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Menampilkan postingan dari Juni, 2005

Thoughts on HSA�s & HRA�s...

One of the hats I wear says �Continuing Education Provider� on it ( not really; it�s a metaphor, okay? ). In preparing for an upcoming class, I�ve had my own learning opportunity: Sometimes, a cat is a dog. There�s been a LOT of press in recent months about how much more successful Health Savings Accounts (HSA�s) have been than Medical Savings Accounts (MSA�s) ever were. It seems that everyone�s talking about them, and they�re selling like hotcakes. Except that they�re not ( and no, I can�t back that up with hard numbers; no one can - yet. But I�ve got pretty good instincts on these things ) Turns out, a LOT of folks -- particularly employers who offer health coverage � are asking about HSA�s, but precious few are actually installing them. Why is that? Well, it helps to know that HSA�s aren�t free. That is, just because the employer may save some premium dollars (and not as many as one might think), it doesn�t mean that he gets to keep them. By the time one adds in the actual contribut

Tuesday Update...

This week's Grand Rounds is up over at Health Business Blog . Enjoy!

A Radical Idea?

Joe Kristan at Roth & Co , tipped me off to a rather interesting forum recently held in our nation�s capital. The panel included members of the President�s Advisory Council on Federal Tax Reform, and included folks from The Heritage Foundation and the Galen Institute . In fact, the representative from Galen, a Ms Turner, opined that � the tax code contributes to employees' ignorance about the costs of health insurance, leading them to demand more expensive health insurance from their employers and raising healthcare costs. � Robert Moffit of the Heritage Foundation added that " (i)f you want to reform the health insurance markets, you must reform the tax system. " He went on to advocate the elimination of the tax-free status of employer-provided health insurance. Right problem, woefully wrong answer. If one frames the dilemma in those terms, then the only fair, equitable, and reasonable answer is to make health insurance premiums deductable for everyone, not just tho

Who knew?!

One of the fun things about blogging is being able to relate true (but potentially boring) stories, in an entertaining way. Well, hopefully entertaining. Insurance carriers each do things their own way. For instance, some carriers charge for each child they cover, while others charge a flat rate, regardless of the number of progeny involved. The latter case is a good deal for large families, but not such a bargain for smaller ones. Case in point: Another nice lady calls in to discuss health insurance (this tends to happen in cycles, so I don�t keep the little �Take A Number� sign out all the time). Her group coverage at work is getting expensive, and she�s looking for ways to trim the budget. So far, so good. She is married, and they have one child, a teenaged son. Her contribution toward the group plan is about $230 a month for herself and her son, plus another (whopping) $600 for hubby. That�s over $800 a month that she pays out of pocket (I didn�t ask how much her employer contribu

Unintended Consequences�

It is axiomatic that demand drives price. That is, if there�s a particular item that is greatly sought after, the price of that item will (almost) inevitably rise. At least until something better comes along. At which point, the cycle starts again. And so it is with health insurance, as well. Sure, there are risk factors and market pressures, underwriting issues and pre-existing condition exclusions. But by and large, insurance is subject to the whims of the marketplace. Until now: � Gov. Mitt Romney doesn't just want to make health insurance universal. He wants to make it compulsory. � In fact, he goes further: " Everyone must either become insured or maintain an adequate savings account to cover their medical expenses. " (fop cit) Now, this may sound like a good idea, but let�s examine the consequences of such draconian measures. When something becomes mandatory by law, it has several effects: First, people do vote with their feet. Those that rebel at the notion that th

Transparency�

Merriam-Webster defines it as � free from pretense or deceit...easily detected or seen through...readily understood ." In the context of this post, any of those work equally well: � Continuing his efforts to improve access to health care for Illinois families, Gov. Rod R. Blagojevich today signed the Illinois Health Care Consumer�s Right-to-Know bill, which makes health care price and performance information for outpatient procedures available to all Illinois consumers. � The Illinois Department of Health will publish the average charges for as many as 30 common outpatient procedures. � It is important that information be obtained on all surgeries to get a more accurate picture of this component of health care ,� said Dr. Eric E. Whitaker, state public health director. According to a recent survey, 85% of Prairie State voters said that such information would � affect their decision � in health care matters, and 75% agreed that such disclosure would � create competition, lower pric

"Don�t Hang Up!"

