A. New procedures are more expensive.
B. Liability insurance costs have gone up.
C. Coverage includes a wider range of optional procedures.
D. We're keeping people alive longer with a lot of the new proedures in A.
E. There is a growing population of old people and a shrinking population of young people.

I'm not sure which one, if any, factor is the prime culprit
but I'd venture to guess that even if you eliminated B and C, costs would still be rising albeit at a slower pace.

Fact of the matter is I don't think most people have a clue. Ask a doctor, he'll say it's tort. Ask an HMO admin they'll say other A. Ask a lawyer, they'll say it's insurance provider greed. It's like trying to find out how many licks it takes to get to the tootsie roll center of a tootsie roll pop.

And I think the arguement that birth control shouldn't be covered is rich, since asking women to pay out of pocket to avoid pregnancy will certainly ensure that women have access to reliable birth control. Don't want to get pregnant? Abstain. You don't need sex to survive. And if you do get pregnant, guess what, you either have to pay for the abortion or the kid. Boy, that's choice I tell ya.

Snarkiness aside, I think her arguement is flawed since there is only so much extra one can really cut from a health care plan. Sure, I'm a healthy woman of childbearing age, and I'd love to cut those seniors who need expensive medicines and care right out of my insurance group. I mean, why the heck should I subsidize granny's care so she can live an extra few years when she isn't productive? In other words, without my subsidizing granny's 15 prescription medications, granny wouldn't be around for too long.

In other words, I just think there's different usage patterns doesn't mean the differences are less worthy. While young adults don't normally need require intensive health care, my kid does. And so does granny. And the old guy who takes medicines which has sports figures as spokespeople.

Her argument is that people should be able to choose plans that are more "no frills" if that's what they desire--or all they can afford. If states require companies to cover everything that's "nice to have," then they have to charge enough to cover all that.

It seems to me that radical treatments like in vitro fertilization--which I have no objection to as a matter of principle--shouldn't have to be covered. Ditto addiction treatment. But if you want a plan that covers those things, then you should be able to pay extra for them.

Let's go universal! That way we can ALL pay through the nose for a health plan that won't provide any service!

Seriously though, as I said above, the crux of the problem may be things we may not have control over. In twenty years you'll have lots and lots of old people and not too many healthy young workers.

Let's go universal! That way we can ALL pay through the nose for a health plan that won't provide any service!

Seriously though, as I said above, the crux of the problem may be things we may not have control over. In twenty years you'll have lots and lots of old people and not too many healthy young workers.

Let's go universal! That way we can ALL pay through the nose for a health plan that won't provide any service!

Seriously though, as I said above, the crux of the problem may be things we may not have control over. In twenty years you'll have lots and lots of old people and not too many healthy young workers.

Let's go universal! That way we can ALL pay through the nose for a health plan that won't provide any service!

Seriously though, as I said above, the crux of the problem may be things we may not have control over. In twenty years you'll have lots and lots of old people and not too many healthy young workers.

Drug costs have gone up significantly as well, due to both the increased complexity of the drugs themselves and the R&D needed to develop them. In many cases it costs 10x as much to develop a typical new medication (celecoxib was given as an example) as it did 20 years ago, thanks in part to increased FDA regulations and costs of doing clinical trials. There are also significantly more failed trials than before. And, many "obscure" diseases are receiving significant R&D--which I think is great but it's someing we all end up paying for.

The average 35-year-old is receiving about the same amount and types of health care he/she would've been 15 years ago, with the exception of mental health. (Most health care plans either no longer cover psychiatric or psychological treatment at all, have a very high deductible, or have a low yearly ceiling.) Not really a surprise. Cutting corners (outpatient surgery the most blatant example) have kept some of the costs down, but this has been more than offset by other factors.

The big shockaroo in the under 50 age group is the number of people developing type II diabetes. Treatment is a significant chunk of money, and it's expected to become a $250+ billion industry in 10 years (total cost right now is approximately $120 billion, or about 11% of the total health care bill in the US). Number of diabetics will at least double in that timeframe. Even worse, since we'll inevitably have plenty of noncompliant people we'll also be dealing with lots of 60 and 70 year olds with neuropathy, retinitis and other chronic illnesses, not to mention people becoming full-blown diabetics and the associated costs.

The sad part is the majority of these cases are preventable. Simple answer: lose weight! The connection between type II diabetes and being even 10% overweight is unarguably clear.

Anyway, I hope that helps to explain a few things. While it's fun to try to blame X, Y or Z the reality is there are a ton of reasons why costs are going up, many of which are unavoidable outcomes from increased technology. The one hope for us healthy folks is that the insurance companies will also become better at predicting who will get sick and will start charging appropriate premiums (the idea is to encourage people to live healthier lifestyles or pay the price--literally).

I pay for my own insurance, and I pay about $60 a month for a $1,000 deductible PPO plan. (I'm 35, nonsmoking, nondrinking, non-drug-using, athletic, no chronic health problems. Ideal person to insure from the health insurer's point of view.) I rarely go to the doctor except for yearly checkups, but the insurance is well worth it in case of a major health problem. Otherwise the insurance is effectively worthless for me in terms of paying for my average health care costs since they're far under $1k a year. (I even had a couple of cysts removed a few months ago and I'm still going to end up way under my deductible.)

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