One of the many many ways that the health insurance market doesn’t act like “real” insurance is through the use of self-insured plans by most large employers. When a plan is self-insured, it means the employer is paying all of the health care costs plus administration costs—not “just” premiums.
It took a proofreader to remind me the other day about how confusing so much of health care jargon is out there. On a comparison chart, the edits noted “Wouldn’t it make sense that the preferred drugs are the most expensive?” The widely-adopted “preferred brand name” and “nonpreferred brand name” labels are very common in prescription drug benefits. But, preferred by whom? “Preferred” drugs are preferred by the plan because they are less expensive or have better outcomes than other brand name drugs that may be highly-advertised (and may be “preferred” by the patient) but more expensive for the plan. It is no wonder employees are confused by these labels—they are created from the perspective of the plan, not the patient.