NYT Article re: high consumers of healthcare

[Buckeye]

Interesting article about who uses healthcare and how the insurance companies are begining to think about how to manage high consumers.

http://www.nytimes.com/2012/02/28/h...ealth-insurers.html?pagewanted=1&ref=business

 

[LOL!]

Thanks for posting this. The article ended up being fluffier than I expected from the NYTimes. I was hoping there would be more insight and analysis, but I was left high and dry.

The reason I was hoping for more is that we just signed up for a new HDHP at work. We reviewed our health care expenses for the past 2 years. Our family spent about $6000 a year on health care between the premiums, deductibles, co-pays, and prescriptions. Is that average, above, or below? Or is it excessive?

I was appalled by that since we never get sick, so where does all the money go? We will have to be a little lucky if the HDHP route is going to be better for us, but we are willing to chance it.

 

[zinger1457]

I'm all for placing a greater emphasis on preventive care, far too little of it in our current health care system. Need to come up with some way to encourage/force patients to take better care of themselves. That will be a hard nut to crack.

 

[Brat]

I have read that a community in NJ took a look at Medicaid users and selected several where proactive management made a huge difference in both cost and patient health. I understand similar efforts are being made in Oregon, where I live.

Maybe I am suspicious of for profit insurance companies because they have a record of operating in their self interest but, in all honesty, some people need to be led by the hand.

 

[Buckeye]

NYT: Cocktail of Popular Drugs May Cloud Brain

"Many people are unaware that dozens of painkillers, antihistamines and psychiatric medications — from drugstore staples to popular antidepressants — can adversely affect brain function, mostly in the elderly. Regular use of multiple medications that have this effect has been linked to cognitive impairment and memory loss."

Cocktail of Popular Drugs May Cloud Brain - NYTimes.com

 

[LOL!]

Drugs also mess with the liver, kidneys, and other organs besides the brain.

 

[Midpack]

Interesting article about who uses healthcare and how the insurance companies are begining to think about how to manage high consumers.

http://www.nytimes.com/2012/02/28/h...ealth-insurers.html?pagewanted=1&ref=business

Interesting if thin read. There are more than 30 developed countries who have successfully dealt with all these issues far more cost effectively than we have, with better quality of care overall for many for decades now. While insuring their entire populations and no medical bankruptcies.

Hard nut to crack, undeniably. But doable, undeniably.

It would never happen, but imagine if all employers increased their employee's gross pay by the exact amount they actually pay for health care premiums and health care expenses on behalf of employees (averaged across all employees, showing them individually would be unnecessary admin nightmare). And then showed them as payroll deductions on each check. IOW, company total cost and net pay would be completely unaffected but employees would actually see the costs.

I know my employees paid about 15% of their health care costs in mandatory payroll health care contributions, and many were just livid "it was so unreasonably high", some still contended "we shouldn't have to pay anything!" Imagine if they saw 100% of it every paycheck - they'd see how much they are really being paid, and how much health care really costs them. Wonder if they'd be alarmed enough to act?

 

[FUEGO]

It would never happen, but imagine if all employers increased their employee's gross pay by the exact amount they actually pay for health care premiums and health care expenses on behalf of employees (averaged across all employees, showing them individually would be unnecessary admin nightmare). And then showed them as payroll deductions on each check. IOW, company total cost and net pay would be completely unaffected but employees would actually see the costs.

My current and former employers report what it costs to provide health insurance per employee to make it explicit. Helps get rid of the griping. "Yes, Employee, I understand paying thousands per year for your share of health insurance sucks, but we, the Employer, pay many more thousands than you do and we consider it part of your total compensation".

But the employer share of health insurance costs aren't reported on each paycheck, but rather on an annual form or annual basis ("statement of total compensation" I think they call it, or "total employee compensation" for previous employer).

