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Menampilkan postingan dari Agustus, 2005

Timely Life Insurance Notice...

Joe Kristan at Roth & Co has a timely and important post about some of the games folks have been playing with life insurance policies. If you're a business owner, and especially if you're using life policies inside your pension plan, this is a must read .

Grand Rounds is up...

Over at Healthy Concerns . This week's host, Elisa Camahort, has organized the posts according to how each one helps laypeople understand the health care delivery system. Nicely done !

HSA and LTCi...

As we continue with the theme � Better Living Through Acronyms ,� we turn to how HSA�s can serve another purpose: funding for long term care insurance. Over the past several posts , we�ve discussed how an ageing America needs to deal with the long term impact of increased life expectancy, and how Health Savings Accounts enable folks to make informed and pre-funded choices about their health care. But these two ideas are also inextricably intertwined [ ed � that�s pathetic ]. Did you know that you can pay for Long Term Care insurance (LTCi) out of your HSA? And when you do, Uncle Sam is subsidizing your premium. So there�s a double benefit at work: saving premiums on your health insurance by purchasing that High Deductible Health Plan, and using some of those savings to fund insurance against a catastrophic long term care claim. Not bad for a plan that was supposed to destroy the health care system as we know it. Why is this so important? Well, as Boomers age, the need for long term car

Financial Carnivals Update...

The Carnival of the Capitalists is up at CaseySoftware . And the Carnival of Personal Finance is hosted this week by All Things Financial . The C of the C's tends to be more business-oriented, while the C of PF is geared more toward the consumer. Of course, there's always some overlap. If you're looking for a break from the mundane, both places offer a smorgasboard of new ideas.

NOLA...

Gambar
Our thoughts and prayers are with you.

DOI vs CDHC (Part 2)...

In Part I we began our dissection of California Insurance Commissioner John Garamendi�s baseless screed against Consumer Driven Health Care plans. Interestingly, in his own backyard, such plans are helping to drive down the cost of health insurance. The Galen Institute (a think tank specializing in health and tax policies) reports that: � Premiums for HSA-eligible insurance dropped 15% between 2004 and the first half of 2005...Several California cities, such as Long Beach, had the most affordable rates ." In any case, let�s complete our analysis of Commissioner Garamendi�s dire warnings that Health Savings Accounts and Health Reimbursement Arrangements would: � Make the health system more complex � If anything, the beauty of CDHC is that it simplifies how medical care is reimbursed. By way of example, let�s compare a typical, ubiquitous �plain vanilla� co-pay plan with a generic HSA plan: Under the co-pay plan, one has the privilege of paying just $25 at the doc�s office. Let�

More on CDHC...

Health Business Blog has a post on how more and more large companies are beginning to offer some form of Consumer Driven Health Care, including HRA�s and HSA�s. One of proprietor David Williams� conclusions � one with which I wholeheartedly agree � is that � (a)s more employees try out consumer directed plans, expect consumers to demand better information about quality and cost. � Read the whole thing.

It's Carnival Time!

WoW! Three blogbursts today: Grand Rounds is up over at Straight From The Doc . The Carnival of the Capitalists lands at Strange Brand . And this week's Carnival of Personal Finance can be found at Frugal For Life . This is a fun and easy way to experience a lot of different blogs that share common themes. Have fun!

DOI vs CDHC (Part 1)...

Recently, California�s Insurance Commissioner blasted consumer driven health care in general, and Health Savings Accounts in particular. Commissioner Garamendi claims that these �skeletal� policies will: -Put the entire health insurance system at risk (yikes!) -Cause patients to forego needed care -Increase cost shifting -Exacerbate loss of benefits -Make the health system more complex -Result in inefficient use of resources -Increase inequities in access -Raise your cholesterol -Increase global warming Okay, I threw those last two in to see if you were paying attention. Seriously, though, it�s these �the end is near� doomsday scenarios which bureaucrats like Commissioner Garamendi bandy about that cause them to lose credibility, since they are so easily debunked. Let�s examine (and put to bed) each of these claims one by one: � Put the entire health insurance system at risk � Putting this one first was probably a bad strategy: after all, if you�ve already destroyed the whole system,

Healthy AND Wealthy...

