Matt Mazurek, MD, MBA, CPE, FAAPL, FACHE, FASA

According to the Kaiser Family Foundation, in 2023, the average annual cost of employer-sponsored health insurance premiums per employee was $23,968 for family coverage and $8,435 for single coverage. Many employers also continue offering valuable telemedicine, mental health services, and wellness programs. Look at the graph below: Median income is more reflective of 'real' income, as higher income families skew the average significantly. I will spitball some numbers here and make some ratios: Median income: $76k Employer sponsored health insurance premiums: $8,500 single. $24k family. 24/76=31.5% Premium cost/median income 8.5/76=11.2% Premium cost/median income (Note: A single employee does not earn, on average, $76k. The average is around $60k). 😲 😲 😲 😲 😲 😲 😲 😲 Household out-of-pocket expenses (OOPE) for healthcare range from roughly $1,000 to over $5,000 annually (premiums and deductibles included). In some states, particularly the South, where median incomes are low, the percentage of household income paid toward healthcare is quite high--above 10%. How many households can afford these OOPEs for healthcare? A Gallup poll found that roughly 38% of Americans put off getting care due to cost. Most were lower income workers, women, and younger adults. Link to poll: https://lnkd.in/eY4Tvvmr These premium costs and OOPEs are dollars that could be invested in retirement, housing, education, community development projects, etc. Let's go back to the 1950's for a minute. Today’s consumer working at the average wage of $19.19 would only have to work 26.6 hours (a little more than three days) to earn enough income ($511) to purchase a toaster, TV and iPod. The equivalent products (in terms of their basic function, not their quality) would have required 4.64 weeks of work in 1958. In short, the “time cost” of these items has massively declined by 86% in less than 5 decades. What if we applied this kind of analysis to health care? The results are quite interesting. In 1958, per capita health expenditures were $134. This may seem astonishingly small, but it actually includes everything, inclusive of care paid for by government or private health insurers. A worker earning the average wage in 1958 ($1.98) would have had to work 118 hours—nearly 15 days--to cover this expense. By 2012, per capita health spending had climbed to $8,953. At the average wage, a typical worker would have to work 467 hours—about 58 days. In short, while time prices for other goods and services had shrunk to less than one quarter of their 1958 levels, time prices for health care had more than quadrupled! The percentage of GDP the US spends on healthcare in and of itself is a problem not only due to the unsustainable spending--but how much does this cost future generations who are not receiving the same level of investment as prior generations?

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