Thrift Week, Day Four: Health care (or the lack thereof)

The scheduled topic for day four of Thrift Week is health care, which costs the average American household $2,976 per year, or 5.9 percent of total spending. Of course, this average figure is misleading. Some people pay far more, as this conversation on the Dollar Stretcher forums reveals. Our annual medical expenses, by contrast, come to less than half the national average.

So, you may ask, how do we do it? What thrifty strategies do we employ to keep our health-care costs so low? Answer: pure luck. For one thing, we are lucky enough not to have any serious health problems. But also, the Troll is lucky enough to work for an employer that provides a very generous health plan, for both him and his spouse, at a very reasonable cost. If he were ever to lose this job, we would be forced into the private health-care market, and our annual expenses (including premiums, copayments, and medications) would more than sextuple overnight.

So I can't offer any advice about how to be thrifty in the area of health care. Basically, the US has an absurd, arcane health-care system in which the quality of the care you receive and the amount you pay for it are determined almost entirely by luck. If you're lucky enough to have a good employer, or a good union, you will probably have a good health plan; if you're unlucky enough to be unemployed, or employed by a small company that can't afford a good plan, or employed by a big company that refuses to pay for a good plan, you won't. And because of the outcome of the Massachusetts election, there is pretty much no hope that this expensive, inefficient, and unjust system will change any time in the foreseeable future.