Another nail in the high deductible health plan coffin

[BaliBabyDoc]

WaPo

In the real world, a very small percentage of the population accounts for a very large percentage of health-care spending. By contrast, a large majority "consume" relatively little health care each year.

I've been saying this over and over but unfortunately the dimwits just cannot grasp the notion of sick people being expensive.

A recent study by benefits consultants Watson Wyatt Worldwide found that among a group of large employers, which Watson Wyatt has followed closely over the past 11 years, 72 percent of workers and their families account for only 11 percent of employer health-care expenditures annually. At the same time, a tiny group -- 4 percent -- account for almost half (49 percent) of the employer costs.

It's a great analogy with Bush fiscal policy. Feed the sick part of government (Defense) while squeezing much smaller programs ($) that serve FAR more people (education, environment).

Meanwhile, the high-consuming 4 percent "are really sick people, and a $1,000 or $2,000 deduction is not going to change their behavior very much," Nussbaum said. Parents of a premature baby, for example, aren't likely to be doing an economic analysis of their infant's care.

I bet every advocate for HDHPs has no idea that a NICU bed is going to run $1000 a night and the typical stay is weeks.

The conclusion, he added, is that "in and of themselves, the high-deductible health plans have a zero impact on health-care [cost] trends. Clearly, if you ask people to pay more money, you will get a one-time reduction in the base cost. But they have a zero impact on annual trends."

Welcome to more policy idiocy in the Bush regime . . . on occasion they identify a real problem but their solutions rarely help anyone other than those least in need.

I've excerpted the provocative elements but the broader argument about how to improve healthcare - restrain costs is pretty good. The takehome is that improving healthcare and restraining costs are sides of the same coin instead of the retarded approach such as Enzi's health insurance plan.

 

[Hayabusa Rider]

Raise the copays and deductables to the point that people can't afford medical care. If they be like to die, they had better do it and decrease the surplus population.

 

[charrison]

Originally posted by: BaliBabyDoc

Meanwhile, the high-consuming 4 percent "are really sick people, and a $1,000 or $2,000 deduction is not going to change their behavior very much," Nussbaum said. Parents of a premature baby, for example, aren't likely to be doing an economic analysis of their infant's care.

I bet every advocate for HDHPs has no idea that a NICU bed is going to run $1000 a night and the typical stay is weeks.

ANd this is the exact thing that insurance is for. THe unplanned and the unexpected. Insurance should not for things that you know you are going to need(checkups,shots, common medical expenses).

You are not advocating insurance, you are advocating someone else pay the every medical bill that the general population might have. And so far that has not worked out very well.

 

[BaliBabyDoc]

Originally posted by: charrison

Originally posted by: BaliBabyDoc

Meanwhile, the high-consuming 4 percent "are really sick people, and a $1,000 or $2,000 deduction is not going to change their behavior very much," Nussbaum said. Parents of a premature baby, for example, aren't likely to be doing an economic analysis of their infant's care.

I bet every advocate for HDHPs has no idea that a NICU bed is going to run $1000 a night and the typical stay is weeks.

ANd this is the exact thing that insurance is for. THe unplanned and the unexpected. Insurance should not for things that you know you are going to need(checkups,shots, common medical expenses).

You are not advocating insurance, you are advocating someone else pay the every medical bill that the general population might have. And so far that has not worked out very well.

What are you talking about? I'm just speaking truth to this HDHP nonsense as a means to substantially impact healthcare costs OR health insurance availability.

I actually like the concept of "insurance" . . . just not the for-profit model that's leeching 20% of our healthcare dollars. People that advocate for that . . . want someone else to profit from our healthcare expenditures without actually providing healthcare.

 

[charrison]

Originally posted by: BaliBabyDoc

Originally posted by: charrison

Originally posted by: BaliBabyDoc

Meanwhile, the high-consuming 4 percent "are really sick people, and a $1,000 or $2,000 deduction is not going to change their behavior very much," Nussbaum said. Parents of a premature baby, for example, aren't likely to be doing an economic analysis of their infant's care.

I bet every advocate for HDHPs has no idea that a NICU bed is going to run $1000 a night and the typical stay is weeks.

