Those who feel like they’re working for "the man” now should consider what it’ll be like working for "the men” sometime soon. Depending on the scenario applied, sometime between 2021 and 2033 health insurance premiums have been modeled to suck up anywhere from 50 percent to 100 percent of average household income.

The Annals of Family Medicine analysis offers relatively good news that the Affordable Care Act’s impact could push the ‘premiums = 100 percent of average household income’ date out as far as 2037, but that’s a little like putting lipstick on a pig (no offense to pigs intended). Projections were made using insurance premium inflation trends of the most recent 10 years, and the results put a fine point on the fact that recent trends for significant rate increases and expanded consumer out-of-pocket spending deliver a double whammy to pocketbooks just about any way you choose to look at the numbers.

These future scenarios, like so many shocking 20-year projections that have come before it, will not come to pass, but that’s not the point. The long-term trend of health care taking more and more of a household budget is a reality today, and there are few signs that the future holds any better news.

If the past provides any other clues, it’s that a strong system of transparent and accountable insurance rate review is a must. According to the Annals paper, the times that rates increase more slowly are those years where rates are facing legislative and/or public scrutiny. Either consumers gain some footing in the insurance purchasing process such that the market can operate more efficiently, or we’ll all find ourselves with another boss in about 20 years.