Private HSAs?

[mykidslovedogs]

Originally Posted by brewer12345

Besides, I know where we can save a LOT of money to more than pay for healthcare: stop the enormous military boondoggle that is draining the coffers.

Well, I guess I'd rather pay only 30% of my income in taxes than 60%-80%

Stopping the military spending might be a good temporary solution, but within 20-30 years, IMO, the cost of national insurance will FAR exceed any current military spending. The problem is that no-one wants to think about the long term consequences of nationalizing. In the short term, nationalizing will be heavenly, but 20-30 yrs down the road....?

[brewer12345]

Doesn't matter who is footing the bill: ecalation in medical spending will remain a national problem for the forseeable future. I'd rather deal with it under a system where everyone is guaranteed care.

So will you be selling equityy indexed annuities when we switch to a single payor system?

[mykidslovedogs]

Originally Posted by brewer12345

So will you be selling equityy indexed annuities when we switch to a single payor system?

No way, I'm a closet techie (used to work for Oracle before becoming an agent, so I will probably go back to something like that)..

[mykidslovedogs]

Originally Posted by brewer12345

Doesn't matter who is footing the bill: ecalation in medical spending will remain a national problem for the forseeable future. I'd rather deal with it under a system where everyone is guaranteed care.

Well, if you think the costs are spiraling out of control now, just wait 'till there is no personal responsibility for costs at all....taxes will fly through the roof, as people/providers will have no regard to wasteful spending on unnecessary tests, prescriptions, etc...)

[brewer12345]

Originally Posted by mykidslovedogs

Well, if you think the costs are spiraling out of control now, just wait 'till there is no personal responsibility for costs at all....taxes will fly through the roof, as people/providers will have no regard to wasteful spending on unnecessary tests, prescriptions, etc...)

Hahahahaha! You think there is personal responsibility for spending now? Can I have a hit of whatever you are on?

[mykidslovedogs]

Originally Posted by brewer12345

Hahahahaha! You think there is personal responsibility for spending now? Can I have a hit of whatever you are on?

Yes, I do believe that at least some of the cost of healthcare is due, in part, to overutilization. (taking unecessary brand name drugs such as anti-depressants when they may not really be needed, or having expensive MRIs that may not really be necessary, etc...) Granted, not all, but a big part of our problem does have to do with overutilization, particularly with Medicare and Medicaid recipients who have virtually no responsibility for out of pocket expenses, and also by doctor request because the doctors are worried about getting sued if they don't, and then these costs of care are then shifted to the private market in the form of higher premiums.

In a guaranteed system with low out of pocket responsibility, people will have ZERO incentive to use generic drugs or to even question tests that may not be necessary, or to demand better technology at lower prices.

[brewer12345]

Originally Posted by mykidslovedogs

In a guaranteed system with low out of pocket responsibility, people will have ZERO incentive to use generic drugs or to even question tests that may not be necessary, or to demand better technology at lower prices.

This i just me thinking out loud, but I could imagine a world where the single payor complels the use of generics, unless there isn't one.

[mykidslovedogs]

Originally Posted by brewer12345

This i just me thinking out loud, but I could imagine a world where the single payor complels the use of generics, unless there isn't one.

Hmmm....I don't see how that would be. If the cost difference between generic and brand is minimal (as in low copays for either choice), then why would you choose a generic over brandname if you are not responsible for paying the bill? Human nature says that if I'm not footing the bill (and someone else is paying for it), then I'm going to buy the best.... I don't see the government (the single payor) compelling people to use generics. It would be an administrative nightmare for the government to try to manage prior authorization for brand name drugs. In fact, I have seen some of the proposals for the "basic" level of coverage, and they all include low copay prescription drug coverage. Sure, generics are going to have a little bit lower copay than brand, but even today, that doesn't seem to be enough to compel people to choose generics over brand name.

If you were the "single payor", how would you do it? How would you get people to buy the generics? How would you encourage people to use urgent care centers instead of the ER, when the "basic plan" offers a mere $50.00 copay for ER services? How would you encourage people to demand better technology for lower prices when they only have to pay a $100.00 copay for their MRI?

IMO, when people have to "feel a little bit of pain" (as in a high-deductible) in order have high-tech medical products and services and as demand drops a little bit for high-tech products and services (whether it be because people realize they may not need the test or because they simply cannot afford it), there will be incentive, technologically, for providers of high-tech equipment and services to R&D products that are more cost-effective and that more people/healthcare providers can afford. But in a system where people "feel no financial pain" for their medical services, we simply increase demand without any additional financial reward for the providers of the services. (a very bad combination in the long run).

[Beststash]

Does anyone know if it would be better to try and go thru an agent to find a HSA healthcare solution or just go with an application online (ex. BCBS of Texas). After doing a little looking around - it seem that for my only choices for an HSA would be very limited.

Also - Since my company elected to no longer cover dependents..although I can still get a family policy thru my former employer - I assume she does qualify for a HSA??

This healthcare situation sucks - I will be glad when we force the politicians to deal with this ridiculious situation.

Peace

[mykidslovedogs]

Originally Posted by Beststash

Does anyone know if it would be better to try and go thru an agent to find a HSA healthcare solution or just go with an application online (ex. BCBS of Texas). After doing a little looking around - it seem that for my only choices for an HSA would be very limited.

