观点：医疗保健需要敢于说“不”的购买者
摘要
目前，数百万员工正在为自己的下一年度医疗计划做出选择。2026年，雇主提供的家庭平均保费达到28，303美元，在过去五年中上涨了28%。尽管雇主似乎承担了大部分保费，但员工最终通过较低的工资来承担这些福利的全部成本。然而，几乎没有人真正提出反对。行业的主要参与者对变革兴趣寥寥。保费上涨时，保险公司的收益会增加。保险经纪人和福利顾问则从这些保费中分得一杯羹。大型医院系统利用其议价能力要求高价格，而鲜少担心失去患者。医生通常按服务收费，做得越多挣得越多。制药公司凭借专利保护，在很大程度上自行定价。各方都有充分的理由维持现状。
English
Right now, millions of workers are choosing their health plans for next year. The average family premium for employer coverage hit $28,303 in 2026, up 28% in the last five years. While employers appear to cover most of that premium, workers ultimately bear the full cost of those benefits through lower wages. Yet no one is really pushing back. The industry’s major players have little appetite for change. Insurers record higher earnings when premiums rise. Insurance brokers and benefits consultants get a piece of those premiums. Large hospital systems use their bargaining leverage to demand high prices with little fear of losing patients. Physicians, who are commonly paid fee-for-service, earn more by doing more. Drugmakers, with patent protection, largely set their own prices. Each has good