The Washington Post’s story was puzzling. Nowhere did it report that average annual premiums had now reached $15,000—a curious omission indeed. Instead, the paper focused on workers getting less coverage, with half of those working for small firms facing annual deductibles of $1000 or more for their individual policies. “Employers seem to be turning to cost-shifting as an alternative to dropping coverage outright,” the Post concluded. As proof it laced its piece with boring anecdotes—one from an employer agonizing over making its workers assume greater costs and one from a patient who had a hard time paying them.
The NewsHour presented an elliptical discussion between host Judy Woodruff and analyst Susan Dentzer, who once reported for the NewsHour. Dentzer talked some about chronic disease driving up health care spending, noting that insurance isn’t the thing that’s really pushing up the increase right now. Rather, the underlying cost of health care is the culprit. Well, yes that’s true. Dentzer did say that there’s downward pressure on health spending and on insurance, and that could be beneficial. That was as close as the NewsHour came to explaining my disconnect problem. At the end, Dentzer said: “We will have to see what happens when subsidies begin to kick in and other things take effect to broaden insurance coverage.”
Woodruff brushed this comment off with a brief “a lot of factors at play.” But Dentzer’s remark cried out for explanation. Guess what will happen when millions of newly insured people seek medical care? They will use more services, which will increase spending. And what happens when insurers must cover everyone even those at death’s doorstep? What will happen to premiums to reflect the added risk to the carriers?
In sum, the reportage emphasized different points, plucking different quotes from Altman and different details from Kaiser’s report, which, if strung together, would have provided a terrifically illuminating picture of health insurance premiums. The price of insurance is key to whether or not health reform works. It’s a continuing story that involves tons of dot connection to get it right. Reporters almost need to think like litigators who must know where every piece of the evidence is buried.
As I combed through the coverage, I recalled another stat about health insurance premiums. As the health reform debate wound down, the insurance industry issued another of its studies designed to influence the outcome. This time it was a study from the consulting firm PricewaterhouseCoopers, which found that several provisions in the legislation would help drive up the cost of insurance. Its report showed that the cost of an average family policy, then costing about $12,300, would zoom up to $15,500 in 2013 under current law and to $17,200 if all the provisions were implemented. Reform advocates and the White House attacked the study, and the media reported almost gleefully that the industry had discredited itself. Perhaps the study wasn’t so farfetched after all.