 

[Midpack]

My current and former employers report what it costs to provide health insurance per employee to make it explicit. Helps get rid of the griping. "Yes, Employee, I understand paying thousands per year for your share of health insurance sucks, but we, the Employer, pay many more thousands than you do and we consider it part of your total compensation".

But the employer share of health insurance costs aren't reported on each paycheck, but rather on an annual form or annual basis ("statement of total compensation" I think they call it, or "total employee compensation" for previous employer).

We shared total costs with our employees periodically too, but most weren't impressed. Again, we still had employees who honestly couldn't understand why they had to pay anything at all! But they seemed to be acutely aware and angry about the payroll deduction they say every two weeks. That was only about 15% of the total cost, so I wonder if it would register if they could see 100% every two weeks? But I'm not kidding myself, thinking it would ever happen...

 

[Mulligan]

Thanks for posting this. The article ended up being fluffier than I expected from the NYTimes. I was hoping there would be more insight and analysis, but I was left high and dry.

The reason I was hoping for more is that we just signed up for a new HDHP at work. We reviewed our health care expenses for the past 2 years. Our family spent about $6000 a year on health care between the premiums, deductibles, co-pays, and prescriptions. Is that average, above, or below? Or is it excessive?

I was appalled by that since we never get sick, so where does all the money go? We will have to be a little lucky if the HDHP route is going to be better for us, but we are willing to chance it.

To me, its a risk either way, but you have to calculate it, determine your risk level, and accurately assess how healthy you are. What did it say in the first paragraph that the top 1% pay over 25% of all healthcare costs? In threads gone by, I believe it has been determined that about 30% of the population consumes somewhere around 75%-80% of all healthcare costs. I personally am taking the risk that the past 40 years, having spent more money on teeth cleanings than I have medical care, this trend will continue. I am going to risk that I am part of the 70% that doesnt consume alot and keep it together until I fall apart after 65 . I can cover my $5k if necessary, and I do fund my HSA each year, so I am not foolish. But that being said the HSA tax deduction fully covers my premiums so my insurance is "free", and I fully expect to to have a nice HSA stash come 65. If I am wrong, well I will complain and pay! Like I said, I am not foolish.. Going skiing in Aspen this weekend, and I am only doing the green and blue slopes, as I dont need to blowout a knee and pay $5k!!!

 

[FUEGO]

We shared total costs with our employees periodically too, but most weren't impressed. Again, we still had employees who honestly couldn't understand why they had to pay anything at all! But they seemed to be acutely aware and angry about the payroll deduction they say every two weeks. That was only about 15% of the total cost, so I wonder if it would register if they could see 100% every two weeks? But I'm not kidding myself, thinking it would ever happen...

Showing it every 2 weeks would make things even worse for the employees because some would undoubtedly say "Hey, just give me the cash instead of this crappy health insurance and I'll figure it out on my own". At least I (and many of my coworkers) would. At least right now I only have to think about it 1-2x a year when I see how much my employer wastes on crappy health insurance that I never use. DW's insurance is cheaper and better but my individual coverage is free to me so why not get it even if it costs the employer $6000 a year and I never use it.

 

[Brat]

Group coverage includes both healthy and not so healthy employees, all must be included. Some insurers permit an employee who can be included in a spouse's policy to opt out with proof of insurance and some employers permit that employee to bank their contribution $ in an hsa.

 

[Buckeye]

Group coverage includes both healthy and not so healthy employees, all must be included. Some insurers permit an employee who can be included in a spouse's policy to opt out with proof of insurance and some employers permit that employee to bank their contribution $ in an hsa.

My previous employer (large corp) advertised the total cost because the employees were responsible for 25%. A good portion of the 25% was reimbursed into your HSA if you chose the high deductible plan.

 

[FUEGO]

Wow - just got the annual enrollment notice from my [-]overlord [/-] employer. $667 is my share of the family coverage (for crappy insurance with huge copays and huge deductibles).

Good thing DW has good cheap insurance for all of us. Otherwise DW would be best off not working and getting on medicaid and getting the kids on medicaid.