Also - Since my company elected to no longer cover dependents..although I can still get a family policy thru my former employer - I assume she does qualify for a HSA??

This healthcare situation sucks - I will be glad when we force the politicians to deal with this ridiculious situation.

Peace

Here is a list of Texas insurance carriers selling individual coverage in your state:

http://www.tdi.state.tx.us/company/lhiah_lst_incl.html

I am familiar with Humana, Golden Rule, World Insurance...as far as I know, they all offer HSA products.

[eridanus]

In Texas, Aetna has an HDHP without prescription coverage. Some of the Assurant plans cover drugs but the yearly limit is $2000. The Blue Cross HDHP plans cover it but the yearly limit is also very low ($5000?, but I'd have to look at my coverage booklet).

Any serious illness would take out that yearly limit in no time.

[mykidslovedogs]

I do not like limited benefit HSA plans. What you want to find is one that will cover prescriptions at 100 percent after deductible. In Colorado, Aetna has one that covers Rx after a 5K ded. Golden Rule has one called the HSA 100 plan, Anthem Blue Cross and Blue Shield has one called the Lumenos HSA, Humana has their 100/70 HDHP, Assurant has the One Deductible Plan. Other than Anthem, I am guessing that most of these plans are also available in Texas. I would call an agent or look on ehealthquotes to verify.

[Oldbabe]

Originally Posted by mykidslovedogs

BTW, the HOUSE just passed a bill to change small group rates to community rating in the State of Colorado. Watch out! Premiums are about to skyrocket for EVERYONE in our state.

MKLD,

I live in Colorado. How would this affect my individual health insurance if the legislation going to change small group rates? And what is a community rating?

[mykidslovedogs]

Old Babe,

If you have an individual health insurance policy, you will not be affected. However, if you are part of a small group benefit plan provided by a small employer (2-50), your rates will likely increase dramatically, or your employer may just drop benefits altogether, because it is just going to become much harder for these small employers to be able to afford the benefits.

You see, when you have community rating (the same rates for everyone regardless of age/health status) VS. rating flexibility in the group market, the insurance carriers are not allowed to assess risk by health status, so what happens is, they raise rates across the board to compensate for the lack of ability to statistically assess risk. Some insurance carriers simply drop out of the business of providing products for the small group market, because they feel it is too risky to try to come up with proper pricing without being able to underwrite (assess risk). The lack of competition in combination with the inability to assess risk properly only means one thing - HIGHER PREMIUMS FOR EVERYONE!

Sure some older and less healthy folks will qualify for lower rates while younger and healthier folks will pay more, but what good will that do if the small employer drops the benefit plan altogether because the bottom line is 20-50% higher than it was last year? Community rating in the small group market is NOT a good idea. The law of large numbers does not compensate for the risk in the small group market, because there aren't "large numbers" of members in the small group market, so community rating results in higher premiums for everyone.

Over time, you end up with a phenomena of employers either cutting back on their contributions (ie..charging more to the group members, deciding not to contribute towards dependents premiums, or dropping their benefit plans altogether). Even worse, the healthier folks, due to the higher pricing tend to look for better ways to cover their dependents (ie..in the individual market), thus resulting in a change in the overall health status of people who remain in the small group market; typically the unhealthier folks stay in, while their healthier family members drop out of the pool and obtain cheaper coverage in the individual market. It's a self-perpetuating phenomenon that leads to large rate increases year after year. When you combine that with the cost-shifting to the private sector that healthcare providers must continue to do year after year as their pay provided by the government for public programs such as medicare and medicaid dwindles, you end up with annual renewals of small group healthcare premiums ranging from 20-50%.


Please encourage senator Dave Shultheis to vote NO on HB 1355.

[brewer12345]

In case you missed int in the torrent of bombastic sludge, the bill apparently does not apply to individual policies, so don't worry about it.

[ESRBob]

mdlk,
Do you know about the NY market? Here, I think it is our individual plans that are cost-prohibitive (2k-3k per month for a family), and the small group plans still appear to be the only relative bargain. And unless something changed recently, NY is still one of the few states with no high-deductible plans. With no way for people to opt out of the plans a la the scenario you were just mentioning, how come prices are still so high across the board compared to other states? Been looking for someone who could 'splain this to me for awhile... thx.

[mykidslovedogs]

NY has guaranteed issue and community rating in the individual market. Ugh!!! the worst of the worst...In otherwords, you can't be declined AND if you are young, you are subsidizing the cost of coverage for older and unhealthier folks. This is great for a very small percentage of the population who otherwise would not be able to qualify for insurance, but then, the large majority of the rest of the population suffer the consequences of higher or unaffordable rates....

There are very few insurance carriers that want to do business in the state of NY, due to the mandate of "guaranteed issue", thus competition is lacking, further contributing to higher premiums.

Democrats tend to think it is better for everyone to be accepted for coverage and to have access to the same rates, even it means that the price becomes prohibitive for the great majority of the population.

[ESRBob]

Well, I guess I don't have to worry about not getting coverage! Now paying for it is another matter.... Idle thought: I wonder if unhealthy people move here just to be able to get coverage?