The nice lady called about 4:30 on a Tuesday afternoon (and no, the sky was NOT �dark and gloomy.� Sheesh). She was calling, she said, to find out about health insurance for herself and her family. She�s self-employed, and her husband wants to quit his job to come work with (for?) her, but they�re loathe to give up his benefits. It�s then that she literally begged me �please, don�t hang up.� As one would expect, I was a bit puzzled by this. Why would I hang up on her? Well, "because everyone else has� once she disclosed that she�s a Type I diabetic. I simply responded �well, you just weren�t talking to the right agent.� One of the first things one learns in this business � and then most of us promptly forget � is to ask a lot of questions. Which I proceeded to do. It turns out that she�s actually on several meds, including self-administered insulin injections, and she has some other problems, as well. She and her husband desperately wanted to be in a position for him to quit his j

Congratulations, Class of 2005! Now about that insurance�

As the father of a recent high school graduate (with Honors, no less!), I can begin to look forward to the next phase: college. For those that have a recent college grad, however, there�s an additional consideration: Most group insurance plans cover your post-teen progeny only until they graduate. That is, if they�re not full-time students, they�re not covered. This is of no small concern, because there are a few options available, and it�s important to pick the right one. Your first stop is your group insurance certificate of coverage (which is actually a booklet). It will outline when your grad�s insurance stops � sometimes it�s the end of the month following graduation, sometimes it�s that very day. At that point, there are really three basic choices, and which one you choose depends a lot on your grad�s post-grad plans: If he�s headed to grad school, you may be able to keep him on your plan. Check your certificate, or call your HR department. If he must drop off, and he�s in good

Oy, Canada!

Sorry for the pun, but I couldn�t resist. The last few postings here have dealt with some of the shortcomings of our health care delivery and finance system, and the temptation is to look northward at �free� healthcare. As the saying goes, though: �TANSTAAFL� ( There Ain�t No Such Thing As A Free Lunch ). While our system definitively needs work, our brethren to the north have some problems of their own: � The Supreme Court on Thursday struck down a Quebec law banning private medical insurance in a decision that represents an acute blow to the publicly financed national health care system. " The reason that this is significant is that Canada�s much-vaunted nationalized health care system has quite a few problems, not the least of which is long waits for even simple procedures, and often fatal waits for more critical ones. The problem is exacerbated by a law which made it illegal for desperately ill patients to seek care outside the system, even if they could pay for it themselves.

Who�s YOUR Beneficiary?

Several years ago, I had a client who apparently longed to win a Darwin Award : while riding his motorcycle, he decided that it would be fun and/or prudent to play �chicken� with a Ford Explorer . CareFlight scraped up the bits, and flew them to the local trauma center, which proceeded to perform over $20,000 of medicine on said bits. Needless to say, this was of little efficacy. The client had $15,000 of term life through the group health plan. The employer, and premium payor, was his folks� small business. And they took responsibility for making � and paying for � the funeral arrangements (which, given the circumstances outlined above, was no small thing). Naturally, I helped them file the Death Claim, and we awaited the check. Which came to me payable not to the deceased�s parents, but his ex-wife. As you can imagine, this took both his parents and me by complete surprise. Now, as an aside, I should have known this would happen, being the agent. This took place about 15 or so years

A Glimmer of Hope?

While there is some disagreement as to the exact number of folks without health insurance, the number most commonly bandied about is 45 million. And, of course, this is a �fluid� number in that, in any given month, it is not the same 45 million. And, of further course, absence of health insurance does not equate with absence of health care . Nonetheless, this is a serious problem, and merits serious consideration. While our politicos � elected and otherwise � jockey for position(s) on addressing the problem, a disparate group of organizations, companies, and institutions have been meeting to brainstorm from a more broad-based perspective. So, who makes up this broad-based collation? You may be surprised: � (R)epresentatives of trade and professional groups, such as the American Hospital Association and the American Medical Association; labor organizations, such as the A.F.L.-C.I.O. and the Service Employees International Union; business groups, such as the U.S. Chamber of Commerce; i

Late Spring Housecleaning...

First, the good news: I've added the Haloscan commenting and trackback system. Unfortunately, this process deleted all the previous comments -- Ooops! PLEASE don't take this personally...I really enjoy the comments here. Have a great weekend!

He Ain�t Heavy�

Well, actually, he is. And to his credit, he wants to do something about it: he wants to undergo weight-loss surgery in order to treat his morbid obesity. Which is commendable, if drastic. And he wants his insurance to pay for it. Which is unrealistic. By and large, carriers do not cover weight-loss surgery. Or stop-smoking programs, infertility treatments, or growth-hormone regimens. There�s actually a very good reason for this: they are not issues which should be covered by medical insurance. Look at it this way: do we expect our auto insurance to cover oil-changes or transmission repairs? Do we rely on our homeowners insurance to pay for leaky roofs (I�m talking about ordinary wear-and-tear, not hail or tornadoes) or cleaning out our chimneys? Insurance is expensive enough without adding even more overhead to plans. Is it discrimination against obese folks? Yes, but discrimination is not, in and of itself, a bad thing. We all discriminate: Wendy�s over McDonald�s, steak over chic