ANd this is the exact thing that insurance is for. THe unplanned and the unexpected. Insurance should not for things that you know you are going to need(checkups,shots, common medical expenses).

You are not advocating insurance, you are advocating someone else pay the every medical bill that the general population might have. And so far that has not worked out very well.

What are you talking about? I'm just speaking truth to this HDHP nonsense as a means to substantially impact healthcare costs OR health insurance availability.

I actually like the concept of "insurance" . . . just not the for-profit model that's leeching 20% of our healthcare dollars. People that advocate for that . . . want someone else to profit from our healthcare expenditures without actually providing healthcare.

SO why do you keep advocating against high deductable plans that cut out the insurance middleman? The reality is, HDHP is having a significant impact on healthcare costs and they are being adopted very rapidly. 40% of the people getting them did not even have insurance before, but somehow you think this is bad thing.

 

[Slew Foot]

Originally posted by: charrison

Originally posted by: BaliBabyDoc

Meanwhile, the high-consuming 4 percent "are really sick people, and a $1,000 or $2,000 deduction is not going to change their behavior very much," Nussbaum said. Parents of a premature baby, for example, aren't likely to be doing an economic analysis of their infant's care.

I bet every advocate for HDHPs has no idea that a NICU bed is going to run $1000 a night and the typical stay is weeks.

ANd this is the exact thing that insurance is for. THe unplanned and the unexpected. Insurance should not for things that you know you are going to need(checkups,shots, common medical expenses).

You are not advocating insurance, you are advocating someone else pay the every medical bill that the general population might have. And so far that has not worked out very well.

I guess I see your point. You dont expect your car insurance to pay for gas or oil changes, but for the major damages and such.

 

[BaliBabyDoc]

Humans are NOT cars . . .

Everyone is going to need health insurance (or some other means of sharing costs) over the course of their lifetime. Even the ridiculously healthy (like me) are likely to encounter a serious health problem in person or family over their lifetime.

Regular health maintenance is NOT cheap but its cost effective. HDHPs do not address this basic principle of healthcare. In fact, they encourage people to spend as little as possible which is the antithesis of prudent healthcare consumption.

 

[charrison]

Originally posted by: BaliBabyDoc
Humans are NOT cars . . .

Everyone is going to need health insurance (or some other means of sharing costs) over the course of their lifetime. Even the ridiculously healthy (like me) are likely to encounter a serious health problem in person or family over their lifetime.

Regular health maintenance is NOT cheap but its cost effective. HDHPs do not address this basic principle of healthcare. In fact, they encourage people to spend as little as possible which is the antithesis of prudent healthcare consumption.

You right humans are not cars and risk should be pooled. But htere is very little risk pool at the maintenance level as most people require that on a regular basis. So there is no point in covering reguluar maintenance as it only adds costs to the system.

However like it or not it appears those with HSAs are following the docs orders better and doing better because of it. Lets face it a little pill may lower blood pressure or cholestrol, but i am sure you wuld not disagree it is not a replacement for diet and exercise.

So far a in few short posts you have gone from only a few percent of the population uses most of the medical. ANd that major care is covered by HSAs. And then you switch to you wanting insurance to cover everything, which no type of insurance will excel at. You want medical care to be an all you can eat buffet whth someone else footing the bill.

 

[glenn1]

You right humans are not cars and risk should be pooled. But htere is very little risk pool at the maintenance level as most people require that on a regular basis. So there is no point in covering reguluar maintenance as it only adds costs to the system.

However like it or not it appears those with HSAs are following the docs orders better and doing better because of it. Lets face it a little pill may lower blood pressure or cholestrol, but i am sure you wuld not disagree it is not a replacement for diet and exercise.

So far a in few short posts you have gone from only a few percent of the population uses most of the medical. ANd that major care is covered by HSAs. And then you switch to you wanting insurance to cover everything, which no type of insurance will excel at. You want medical care to be an all you can eat buffet whth someone else footing the bill.

Not to mention that the OP's perception seems to be that "to hell with what would be better for the vast majority of people, we have to build our healthcare model around the 4% outlier population."

 

[Snoop]

Originally posted by: BaliBabyDoc
Humans are NOT cars . . .

