Credit: WorkLife Partnership

Health Insurance Needs to Grow Up

Kim Bellard
5 min readAug 1, 2020


I’ve been covered by private insurance my entire life. Even more telling, I worked in the health insurance industry for — gasp! — some thirty years. It’s not just paid for my healthcare, it’s financed my life.

Today, though, for the first time in my life, I’m covered by public insurance — and I couldn’t be more relieved.

Now, I’m not going to go all Wendell Potter. I know many people have their health insurance horror stories, but, sadly, people have them about pretty much every part of the healthcare industry. I believe most people working in health insurance, like most people working in healthcare generally, sympathize with the people they serve and are just trying to do a good job.

The problem is that the health insurance model has outgrown the times. I’ll try to explain some ways how.


Once upon a time, most people had employer coverage, and those employers paid all or most of its cost. Those days are gone. Employer coverage is still the predominant form of private health insurance, and employers still pay the majority of its cost, but percentage of people with employer coverage continues to drop and the amount they pay for it continues to increase.

Kaiser Family Health’s 2019 Employer Health Benefits survey found that annual premiums for family coverage topped $20,000, with employees paying $6,000. The average income for workers is $48,000. Those premiums are awfully daunting — yet people in the individual market would long for those numbers.

The fact is, premiums have become unaffordable for most Americans. If you have a marketplace plan you might quality for a premium subsidy, and if you have employer coverage your employer might vary contributions by salary, but there’s few of us who don’t take a gulp at every premium payment, especially given the prospect that they’re only going to keep going up.

Our scattershot, segmented, and inequitable mechanism for financing health insurance is no longer sustainable. We need a more universal financing mechanism — such as taxes — that is based on wealth/income/ability



Kim Bellard

Curious about many things, some of which I write about — usually health care, innovation, technology, or public policy. Never stop asking “why” or “why not”!