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Posted on 11/12/2025 4:59:16 PM PST by E. Pluribus Unum
Higher education institutions are confronting surging health plan rates and costs that erode revenues and exacerbate tuition pressures. Colleges and universities allocate billions of dollars annually to student and employee coverage, often mired in inefficiency and unchecked inflation. Projections for 2026 forecast premium escalations of close to 10 percent nationally for employer-sponsored plans, while some carriers issue renewal quotes exceeding 18 percent. This means that a mid-sized university insuring 400 full-time employees, and averaging $27,000 annually per family, will now face costs exceeding $10.8 million for employee coverage alone. Proven alternatives and strategies to combat these cost escalations include direct primary care (DPC), campus clinics, AI-driven payment integrity, and collaborative health consortia. These solutions can deliver savings of 15 to 30 percent with enhanced clinical outcomes.
This myopia stems from the entrenched legacy structures of higher education, which engender profound resistance to innovation. Education administrators tend to gravitate toward their incumbent health insurance plans because they are perceived as reliable or they simply trust their broker. The repercussions prove systemic: provider overpayments comprising 5 to 10 percent of claims, procedure payments one hundred to two hundred percent higher or more than Medicare rates, disproportionate reliance on high-cost emergency departments due to primary care barriers, and negligible negotiating leverage vis-à-vis insurance conglomerates. With all of this inefficiency, waste, and potential fraud, colleges now have to face renewal quotes climbing well over 10 percent.
As a higher education executive with extensive experience in designing and optimizing health systems, I have developed and researched solutions for organizations that yield cost reductions of 15 to 30 percent, accompanied by enhanced clinical outcomes, including decreased absenteeism, increased satisfaction among students and faculty, and robust preventive care paradigms. One such solution is DPC, which supplants health insurance's "middle-man" approach, connecting doctors...
(Excerpt) Read more at realcleareducation.com ...
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If higher education were forced to live by the rules they have spread through their indoctrination things would change. Every deadly stupid insane murderous idea comes out of a college.
The system that has been created to pay hospitals, doctors, and nurses was started in the 1930s with the best of intentions.
It has taken many steps, between 1948 and now to get us to the point of collapse - but here we are.
There is no way out.
In the 1950s health care costs were 5% of GDP.
Then government got involved.
Today they are almost 20%.
Projections for 2026 forecast premium escalations of close to 10 percent nationally for employer-sponsored plans, while some carriers issue renewal quotes exceeding 18 percent.
And you can thank obummercare....
Government has been involved since employee benefits were exempted from WW II wage and price controls, and since the Hill-Burton Act in 1948. Medicare in 1965 was always a fantasy - it’s taken this long to fail, and both parties are equally guilty.
It’s time to bury what we have - it is not surviveable.
« And you can thank obummercare... »
You can thank Medicare.
If higher education was in a competitive market without government subsidies and tuition guarantees, they would be a lot more leaner, efficient and productive.
When Medicare was created in 1965, a healthy country would have started coverage from birth to age 18, instead of >65.
The distortions created by funding enormous expansions of care for a population headed for the Eternal Care Unit are no longer sustainable.
It’s over.
Direct Primary Care doctors who do not accept medical insurance have shown the way. They can get diagnostic tests done for pennies compared to getting the same tests through the same labs through a hospital. And they can actually look out for the best interests of their patients instead of being forced to follow protocol$.
Info from google ai as fyi. Huge huge difference in how much people actually paid for healthcare out of their pocket in the 1950s vs now. Good and bad.
“1950s
In the 1950s, health insurance was a newer concept, and coverage was less comprehensive:
Overall Coverage: In 1950, insurance covered just 12% of total private consumer health expenditures; this increased to about 33% by 1964.
Surgical Coverage: While surgical benefits were a core part of early plans, along with hospital care, individuals were still responsible for a substantial portion of the bill. In 1955, voluntary insurance benefits covered about 23% of the aggregate personal expenditures for all medical care and health services.
Out-of-Pocket: The majority of healthcare expenses, particularly for physician services outside of surgery and hospitalization, were paid for directly by the patient out-of-pocket. The prevalence of direct payment meant patients were more connected to the actual cost of their care.
Now (2020s)
The modern healthcare landscape is fundamentally different, with insurance covering a much larger share of the total cost:
Overall Coverage: In 2020, out-of-pocket spending represented only about 10% of total health spending, a massive flip from the mid-20th century.
Surgical Coverage: For typical operations, modern employer-sponsored plans might cover 80% to 100% of the negotiated cost after a deductible is met, with patient responsibility limited to deductibles, copayments, and coinsurance.
Out-of-Pocket Maximums: A key difference is the implementation of annual out-of-pocket maximums in most modern plans, which limit a patient’s total financial exposure in a given year, a protection largely absent in earlier, less comprehensive policies
My mom passed this morning from dementia. In the last year she’s racked up well over $1,000,000 in costs to Medicare.
L
In 1962, my mother would take me to the doctor (an MD) and the bill would be $5.00 which she paid at time of service. That $5.00 in 1962 has the purchasing power of $53.00 today. There was no insurance involved in the transaction.
My most recent (2025) visit with my primary care provider (a PA), the bill total was $817 for a routine exam. Insurance covered $667.69 and I paid out of pocket $139.31. I spent about 15 minutes with the PA, and less than 5 minutes with the nurse who took my vitals prior to the PA. There was routine bloodwork associated with the visit which cost $40.00.
My family medical doctor 1962 was in a solo practice. His only employee was a registered nurse. His office was located in a small 5 room addition to his home in a rural village.
My physician in 2025 (a PA) works for a hospital system that bought the practice about 10 years ago from the 6 MD’s who started in the 1980’s. The practice currently is housed in a spacious stand alone clinical building with a huge waiting room, multiple exam rooms, a lab, and an X-ray machine. There are 10 physicians or PA’s who attend patients, several nursing assistants (not RN’s), and at least 8 administrative people who man the reception desk or are scattered around the building staring at computer screens. In addition to pay a physical charge and a clinic charge I pay an outpatient hospital facility fee even though the clinic is located several miles from the hospital.
The family doctor in 1962 had almost no overhead and little administrative burden since most patients (rural farmers) had no insurance and paid cash at time of service. The clinic today has a huge administrative overhead which undoubtedly is a significant part of the bill plus there is the cost of overhead and profit associated with the insurance company.
In 1962 two people were involved in my care, the physician and the nurse. In 2025 a huge administrative hospital and insurance bureaucracy is supported by my payments for a simple physician visit.
Is my health care significantly better than it was in 1962? From my perspective, than answer is no. Yet the cost is astronomically higher.
They have too many non-teachers
My mom passed this morning from dementia. In the last year she’s racked up well over $1,000,000 in costs to Medicare.
A $50/hour nursing coverage 24/7/365 one-on-one is $438,000.
Good points. We are quite lucky in this day and age to be able to get transplants, etc.
Might be $35K/hospitalization on average for the hospital.
“averaging $27,000 annually per family”
More than the typical pay of a typical Walmart associate.
Not just higher education.
Check out your local school district’s budget...
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