Health care money and the CSA

The amount of money flowing into health care is a continuing national story. Talking it over recently after the latest rate hike from our insurance company, we realized just how tightly our lives as farmers are tied into this system, both for better and for worse.

On the positive side, we calculated that  ~40% of our CSA households have at least one person employed in health care or supporting roles (and we don’t know what a quarter of our members do for a living). So in that sense, health care spending is creating many decent jobs that allow consumers to spend money on businesses like ours. We might not be in business if it weren’t for the health care industry centered in Columbia.

On the negative side, rising health care costs hit us hard as self-employed business owners. Our insurance rates have been rising steadily for years (25% increase this year alone); we’re about to be paying over $4,500/year for a bare-bones high-deductible plan with no dental/eye coverage, even for two young, healthy people running an organic farm. We’ve never actually drawn on this coverage, paying for all our routine medical visits (as well as premiums) out-of-pocket. In other words, about four full CSA shares do nothing but pay for health insurance that we’ve never used but have to have just in case. It’s actually more than that when you account for the fact that CSA shares aren’t pure profit; they cost money & labor to produce. We can only spend the profit margin from a share, not its retail value, on “optional”  budget items like health insurance, so in reality a whole lot more than 4 shares go to pay for health insurance alone, before anything’s left over for us to live on.

So what to make of this? Our long-term hope is that Big Health will eventually figure out the value of focusing medical care on long-term, preventative care rather than short-term reactive care, and start to put more emphasis on really encouraging healthy living and/or fighting the worse abuses of the current food system. We know of one insurance company in Wisconsin that offers discounts to CSA members (even requiring the farms to be organic!); that’s a great start, but wouldn’t it be nice if direct-market farmers making healthier diets possible could get a break, too? Instead, as self-employed small business owners, we’re being asked to shoulder the financial burden for lots of newly insured sick/unhealthy people, in combination with the overall steady increase in costs & spending, with no appreciable return benefit for our lifestyle and business choices. It’s a heavy load, even if it creates customers for us. Hopefully our experience shows that individuals in health care are starting to recognize the value of healthier diets and lifestyles, and can eventually start to put some bottom-up pressure on the system.

4 thoughts on “Health care money and the CSA

  1. I definitely agree with your thoughts in this post. Luckily, there has been a big shift especially in the last couple of years toward “Population Health” and managing the health of a population – echoing the idea you mentioned of preventative care. More health insurers are moving toward rewarding those who practice “healthy” living and providing them with some sort of benefit or money back for electing to living in a health way – if you don’t smoke, exercise regularly, maintain a health weight, etc. It would be great if there was a way to better incorporate healthy eating choices. I haven’t seen that included yet but I hope we will get there because it is vital to our health. I am excited to see this trend move forward and evolve because it is definitely the correct way to go.

  2. Hey Eric,
    I’m in the process of switching my health care plan right now to a health savings account. It’s going to provide me with basically the same coverage (high deductible, major medical insurance) that I’ve had before but is significantly less expensive. We use Kasmann Insurance (a local company in town right near the library). Give Bill Kasmann a call if you want to look into it. Our family has used them since before I was born. All of our insurance is with them.
    Stay cool out there this week!!!

  3. Liz,

    We’ve had an HSA for years, and really like the concept, but the premiums have still been insane for us. Thanks for the reference; our plan was to spend some time this winter shopping around, so this is a very helpful lead. Thanks.

  4. And…we just got a notice that the monthly minimum balance necessary to avoid monthly fees on the HSA bank account is going up to $4,850. (That amount is more than we can even legally deposit into the account for a single year.) Interest rates have also plummeted since we moved the account to this bank. Sigh.