companies with fewer than 200 employees, who have been less able to absorb the cost increases and have had to pass on a greater share of the cost burden to their employees.

The shift toward high-deductible insurance was most dramatic for workers in small businesses, where more than one in three covered workers must pay at least $1,000 out-of-pocket before their plan will start to pay a share of their health care bills. Generally, the more liability consumers assume for their health expenses, the less insurers charge for premiums, which probably is the biggest reason premiums are rising less quickly. Often, high-deductible plans are coupled with health savings accounts (HSAs). Consumers that enroll in such plans can set aside money on a pretax basis and then use the savings to help pay for some of their medical expenses.

"We may be seeing the tip of the iceberg of a trend towards less comprehensive, skimpier health insurance coverage for many working people," said Drew Altman, president and CEO of the Kaiser Family Foundation. Altman said the Kaiser survey shows more companies opting for health saving accounts. But a bigger trend was the movement toward high-deductible plans with no savings component.

So, while the rate of premium increases are going down, much of the slowdown in rate increases may be attributed to increased deductibles and/or reduced coverage levels, not necessarily to a slowdown in the core rate of healthcare inflation.

That said, there have been recent reports of a slowdown in demand for some health services including a small drop in prescriptions filled last quarter, preventative and elective procedures being delayed, etc. It will be interesting to see if healthcare costs follow the same laws of supply and demand that most other goods and services do. If they do, we could expect to see a slowdown in cost increase at the consumer level, not just a slowdown in premium increases via reduced coverage.