Other WA Resourcess   

                                      Health Insurance Washington  

         Robert S. Mori, CPA, President     7429 East Heather Way, Everett, WA  98203-5424

Health Insurance Washington             

Health Insurance Washington , or Washington Health Insurance is defined as the contractual agreement between an insurance company doing business in Washington  and the insured whereas the insured pays to the health insurance company  regular payments over a period of time in exchange for the assurance that the insurance company will hold the insured indemnified against healthcare costs.  Health insurance plans in Washington  pay the bills from healthcare providers such as physicians, hospitals, lab companies, pharmacies and other providers of medical services. By doing so, health insurance protects people from financial hardship caused by large or unexpected medical bills

People obtain health insurance from private organizations or from government agencies. In the United States private organizations have traditionally provided the vast majority of health insurance coverage. The U.S. government operates some publicly funded health insurance programs but access is limited to specific groups, such as the poor and the elderly. Most Americans obtain private health insurance through their places of employment. Increasingly, though, employers are withdrawing from being the sponsor of such plans and are requiring that employees make their own decisions on how they obtain health insurance.  

Americans pay the cost of health insurance in a variety of ways. Workers may pay for private health insurance by authorizing their employers to deduct a specified amount from their paychecks. Alternatively, individuals may work for employers who pay the direct costs of health insurance. People who do not receive health insurance through their jobs or through government programs can purchase private health insurance policies by paying premiums directly to an insurance company.

Health Insurance in Washington is a costly enterprise.   The severe and continuing escalation of Washington health care costs over the past 20 years is a matter of immense concern to virtually all segments of our state.  Washington State and local governments are having  to wrestle with these inflating costs in the face of smaller growth rates in tax revenues.  Private businesses are having to  ration out and prioritize employee benefits because the costs of Washington health insurance policies are running at inflation rates of high single digits or double digit increases year after year when  companies' ability to increase revenues are not at similar growth rates. The cost of health insurance in Washington is causing great financial stress to both  public and private sponsors of medical expense benefit plans, with the private sponsors being especailly hard hit. Yet, despite much rhetoric, there is little evidence of lasting solutions being developed.   

It is true that enormous changes have taken place in the delivery,  financing, and organization of medical care in recent years.  Some years back there were those  who claimed  there was some "light at the end of the tunnel" in the seemingly endless battle against soaring costs thru  the solution of manage care plans.  Since then, some of the more extreme examples of managed care such as HMO's have become less popular and total health care costs have continued to rise more rapidly than the overall consumer price index (CPI) .  In any case, the aggregate costs are staggering. 

By several measures, health care spending continues to rise at the fastest rate in our history.  .The National Coalition on Healthcare reports as follows: 

"In 2007, total national health expenditures were expected to rise 6.9 percent — two times the rate of inflation.¹ Total spending was $2.3 TRILLION in 2007, or $7600 per person.¹ Total health care spending represented 16 percent of the gross domestic product (GDP).

U.S. health care spending is expected to increase at similar levels for the next decade reaching $4.2 TRILLION in 2016, or 20 percent of GDP.¹

In 2007, employer health insurance premiums increased by 6.1 percent - two times the rate of inflation. The annual premium for an employer health plan covering a family of four averaged nearly $12,100. The annual premium for single coverage averaged over $4,400.^2"

^{These numbers , taken in the context of the ongoing and acrimonious debate in Washington DC over how to control the costs of Medicare and Medicaid, suggest there is  much remains to be done before victory can be claimed in the battle over health care costs.}

^{Health Insurance Washington  State Cost  Containment and Control}

^{The issue of cost containment  for Washington  State Health Insurance continues to occupy center stage at both the public and corporate policy levels.  Benefit innovations are continualy introcued, seemingly limited only by the imaginations of plan designers .  Some of the innovations are soon discarded, having proved to be either ineffective or so offensive as to be impractical.  Others work and become part of a new "tradition".} 

There are only a few basic approaches to effective control of the cost of  health insurance Washington. One  approach is to control  the cost of each factor that goes into the list of benefits.  Example: require that plan members use generic drugs instead of brand name when there is an effective generic available.  Another approach is to study the treatments implemented and the outcomes of medical care from various providers.  Only those with the best cost effective treatment regiments  are included in the preferred provider list.