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The Health-Care Industry’s Relationship Problems
The New Yorker

When I became a doctor, last year, I had to sign up for health insurance. The hospital where I work offered two primary options, a Value plan and a Plus plan. One cost less up front, while the other promised more benefits. I didn’t know which to choose; after factoring in co-pays, deductibles, and variations in coverage across networks of doctors, it wasn’t clear which would be more economical. Ultimately, I enrolled in the Plus plan, the product of guesswork more than reason.

At the start of November, the open-enrollment period for plans on U.S. health-insurance exchanges will begin, and millions of Americans will face a similar struggle. As consumers, we’re accustomed to making informed choices about what food to eat, what car to drive, what school to attend. But health insurance is a striking exception. Only one in seven Americans understands the basic components of a health-insurance plan, according to a study published a few years ago in the Journal of Health Economics. That means most of us are signing up without knowing what we’re getting or what it’s worth.

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