Austin Frakt has a PhD in statistical and applied mathematics from MIT and has published in the New England Journal of Medicine and the Journal of the American Medical Association. In other words, a real intellectual heavyweight. Yet he confesses in an NYT blog post: "I am a health economist, and I cannot rationally select a health plan."
The reasons are pretty simple. First, the plans are maddeningly complex. It is relatively easy to see the rates, deductibles and copays (I am not saying easy, just easy compared to what comes next) but very tough to figure out what you are actually buying. Which medical conditions are covered and which are not? If you need medical services, which providers are included in the network covered by the plan?
Second, you must buy the plan based on a forecast of what health services you think you will need in the coming year. Some are predictable (e.g., annual checkups) but many (perhaps most) are not.
Expect this issue to receive more attention in the future as more and more companies get out of the business of providing employee health insurance. Today's WSJ has a piece on how more and more small companies are doing this.
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