Everyone is going to need health insurance (or some other means of sharing costs) over the course of their lifetime. Even the ridiculously healthy (like me) are likely to encounter a serious health problem in person or family over their lifetime.

Regular health maintenance is NOT cheap but its cost effective. HDHPs do not address this basic principle of healthcare. In fact, they encourage people to spend as little as possible which is the antithesis of prudent healthcare consumption.

My HD plan covers yearly physicals and all relevant health screenings for my age. It is also saving me over 500 a month from what I was paying previously. What is interesting is I could literally meet my deductable every year (which I have in a HSA) and still save 2900 dollars over my previous insurance through my wifes company. After my deductable everything is 100%.

 

[Engineer]

Originally posted by: Snoop

Originally posted by: BaliBabyDoc
Humans are NOT cars . . .

Everyone is going to need health insurance (or some other means of sharing costs) over the course of their lifetime. Even the ridiculously healthy (like me) are likely to encounter a serious health problem in person or family over their lifetime.

Regular health maintenance is NOT cheap but its cost effective. HDHPs do not address this basic principle of healthcare. In fact, they encourage people to spend as little as possible which is the antithesis of prudent healthcare consumption.

My HD plan covers yearly physicals and all relevant health screenings for my age. It is also saving me over 500 a month from what I was paying previously. What is interesting is I could literally meet my deductable every year (which I have in a HSA) and still save 2900 dollars over my previous insurance through my wifes company. After my deductable everything is 100%.

You have an exceptional (exception rather than rule) plan. If more plans were like yours and if they all threw in a little money into your HSA (my company contributes ZERO to HSA), they could be a pretty good alternative.

While a few people come out ahead, I still feel this is more to lower the company burden of healthcare than it is to help the people in general, my 2 cents.

 

[zephyrprime]

Originally posted by: SnoopMy HD plan covers yearly physicals and all relevant health screenings for my age. It is also saving me over 500 a month from what I was paying previously. What is interesting is I could literally meet my deductable every year (which I have in a HSA) and still save 2900 dollars over my previous insurance through my wifes company. After my deductable everything is 100%.

Your previous plans sounds like it sucks. Since you pay $500 less than you did previously, you must have been paying at least $501 before. My 65year old mother paid less than this when she had private insurance through bluecross blueshield. And it wasn't even a high deductible plan.

 

[Thump553]

I don't follow your logic. How does the fact that a small percentage of the population USUALLy has a proportionately large share of the health care costs a "nail in the coffin" for high deductible health plans?

Health savings accounts (HSA) actually makes a fair amount of sense, surprising as that may sound. In my particular case, despite excellent health and minimal health costs, it doesn't fit because of my age and tax category, but it does make sense for a lot of people.

And zephyprime, your comment shows you do not pay for your own health insurance coverage, as you are way out of touch as to what real world 100% private pay (ie, not paid by employer) health insurance costs these days. I was paying over $800 per month for a crappy Blue Cross plan, through recent comparision shopping I replaced it with another plan costing just under $600 per month. This is for a four memeber family that has an excellent health history.

America NEEDS to do something about the insanely high cost of health care here. There is no reason that a simple medical matter, like a kid's broken arm or taking out your appendix should essentially bankrupt the average American family if they don't insurance.

 

[Genx87]

You are not advocating insurance, you are advocating someone else pay the every medical bill that the general population might have. And so far that has not worked out very well.

I dont know why people want to hang on to the old system. Yes it is nice to have a low deductible but what has it created? It has created an unstoppable beast of consumption that has upped the price across the board and eventually driven the low end out of the market due to costs.

While a few people come out ahead, I still feel this is more to lower the company burden of healthcare than it is to help the people in general, my 2 cents.

I think you are right, the costs of healthcare is becoming too much for business's. These HSA plans shift some of the costs onto the consumer which should lower demand.

I think Insurance is needed but do I really need insurance for a regular checkup? Should it be paying for everything things? The car analogy is a good one, does car insurance pay for oil changes and regular maintenence? If it did, do you think it would cost as little as it does?

