No healthcare premiums? In this economy?! Here's how.

0:01Pippa Johnson:NPR.

0:11guest from Canadian-founded startup:This is The Indicator from Planet Money. I'm Adrian Ma. And here today joining us is NPR financial correspondent Maria Aspin. Hey, Maria.

0:20Pippa Johnson:Hey there.

0:21guest from Canadian-founded startup:You're here because you have spent a lot of time covering the broken business of U.S. health care.

0:26Pippa Johnson:Yes, it is such a cheerful topic.

0:28guest from Canadian-founded startup:Uh-huh. Well, as we know, the U.S. has the most expensive health care in the developed world, and the prices we pay for health insurance are getting even worse.

0:37Pippa Johnson:I'm actually here today, though, to talk about a little bit of good news, and it starts with drinking fancy cocktails.

0:44guest from Canadian-founded startup:Okay. Are you saying that we basically need to distract ourselves from how expensive health care is getting?

0:52Pippa Johnson:I mean, look, dealing with my insurance company can definitely make me want to drink. And I grew up with this health care system. People who move to the United States from other countries, like Canada, can go through some serious sticker shock.

1:05guest from Canadian-founded startup:It's like, whoa, like, this is a wake-up call, and this isn't cheap. This is Ryan Close. He's Canadian, but he runs a Chicago startup called Bartesian. And this is where I assume the fancy drinks come in. Bartesian sells a machine that makes you cocktails at home with the push of a button.

1:24Pippa Johnson:But I actually talked to him because his company also has some unusually great benefits for its employees. They don't pay anything up front for health insurance. And Adrian, the really good news is he's not the only employer doing this.

1:39guest from Canadian-founded startup:Today on the show, how much can our employers do to make our health insurance more affordable? support for npr and the following message come from edward jones what does it mean to live a rich life maybe it's full of brave first leaps tearful goodbyes and everything in between and with over a hundred years of experience your edward jones financial advisor can help edward jones member SIPC.

2:08Cardiff Garcia:Support for NPR and the following message come from ID Tech. ID Tech is a summer camp for ages 7 to 17 with over 50 courses like BattleBots, AI, coding, game design, and more. Visit IDTech.com and use code IDTech to save$150. This message comes from BetterHelp. International Women's Day is this march. Time to celebrate all women. The leaders, the caregivers, the hype friends, the how-do-you-do-it-all types. Women deserve to be reminded how much they matter, and that therapy offers a space to care for themselves. BetterHelp makes it simple by matching you with a qualified therapist based on your needs and preferences.

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2:55Pippa Johnson:Ryan Close and his family moved to Chicago from Ontario in 2019 to get Bartesian off the ground. It was right before the pandemic, which turned out to be great timing for a startup that sells a machine to make cocktails at home.

3:09guest from Canadian-founded startup:Yeah, the Bartesian machine kind of looks like one of those Keurig or Nespresso makers, but instead of espresso, it'll make you an espresso martini. Or instead of lattes, you get mocktails and blackberry mango refreshers.

3:24Pippa Johnson:Bartesian sells little pods, also like a Keurig. They're full of juices and other mixers. Then you can add your own booze to the machine or not, press a button, and it sounds like this.

3:38guest from Canadian-founded startup:If you've ever felt like drinking was just too much work, I guess this is the product for you.

3:45Pippa Johnson:Just inject that alcohol straight into your veins.

3:48guest from Canadian-founded startup:Well, maybe that's their next model. Martesian has had a blockbuster few years already. It's lined up some big investors like Suntory Liquor Company, which owns Jim Beam, and Tom Ricketts, whose family owns the Chicago Cubs.

4:02Pippa Johnson:So as Ryan started spending that billionaire money, he decided to put a higher-than-usual amount towards keeping his employees healthy.

4:10Cardiff Garcia:It really stemmed likely from being Canadian, right, I would say, and where I just probably took for granted that, oh, of course I don't pay for health care.

4:20guest from Canadian-founded startup:I guess you could take the Canadian out of Ontario, but...

4:24Pippa Johnson:Oh, Canada.

4:25guest from Canadian-founded startup:Like most employers, Bartesian negotiates with its health insurance company. But then it's offered to pay all the upfront costs or premiums instead of taking them out of their employees' paychecks. We're talking medical, dental, vision insurance. Plus, it's for the workers and their families. The company also gives employees$1 ,000 every year in a flexible spending account to help with out-of-pocket medical costs.

4:50Pippa Johnson:Look, as somebody who both covers this and pays for my own employer-based health insurance every year, this seems pretty great. That said, Bartesian only has about 30 employees, and not all of them choose to use its health insurance. But it is still a pretty big annual expense for a small business, and it keeps going up.

5:10Cardiff Garcia:There has been years where we're redoing the premiums and renegotiating, and there's like a slight gulp in my throat where I'm just like, oh, wow, I remember when it was only this much. That number's getting definitely bigger.

5:22guest from Canadian-founded startup:And the numbers got a lot bigger last year across the board. As Indicator listeners know, premiums are skyrocketing for most people who get their health insurance through the Affordable Care Act exchanges, also called Obamacare. That's because Congress failed to extend subsidies for those plans.

5:37Pippa Johnson:But that's only part of the problem, because there are actually many more people in the United States who get health insurance through their employers. That's the system for the majority of working-age Americans. And those premiums are also surging.

5:51guest from Canadian-founded startup:Altogether, they've gone up about 26 % over the past five years. That's according to the health policy nonprofit KFF. So for an employer covering a family of four, that means the costs average out to about$27 ,000 a year.

6:06Pippa Johnson:Adrienne, you could buy a car for that amount. You could buy one every year.

6:10guest from Canadian-founded startup:That's a lot of money for a small business.

6:13Pippa Johnson:Or anyone.

6:13guest from Canadian-founded startup:So, I mean, most employers generally make employees pay some of this through paycheck deductions, which means a worker is chipping in almost$7 ,000 a year on average.

6:24Pippa Johnson:But the thing is, employers don't have to pass along any of those costs.

6:29guest from Canadian-founded startup:In fact, KFF says that last year about 12 % of all employers offered some kind of no-premium medical plan for individual employees. That's down a little bit from 2024, but it's still more than I was expecting.

6:42Pippa Johnson:I actually talked to several employers offering these kinds of no-premium health insurance plans, including big companies like Boston Consulting Group or BCG.

6:53Cardiff Garcia:Healthy employees make for a productive workforce and also a place where our teams want to come to work every day.

6:59guest from Canadian-founded startup:That's Alicia Pittman. She oversees all things HR for BCG. And her company covers all insurance premiums for U.S. employees and most of their family members, which is close to 20 ,000 people. So we're talking spending a lot of money here.

7:14Pippa Johnson:And it's spending money not only on premiums. BCG actually also pays for insurance plans that keep other employee costs low, like the co-pays at the doctor's office. Alicia even told me that that's won her some points at home.