The American health care system is complicated, and so are proposals to change it. The 2020 Democratic presidential primary campaign has focused a lot of attention on whether to preserve the private, job-based insurance system that covers 153 million people or replace it with a single-payer “Medicare for All” program that covers everyone.
In the past 10 years, the average premium for job-based health insurance that covers a family has risen 54%, to $20,756. Moreover, the amount of that premium workers pay for family coverage has increased 71%, to $6,015.
During that same decade, the share of workers whose health plans carry deductibles requiring them to pay hundreds or thousands of dollars in out-of-pocket costs before their insurance coverage kicks in has increased from 63% to 82%. The size of the average deductible has grown from $826 to $1,655.
At the same time, income hasn’t kept pace. From 2009 to 2019, earnings have gone up just 26%.
Given that employment is the single-largest source of health coverage in the United States, the increases go a long way toward explaining why Americans are so fed up with the current health care system.
U.S. workers and their families with employer-based insurance are paying more and more each year for their health coverage and for out-of-pocket costs, which is consuming a bigger share of their income.
These trends date back even further than the past 10 years, and costs have been rising steadily and outpacing workers’ incomes for decades, previous Kaiser Family Foundation surveys have found.
This year, the average family coverage plan employers offered cost 5% more than in 2018, compared to a 3.4% increase in workers’ earnings. That year-over-year change may appear less troublesome than the longer-term findings, but these relatively small increases in premiums for job-based health insurance have added up over time and have increasingly burdened workers.
In spite of these phenomena, voters may not appear eager to scrap the private insurance system, as Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.) have urged on the presidential campaign trail, according to a separate Kaiser Family Foundation survey conducted this month.
Although 53% of Americans say they view Medicare for All favorably, 69% have favorable views of proposals that retain the private health insurance system and implement other health care reforms, such as a government-run public option program that would compete with private plans.
Democratic voters strongly support both policies, with 77% backing Medicare for All and 87% favorably viewing a public option.
Although this poll and others suggest Democratic voters’ views are fluid, these findings suggest more may be sympathetic to the comparatively moderate approach that former Vice President Joe Biden and several other Democrats seeking the White House have proposed.
The same survey also found that 41% of Republicans support a public option and 20% favor Medicare for All. Among independent voters, 53% support Medicare for All and 73% support a public option.