Recently I had the pleasure of helping someone obtain insurance through healthcare.gov, the official Obamacare health insurance website. The website was easy enough to navigate and do what we needed to do, but we discovered various things while on the website.

In Beaufort County, there is only one health insurance vendor, BlueCross BlueShield of North Carolina, available on the healthcare.gov website. They have a complete monopoly in Beaufort County — there is no competition. If you are an individual in Beaufort County seeking insurance, you only have one choice. You best be happy. I thought one of the benefits of Obamacare was to create competition; it has not worked in Beaufort County.

To see if Beaufort County was unique, I checked Wake County to see what health insurance vendors were available. Along with BlueCross BlueShield, Aetna and United Healthcare are included as vendors. Whereas BlueCross BlueShield has a monopoly in Beaufort County, an oligopoly exists in Wake County. They have some competition but not a lot.

In Beaufort County, for a BlueCross BlueShield $5,000 deductible plan, a 40-year-old individual with income of $50,000 will pay $462 a month. For a similar BlueCross BlueShield $5,000 deductible plan in Wake County, the individual pays $392 a month.

As income goes down, an individual receives a subsidy based on their income. The lower the income is, the higher the subsidy. At a certain point, they cut it off because the individual is eligible for Medicaid. An individual with income of $50,000 receives no subsidy.

An individual in Beaufort County, with income of $25,000, will pay $143 a month for the same policy. In Wake County, for the similar plan, the individual pays $178 a month. All of a sudden, it is backwards; the low-income person pays more in Wake County. Along with the change in the payment, another change takes place, the deductibles of both policies change to $3,000 from $5,000.

The subsidy for the Beaufort County citizen is $329 a month and $216 for the Wake County citizen. There has to be some reason for it, but I have no earthly idea what it is.

I guess the following conclusions can be reached:

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If you’re an individual with $50,000 of income, you’re better off in Wake County.

If you’re an individual with $25,000 of income, you receive a higher subsidy than Wake County and are much better off in Beaufort County.

Increased competition reduces premium prices in the comparison of the two counties.

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At the age of 71, I feel very fortunate to be on Medicare. I pay for Medicare B and D and purchase additional insurance from BlueCross BlueShield at a very reasonable rate and have excellent medical care. The combination pays for about all of my medical care.

People under 65 years of age are fortunate if they are provided insurance by their employer. In most cases, the employee must bear part of the insurance cost. The benefits of insurance from employers have decreased and the deductible has gone up a lot over the years. The cost to the employer has increased dramatically and adding a family member to a policy can be cost prohibitive depending on an individual’s income. Some companies cannot really afford to pay for health insurance. Every year the cost of health insurance escalates in most cases.

Health insurance for individuals under 65 is a major concern. It is said that high deductibles will cause people to shop around for medical care and there is some that can be done. If you have a high deductible, the tendency might also be to stay away from the doctors and compromise your healthcare simply because you don’t have spare money lying around.

Obamacare has helped lower income people, but I don’t see where it has done anything to contain cost. It is still going up. We have the best healthcare in the world, but we also have a healthcare crisis that continues to escalate.

Healthcare cost has increased over the years due to advances in technologies, equipment, procedures, drugs, specialty care, greed and other factors. The government’s involvement has only increased the problem because of mandated administrative and other cost.

As a country, our standard of living is falling for the middle class and the question has to be asked, “How much healthcare can we reasonably afford?”

With a declining middle class, constantly increasing cost for health insurance and medical care has become a burden. This is particularly true of the working middle class under 65 years of age. I’m retired, on Medicare and happy, but what about our young people?

It’s a very complex problem without a solution but it does need immediate attention. Where are our leaders? Just my opinion.

Al Klemm is a retired Beaufort County Commissioner.