Back in May, we discussed how some physician�s may be eligible for cash bonuses for keeping their patients well. Now there may be an opportunity for us patients to get in on the action, too. In an effort to differentiate themselves from their competitors, carriers are always on the lookout for ways to offer �value-added� benefits. In recent years, more and more insurers have begun to offer all kinds on non-insurance products as adjuncts to their plans. For example, several carriers now offer membership discounts to health clubs, stop-smoking clinics, even massage therapy. Why the (not so) sudden largesse? One reason is undoubtedly marketing, but there are other factors, as well. It�s been shown that healthy employees are generally productive employees . And particularly in small businesses, the impact of even just one or two chronically ill employees can have a drastic effect on overall efficiency. And, of course, the proportionate cost of health insurance is magnified in such cases.

Life�s a Beach, Part 2...

In Part 1 we looked at how life expectancy has improved over the years, as well as some of the reasons that it�s not even longer. One prediction in particular really hit home: � (B)y 2050, �seasoned citizens� are expected to make up over 20% of the population. � If this turns out to be the case, it has tremendous implications for both this industry and our culture. There is a great deal of conjecture, on both sides of the political aisle, about when Medicare will become insolvent, but no one on either side seriously believes that it will last until another 45 years without major changes. As well, a lot of these folks are going to need (or may already be receiving) some form of long term care, to be paid for by, well, whom? In the insurance industry, when speaking with folks about retirement planning, we often use a leading question: �What if you live too long?� Now on its face, that seems a rather impertinent, if not obnoxious, question. It�s rooted, though, in the old adage that most

Conflict of Interest?

� About 10 percent of the nation's physicians have signed up as consultants to the investment industry, according to the New York Times. There's nothing necessarily wrong with that except that some of these investors are looking for proprietary data on clinical trials that can affect their sponsors' valuations .� So reports Health Business Blog , in two posts that quickly and comprehensively sum up some of the ethical issues of physicians serving two (incompatible) masters. Recommended.

Grand Rounds...

is (are?) up at Circadiana . This is a unique blog, dedicated to the study of chronobiology . Take a gander , won�t you?

Anthem vs Premier vs Patients...

The contemporary comedian Gallagher is perhaps best known for smashing watermelons with a sledgehammer, covering his audiences with bits & pieces of the delectable fruit. I�m reminded of the resulting mess by this article in the Dayton Daily News : � When Premier's network contract with Anthem expired on Jan. 1, Anthem stopped paying Premier directly for services at Miami Valley and Good Samaritan hospitals. Anthem sent reimbursement checks of four and five figures to enrollees instead .� As one might imagine, not everyone who received this windfall forwarded the cash to Premier. And that�s where this whole messy episode gets complicated: � Now Premier wants its money, taking legal action on what Shaw called "the most egregious cases." He said most of the suits are for bills in the neighborhood of $5,000, but they range from $1,000 to a $99,000 reimbursement check, which the patient said her estranged husband left town with .� As with an onion, there are multiple lay

When $1.5 Million Still Isn't Enough...

I've always believed that the $3 and $5 Million lifetime maximums on medical plans was more than sufficient. Fact is, I've been known to claim that, for most folks, maximums higher than $1 million was more marketing than anything else. Looks like I've been wrong: " Chandler High School assistant principal Chris Knutsen reached the cap of his medical insurance policy last week and now must wait in limbo as his daughter�s life wanes. " Bob at Healthinsurance411 has the whole sad story . UPDATE : Elisa over at HealthyConcerns informs us that one can make a donation on Haley's behalf at Hope For Haley .

Wearing Genes to Work...

Back in May we looked at the debate about using genetic testing in underwriting insurance policies. Recently, though, I�ve come across some examples, potentially either good or bad, of how genetic testing is changing the workplace. For example, Chicago Bulls center Eddy Curry, a 22 year old in seemingly fine shape, was found to have an enlarged heart and an irregular heartbeat. According to an article in the Seattle Times , there is concern that he may have hypertrophic cardiomyopathy , which can be caused by a genetic defect. According to the article, there�s a simple test that can identify up to 60% of folks who inherit such conditions. Seems like a no-brainer, right? Take the test, see if it�s congenital, go from there. Not so fast. As we discussed in May, these things have consequences. Depending on the results of the test, Curry�s career could be over, and he may have trouble purchasing insurance (after all, this is now a known condition). Or he may be one of the 40% for whom the

PBM�s, RPM�s, Whatever...

