The momentum toward health insurance reform at the national level will be enhanced during this employee enrollment season. The New York Times “Employers Offer Workers Fewer Health Care Plans” reports that more than 100 large companies are providing only high deductible health plans, and companies still offering traditional plans are asking employees to pay much higher premiums. High deductible is of course a matter of degree. WellPoint (WLP) has complained that typical employer high deductible plans did not exert enough pain to change employee healthcare spending behavior. WellPoint said that employer contributions to health savings accounts made the unfunded gap before insurance kicked in too small. Without additional incentives for employees to reduce healthcare spending, UnitedHealth (UNH) and WellPoint said they needed to raise premiums on high deductible plans.

The Times is telling us that Nissan (NSANY) and Delta (DAL) have gotten UnitedHealth and WellPoint's message; they are offering only high deductible plans. (I don’t know which insurance providers Nissan and Delta actually use.) One Nissan plan has deductibles of $2500 per individual and $7500 per family; however the premiums are only $35 per single worker and $100 per family. Nissan funds $1600 toward a family’s health savings account. At this level the pain is becoming more severe. Nissan benefits director Marlin Chapman says that high deductible plans get people to focus on good health and watch their healthcare spending.

Delta spokeswoman Betsy Talton’s reasoning paralleled Nissan: “We felt it was important to offer a plan that encourages participants to manage their health care and maintain their health and enables them to get the most out of their health care dollar. We find that when people get engaged in their health care they generally get healthier.” The trouble is that in order to manage their own healthcare, patients would have to tell their doctors which services they want to purchase – impossible today.

I previously wrote that medical service providers put up so many impediments to compare prices that it is impossible to shop, and even the health insurers themselves refuse to reveal their negotiated rates. So consumers have to wonder; what is the objective of this conspiracy? The only logical conclusion is to pass healthcare costs into the future, to the next employer or government agency until it eventually lands on Medicare.