Average Out-Of-Pocket Spending For Families

The paper by Jon Gabel and colleagues (Web Exclusive, 2 June2009) documenting the 34 percent increase in out-of-pocket spendingfrom 2004 to 2007 was interesting. It certainly quantifies people’sfears, in that Americans reported that their number-one concernabout health care was cost in an Accenture study in 2008. However,although a 34 percent increase in out-of-pocket spending soundspretty sobering, the actual average dollar cost of about $700reported in the paper seems like a real deal. In fact, I thoughtto myself, "Wow, I’d be happy if my family’s out-of-pocketexpenses were that low!"

Then I realized that this number is per person for an adult.We are a family of five: three teens and two adults. The deductiblealone for our UnitedHealth policy is $1,300 per individual,not to exceed $3,900 for everyone all together. So, before anyonein our family begins to get coverage for illness, we have tospend $1,300. Then, of course, there follows a 20 percent copayment.There is maximum out-of-pocket protection at $2,700 for an individualand $5,700 for the whole family (but this is much higher ifwe use out-of-network providers). As you can see, this dwarfs$700.

In addition to the deductibles and copayments, my "out-of-pocket"share of the premium deducted from my paycheck was about $2,700in 2008. It should be noted that these numbers come from whatwould be deemed the "richest" United plan (a preferred providerorganization, or PPO) that was offered to its employees.

So, as you can see, $700 out of pocket sounds really good—andreally low. I am wondering if you have a sense of what the averagefamily is spending out of pocket for their health care, includingtheir share of the premium?

Laura Clay Trueman
Independent Consultant, Health Advocacy and Policy, Oakton,Virginia

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Average Out-Of-Pocket Spending For Families