 

[zendari]

Originally posted by: Thump553
I don't follow your logic. How does the fact that a small percentage of the population USUALLy has a proportionately large share of the health care costs a "nail in the coffin" for high deductible health plans?

Health savings accounts (HSA) actually makes a fair amount of sense, surprising as that may sound. In my particular case, despite excellent health and minimal health costs, it doesn't fit because of my age and tax category, but it does make sense for a lot of people.

And zephyprime, your comment shows you do not pay for your own health insurance coverage, as you are way out of touch as to what real world 100% private pay (ie, not paid by employer) health insurance costs these days. I was paying over $800 per month for a crappy Blue Cross plan, through recent comparision shopping I replaced it with another plan costing just under $600 per month. This is for a four memeber family that has an excellent health history.

America NEEDS to do something about the insanely high cost of health care here. There is no reason that a simple medical matter, like a kid's broken arm or taking out your appendix should essentially bankrupt the average American family if they don't insurance.

You really want surgical operations going to the lowest bidder? I'll take my chances and pay a bit extra.

 

[BaliBabyDoc]

Originally posted by: charrison

Originally posted by: BaliBabyDoc
Humans are NOT cars . . .

Everyone is going to need health insurance (or some other means of sharing costs) over the course of their lifetime. Even the ridiculously healthy (like me) are likely to encounter a serious health problem in person or family over their lifetime.

Regular health maintenance is NOT cheap but its cost effective. HDHPs do not address this basic principle of healthcare. In fact, they encourage people to spend as little as possible which is the antithesis of prudent healthcare consumption.

You right humans are not cars and risk should be pooled. But htere is very little risk pool at the maintenance level as most people require that on a regular basis. So there is no point in covering reguluar maintenance as it only adds costs to the system.

However like it or not it appears those with HSAs are following the docs orders better and doing better because of it. Lets face it a little pill may lower blood pressure or cholestrol, but i am sure you wuld not disagree it is not a replacement for diet and exercise.

So far a in few short posts you have gone from only a few percent of the population uses most of the medical. ANd that major care is covered by HSAs. And then you switch to you wanting insurance to cover everything, which no type of insurance will excel at. You want medical care to be an all you can eat buffet whth someone else footing the bill.

I would call it a Straw Man but your presentation of what I'm talking about doesn't deserve to be called reasoning . . . despite being fallacious.

HDHPs are a distraction from the fundamental flaws in our healthcare system AND the separate problem of healthcare financing. I know this b/c I've spent years in the system (from education to clinical practice and research).

Dick Cheney didn't shop for a cardiologist with the best rates or a cardiothoracic surgeon offering coupons. Now when he was a fat, sloppy, sedentary man dodging the draft . . . an HDHP would have been good for him b/c it might have motivated a change in his behaviors . . . maybe. But the primary benefit during his early years would have been financial . . . regardless of his health behaviors. It's the natural market for HDHPs b/c they only work as "healthcare" if people aren't actually sick.

Fundamentally, our system of care and financing must be reformed to REDUCE the consumption of interventional care and INCREASE the utilization of prevention/health maintenance. As luck would have it . . . the very act of doing the latter will produce favorable future outcomes in the former. Some HDHPs take that approach but you don't need HDHPs to improve prevention and health maintenance. Further, for the millions of people with chronic medical conditions (that make up the bulk of our healthcare costs) . . . HDHPs actually discourage proper health maintenance.

I'm not a fan of Romney but MA's approach is at least a step in the right direction. The emphasis is on prevention which often has upfront costs but overall costs will fall due to savings on the back end. As for the presence of insurance companies, even a leech (or maggot) can have medicinal utility . . . but only if used as a means NOT an ends.

 

[Thump553]

Originally posted by: zendari

You really want surgical operations going to the lowest bidder? I'll take my chances and pay a bit extra.

That sounds like the perfect definition of our present HMO-centric system,, except that they have a profit margin built in as well.

We spend way too much on health care, and definately way, way too much on administering health care in the US. We need it fixed-whether that's public health or something else, I'm not qualified to say. But I wouldn't exclude any potential solution on philisophical grounds alone.

 

[Tom]

I think BalBabyDoc gets at the relevant point, we ought to ask ourselves if the profit theory actually works as far as healthcare insurance is concerned.

