Chicago Daily Herald

People choosing their health-care plans might be in for a surprise this fall.

Area employees at large firms are likely to see their managed care bills jump an average of 29 percent, according to a survey by Lincolnshire-based human resources services firm, Hewitt Associates.

Those at smaller firms and the self-employed are likely to see their already-higher premiums increase even more.

Many employees also are seeing jumps in the amount they’re charged as a co-payment for office visits and prescription drugs.

And that’s not the end of it, according to Dave Fortosis, a Hewitt consultant.

“Unless something changes, prices will double in the next three to five years,” said Fortosis, a resident of West Chicago. “Companies are telling us that doubling costs is not an option. Some companies wouldn’t be able to afford it.”

Managed care advocates speculate that as prices begin to tighten their grip on companies and the comfortably-employed, that may be a catalyst for change.

“The breaking point will come when the middle class feels threatened,” said Jerry Flanagan, an activist with the Foundation for Taxpayer and Consumer Rights, a California-based non-profit active in health care issues.

Managed care prices have been rising faster than inflation for years but have accelerated in the last two years. The average Chicago worker at a large firm paid an average 18 percent more this year than last. Next year, the average employee of a large company would pay about $1,148 for single coverage.

In addition, the employee’s share of the total premium is going up 2 percent to 19 percent of the overall cost of the plan.

The other 81 percent is paid by the employers, who are seeing double-digit increases in their share of managed care costs too.

With the tight job market, employers feel less pressure to entice workers with generous plans, leading them to switch a higher percentage of costs to employees. Flanagan said.

Soaring costs have touched off a blame game. Insurers, health care providers, drug companies, employers and patients are wondering who’s getting rich?

Critics of the present system say consolidation of providers, insurers and drug companies has cut down on competitive pricing.

Insurance companies contend part of the problem is that prices were too low for too long, and some are trying to recoup, according to Larry Akey, a spokesman for the Health Insurance Association of America, a Washington, D.C.-based insurance industry association.

“We’re in a hard market right now,” he said. “We are seeing more insurers concerned about recovering costs than growing market share.”

However, Akey said insurance companies are simply responding to their costs.

If the costs are high, say those in the managed care industry, it is because the need is too. By some estimates, up to three- quarters of all medical expenses in the managed care industry is due to the one-quarter who are chronically ill.

Stories abound of illnesses, drugs and therapies not covered by insurers, often causing ill will toward the health maintenance organization or other plan.

Fortosis avoids blaming health care sectors. Instead, he recommends a variety of cures, from increasing a patient’s incentive to chose generic drugs to policies, such as subsidized physical exams, that keep employees healthier longer.

Still, other such efforts to forestall the coming managed health care crisis have proved elusive, as witnessed by the Clinton administration efforts in the mid-1990s.

“We believe that solutions will come to the consumer demanding quality health care,” he said. “How you get there we will have to decide in the next few years.”