JAMA Network March 10, 2023
Kevin Schulman, MD; Aditya Narayan, BS

The costs of private health insurance have continued to soar, consuming an ever-greater share of total compensation for employers and employees. Although the factors associated with the increases in health insurance costs have evolved incrementally during the past 2 decades,1 the role of health insurance in the stagnation of real incomes has been underappreciated by the public. At the same time, escalating costs and declining financial protection from private health insurance call into question whether employees perceive value from health insurance that is commensurate with the cost.

For employers, health insurance costs for family health insurance have increased from $10 157 in 2000 to $22 463 in 2022, a 121% increase (all health insurance and family income values are reported in real...

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