Here�s a way to help control the cost of health insurance. PBM�s, or Pharmaceutical Benefit Managers , are essentially middlemen who buy med�s directly from manufacturers, and then re-sell them to health care plan sponsors. Along the way, they receive rebates and discounts. Problem is, they don�t always pass these savings along. David Williams at Health Business Blog sets the record straight, and tells about how some of those plan sponsors are insisting on sharing in the savings.

Life�s a Beach...

When I first started in this business, lo those many years ago, the industry relied on something called the Commissioners 1958 Standard Ordinary Mortality Table, or 1958 CSO for short. The CSO was a means by which insurance companies (and litigants in wrongful death suits) could determine the likely lifespan of an �average� individual. Insurers relied on it (as well as other factors) in setting their rates for various life insurance products. As time went on, and our lifespans increased (Yay, modern medicine!), there arose a need to update these tables and, in 1980, the NAIC ( National Association of Insurance Commissioners ) approved a new version, which showed significant increases in how long the average American could expect to live. Every so often, these tables are revisited and revised, and we get an interesting snapshot of our own mortality. For example, one who turned 65 at the turn of the previous century had a much shorter expected lifespan than someone who turned 65 just 3 y

Grand Rounds...

Is up over at Parallel Universe . Dr Emer has done an outstanding job organizing over 40 links, covering a wide range of medical and medical-related topics. Take a gander .

The Classic Definition of Chutzpah...

Is the child who murders his parents, and then throws himself on the mercy of the court because he�s an orphan. In today�s Dayton Daily News , there�s a story about a Cincinnati-area insurance agency that�s suing Anthem . Now, for those of us familiar with the recent shenanigans in which Anthem�s been involved (see here and here ), this isn�t so surprising. But what is surprising is why Total Benefits Planning Agency is suing them: Apparently, TBPA put out a booklet called � How to Beat the High Cost of Health Care ,� which advocated that employers should � shift certain employees 'away from the group policy' and replace their group coverage with individual policies. � I suspect that the primary reason that Anthem terminated their contract with TBPA has less to do with what TBPA advocated, and more with the very public way in which they did so. In other words, �don�t make waves.� According to TBPA, their plan resulted in substantial savings for their clients. Other agents,

Talk About a Disconnect...

A lot of folks get their insurance coverage through their employers. And most pay at least a portion of the premium; the employer subsidizes the rest. NB: I agree with Prof Sowell that this is �smoke and mirrors� economics, but that�s really not the focus of this post. Another time, perhaps. In any case, most of us who get our insurance from our employer�s group plan have the premiums deducted from our paychecks (often pre-tax: c.f. IRC Section 125), and many come to believe that that contribution is the sole sum and substance of what the insurance costs. In other words, we believe that it really only costs $50 a week to insure our entire family, and we�re shocked to find out, when it comes time to elect COBRA continuation, that our measly weekly amount is the proverbial �tip of the iceberg.� I had always suspected that most folks were woefully misinformed about the true cost of their insurance, but a recent study by MetLife bears this out: " More than one-third of employees age

Tuesday Update...

This week�s Grand Rounds is up at AloisMD . This blog, by a 2nd year medical school student, chronicles life in med school and a future doc�s perspective on various social issues.

Tales From The Trenches 2...

When we left off , I had called XYZ Boxes, from whence Bill and Loni had been �let go.� I was transferred to Zack, who claimed that he was (in true Alexander Haig mode) �in charge.� After identifying myself and the nature of the call, I asked Zack for information about Bill and Loni�s COBRA situation. Zack bluntly told me that he had �no knowledge whatsoever� of any COBRA-related issues. In fact, he seemed rather proud of his ignorance. I explained to him that COBRA violations run to $1,000 a day, levied not just against the company, but potentially to him, personally. Apparently, this was of no real concern for Zack. So, I asked him for the phone number of the new company, which he was loathe to give. When I explained that it would take me a few seconds on Google to find it, he rather heatedly said �then do that,� and hung up on me. Hmm� Mama always told me �don�t get mad, get even.� So, I Googled Acme Bags (you may recall that they were the older, larger company which had recently ac