If you look at capitalism, and profit, as a choice, not a religion, and then objectively look at what profit motive is supposed to accomplish in a market, I think i'ts at least arguable that we are not served by that choice in the case of health care insurance.

In theory the profit goal would lead insurance companies to hold down costs of delivering care, but health insurance providers know it is a lot easier to control costs by selling insurance to healthy people, than it is to control medical expenses, so the result is a very inefficient system for actually delivering medical care.

What we have created is a system that focuses on NOT delivering care, by allowing insurance companies to pick and choose who they will insure. This is the opposite of what insurance is supposed to accomplish, it's supposed to distribute risk, not avoid risk.

 

[Snoop]

Originally posted by: zephyrprime

Originally posted by: SnoopMy HD plan covers yearly physicals and all relevant health screenings for my age. It is also saving me over 500 a month from what I was paying previously. What is interesting is I could literally meet my deductable every year (which I have in a HSA) and still save 2900 dollars over my previous insurance through my wifes company. After my deductable everything is 100%.

Your previous plans sounds like it sucks. Since you pay $500 less than you did previously, you must have been paying at least $501 before. My 65year old mother paid less than this when she had private insurance through bluecross blueshield. And it wasn't even a high deductible plan.

For my Daughter and I, we were paying around $670/month for full script and Health coverage with a $15 copay (I am 32 self employed and good health, daughter is 1 today ). This was through my wifes work (Aetna standard small business rates), where they pay full benefits for her insurance. My new insurance is around $192/month with a 3000 dollar deductable and 100% coverage after that.

 

[BaliBabyDoc]

some day I'm gonna get tired of being right all the time

CHICAGO (AP) -- Middle-aged, white Americans are much sicker than their counterparts in England, startling new research shows, despite U.S. health care spending per person that's more than double what England spends.
--
The gap between the countries holds true for educated and uneducated, rich and poor.

Thank the Lord for HDHPs . . . they are very economical when you are sick.:roll:

The study, appearing in Wednesday's Journal of the American Medical Association, adds context to the already-known fact that the United States spends more on health care than any other industrialized nation, yet trails in rankings of life expectancy.

The United States spends about $5,200 per person on health care while England spends about half that in adjusted dollars.

"Everybody should be discussing it: Why isn't the richest country in the world the healthiest country in the world?" Marmot said.

1) We be sick so we spend money to pay for sickness.
2) There's money to be made by providing care to sick people (healthcare industry).
3) There's money to be made by NOT providing care to sick people (health insurance).

Only non-Hispanic whites were included in the study to eliminate the influence of racial disparities. The researchers looked only at people ages 55 through 64, and the average age of the samples was the same.
---
The upper crust in both countries was healthier than middle-class and low-income people in the same country. But richer Americans' health status resembled the health of the low-income British.

Best healthcare system in the world, eh?

Earlier studies have shown the United States does a poorer job than other industrialized countries at providing primary medical care to its citizens, particularly to those with less education and income, said Dr. Barbara Starfield, a professor of health policy and pediatrics at Johns Hopkins University.

"Countries oriented toward providing good primary care basically do better in health," she said.

Again, I wouldn't necessarily ban HDHPs . . . but they address none of the truly pressing issues of healthcare in America.

 

[charrison]

Originally posted by: BaliBabyDoc
some day I'm gonna get tired of being right all the time

CHICAGO (AP) -- Middle-aged, white Americans are much sicker than their counterparts in England, startling new research shows, despite U.S. health care spending per person that's more than double what England spends.
--
The gap between the countries holds true for educated and uneducated, rich and poor.

Thank the Lord for HDHPs . . . they are very economical when you are sick.:roll:

The study, appearing in Wednesday's Journal of the American Medical Association, adds context to the already-known fact that the United States spends more on health care than any other industrialized nation, yet trails in rankings of life expectancy.

The United States spends about $5,200 per person on health care while England spends about half that in adjusted dollars.

"Everybody should be discussing it: Why isn't the richest country in the world the healthiest country in the world?" Marmot said.

