The Brown Family — Belmont, California

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Brad Brown still is scraping together enough money to buy health insurance for his wife and two children. But it is getting more difficult with every increase, and the relentless rise in costs – the most recent was 45 percent – is depleting not only his bank account but also his faith in the system.

"You have to stay positive, but we are both cynical as hell,’ Brad says of himself and his wife. "Blue Cross‘s attitude is, pay it or don’t; they’d love to have you fall off."

Brad has reason to be cynical. A 49-year-old licensing agent, he is self-insured. He signed on with Blue Cross, a PPO account for himself, his wife and his two grade-school aged children.

He has watched his rates climb steadily. Two months ago, the deductible shot from $2,000 per person, per year to $2,500 per person. As the deductible increased, the coverage lessened, with Blue Cross paying a smaller percentage of the costs.

In addition, the premium went from $356 bi-monthly for all four to $498 – a 45 percent jump that tacks on $852 to the yearly bill.

It would be an understatement to say that Brad was angry at his family’s shoddy and arbitrary treatment. But with an active family, he felt he had to maintain coverage in case of catastrophe. "I have two young boys who like to throw themselves off things," he jokes. "I can afford to pay $2,500; I can’t afford to pay $25,000" for a major injury or illness.

Brad may have to hold on to coverage, but he doesn’t have to like it, and he wants to see changes made. He sees the health care industry ripping off consumers in numerous ways.

For one thing, the cost increases have nothing to do with his family’s actual use of health care. "We have not had any major surgeries or large claims." To Brad – and many others – it looks as though they are paying for services not rendered. If for some reason you leave or change to another outfit, that represents pure profit. "If you’re out of there and never had a major claim, they’ve taken your money – a significant amount of money."

The amount of the increases as well as their frequency also need to be checked, he says. "You just get clobbered," he says. And nobody stops these outfits. "Why do they do this? Because they can," he says.

"It needs to be regulated," Brad says. "You can’t trust private industry to regulate itself. You can’t give Enron the keys to the building and say, ‘don’t steal anything.’"

Brad would like to see the government conduct a cost analysis that would regulate coverage as well as costs of premiums and other medical expenses, such as deductible. "They’re trying to get everything they can," he says, and "until the government steps in" they will continue to do so.

"We paid our dues for the American dream," Brad says, "and we’re getting hosed. What the hell happened?"

Consumer Watchdog
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