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Two years ago I was late on a credit card bill and my interest rate jumped immediately from 13.4 percent to 28.4 percent. I was upset, but I had made a mistake and clearly the bank had warned me that if I were late on a payment I would be penalized. So I cancelled that credit card and got another that charged me 18.2 percent.

At least I had a choice.

But there’s not much latitude today for workers who want to control the costs of their healthcare. Today, 160 million Americans get health insurance through their employers. For whatever reason, we have chosen having a job as the best way to get health insurance in our country.

A recent report by the Kaiser Family Foundation shows that employees are being asked to pay an average of 14 percent (or $482) more for their share of health insurance premiums this year. And that doesn’t begin to address the 9.6 percent of American workers who are without jobs. Many of those workers are paying $400 to $600 out of pocket each month just to keep their medical benefits. Nor does it apply to those who seek insurance on their own. Those individuals saw an average premium increase this year of 20 percent, Kaiser reports.

Employers have complained about the cost of providing medical care for many years. As healthcare costs escalate, they are complaining louder. Some have cut back benefits, refusing – perhaps rightfully so – to accept the idea that employers should bear the primary burden of providing medical care.

About 70 percent of the cost of employee healthcare premiums today is covered by employers. In recent years, employers searching for a cost-control mechanism began sharing cost increases with their workers.

In small businesses, that has had a dramatic effect in just four years. Many smaller companies require workers to pay their first $1,000 of their annual medical care before insurance kicks in. Four years ago, only 16 percent of smaller firms had this requirement, but today 46 percent do.

If the rising costs of medical care aren’t enough, there is also evidence that people are actually using less medical care because of the recession. Spending on doctors, hospitals, drugs and other medical care climbed only about 2.7 percent during the first half of this year, the smallest increase since the federal Bureau of Economic Analysis began tracking medical costs in 1959. When adjusted for inflation, spending was actually down 0.2 percent. The most significant cutbacks were in prescription drugs, hospital stays, and dental care. The bureau reported the drop was not predicted in government forecasts and appears to be the result of a bad economy and high unemployment.

“It’s the recession effect,” says Karen Davenport, health policy director at the Center for American Progress. She notes that unemployed workers as well as workers with coverage are cutting back on medical spending.

Unlike my situation when I had my credit card shock, workers don’t have a lot of options when it comes to controlling healthcare costs. The current system traps them, sometimes forcing them to stay with employers when they would rather move on.

The idea of the federal government providing access to quality medical care for all citizens is still unrealized and likely will be imperfect as it develops.

In the meantime, a way must be found to help the 160 million Americans who get their healthcare coverage through work and find it eating away not just at their weekly paychecks but at their quality of life.

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