There is an ongoing debate in American health care about this: Does asking people to pay more for their own health care turn them into better customers, who spend smarter and thereby help bring down costs? At the same time, the American people have made pretty clear that the costs they already have to pay for their health care are weighing them down. They want plans with cheaper premiums and lower out-of-pocket costs.
Some economists, and many Republican politicians, argue that people should have plans with higher deductibles (and tax-preferred bank accounts to pay them) — so that they have more "skin in the game" with their health care. The thinking is that if you have to pay more of your own money for your health care, you'll be a smarter consumer. Obamacare got at this idea by introducing a "Cadillac tax" levied on the most generous tax plan. It was expectedthat many plans, like the WGA's, would then tighten their benefits and that would drive down costs by forcing people to be more discerning in their health care choices.
The union, as might many Democrats, would counter that this doesn't actually work in health care. There's a big difference between comparing the price of different refrigerators and the price of different surgeries. (My colleague Sarah Kliff detailed her own experience trying to shop for an MRI and how difficult this can be.)
That's the same argument the Writers Guild makes against the Cadillac tax itself:
The supposed motivation of the tax is to force patients to think as consumers, which is both misguided and ill-founded. It is misguided because price comparison shopping is neither practical nor desirable for a sick and worried patient. It is ill-founded because the price information is not available to a patient seeking care. Cost management can be done by plans, but it won't be achieved by forcing them to cut benefits to avoid a bankrupting tax.
There's also pretty good research indicating that high-deductible health insurance doesn't actually encourage people to shop around. If anything, they just decide to skip out on care.
The writers' union also says it is already taking steps to reduce health care costs. Its plan encourages writers to utilize a special network of doctors and specialists with which it contracts, a common practice for plans to lower costs. It has rejiggered its prescription drug benefits to prioritize lower-cost medications first and moving to more expensive drugs only if the cheaper alternatives don't work.
It's put what it calls "reasonable" caps on how much it will pay for mental health treatments — which, as you can see in the chart above, is a fast-growing part of its medical bills. A federal law, passed in 2008, required health plans to cover behavioral health services as robustly as they cover ordinary medical care.
Yet, even after taking those steps, the cost problem clearly hasn't been solved.
The same thing happens on a national level. We don't yet have a systematic solution to lowering costs for the whole country. We're trying a lot of things — shifting away from paying for each individual service to paying a group of doctors for treating one patient or paying based on the quality of care provided. Encouraging people to try lower-cost treatments first. Trying to keep people healthy rather than treating them only once they get sick.
These are a lot of the same things the WGA is trying. But there isn't a silver bullet — even with this year's Saturday Night Live finale at risk.