1) We be sick so we spend money to pay for sickness.
2) There's money to be made by providing care to sick people (healthcare industry).
3) There's money to be made by NOT providing care to sick people (health insurance).

Only non-Hispanic whites were included in the study to eliminate the influence of racial disparities. The researchers looked only at people ages 55 through 64, and the average age of the samples was the same.
---
The upper crust in both countries was healthier than middle-class and low-income people in the same country. But richer Americans' health status resembled the health of the low-income British.

Best healthcare system in the world, eh?

Earlier studies have shown the United States does a poorer job than other industrialized countries at providing primary medical care to its citizens, particularly to those with less education and income, said Dr. Barbara Starfield, a professor of health policy and pediatrics at Johns Hopkins University.

"Countries oriented toward providing good primary care basically do better in health," she said.

Again, I wouldn't necessarily ban HDHPs . . . but they address none of the truly pressing issues of healthcare in America.

While it is an interesting article, it really does not address HSA or normal insurance at all. On reading the entire article, this appears to have more to do with lifestyle differences than how we pay for medical care.

OF course you keep wanting to ignore basic facts about the effects of HSAs.

linkage

Why? Because this innovative approach to health insurance -- increasingly popularized by Health Savings Accounts -- is one of the most effective ways to control costs. In fact, a 2006 survey by Deloitte Consulting just found that cost increases for consumer-driven plans in large firms will average only 2.6% this year. Meanwhile, other plan types will see their costs increase from 6.6% to 7.5%

Holding medical care cost down below the rate of inflation. This can hardly be a bad thing

This return of control to the consumer may be why people with HSAs pay more attention to their health. McKinsey found that, compared to their colleagues with traditional plans, employees with HSA-style accounts were 30% more likely to get an annual physical, 25% more likely to engage in healthy behaviors, and 20% more likely to follow their doctors' recommended treatments.

Holders of HSA are more likely to change to healthier lifesyle. Exactly what you above article points to being a root problem of our healthcare costs. And somehow you think this is a bad thing. And HSA may not be a be silver bullet for solving our medical problems, they do appear to be a step in the right direction.

Not surprisingly, HSAs are now making a dent in the numbers of uninsured. As many as 40% of individual HSA buyers were previously uninsured. And about half of those signing up earn less than $50,000 a year.

More people being able to afford insurance, again, you think think this is a bad thing.

You may be right on the root causes of our expensive medical problems, but you appear to be extremely biased against an obvious solution that is moving us in the right direction.

 

[charrison]

Originally posted by: BaliBabyDoc

Originally posted by: charrison

Originally posted by: BaliBabyDoc
Humans are NOT cars . . .

Everyone is going to need health insurance (or some other means of sharing costs) over the course of their lifetime. Even the ridiculously healthy (like me) are likely to encounter a serious health problem in person or family over their lifetime.

Regular health maintenance is NOT cheap but its cost effective. HDHPs do not address this basic principle of healthcare. In fact, they encourage people to spend as little as possible which is the antithesis of prudent healthcare consumption.

You right humans are not cars and risk should be pooled. But htere is very little risk pool at the maintenance level as most people require that on a regular basis. So there is no point in covering reguluar maintenance as it only adds costs to the system.

However like it or not it appears those with HSAs are following the docs orders better and doing better because of it. Lets face it a little pill may lower blood pressure or cholestrol, but i am sure you wuld not disagree it is not a replacement for diet and exercise.

So far a in few short posts you have gone from only a few percent of the population uses most of the medical. ANd that major care is covered by HSAs. And then you switch to you wanting insurance to cover everything, which no type of insurance will excel at. You want medical care to be an all you can eat buffet whth someone else footing the bill.

I would call it a Straw Man but your presentation of what I'm talking about doesn't deserve to be called reasoning . . . despite being fallacious.

Other than I have backed my claims up, so it is neither a strawman or fallacious.

HDHPs are a distraction from the fundamental flaws in our healthcare system AND the separate problem of healthcare financing. I know this b/c I've spent years in the system (from education to clinical practice and research).

And it appears the HSA is moving us in the right direction of fixing some of those flaws.

Dick Cheney didn't shop for a cardiologist with the best rates or a cardiothoracic surgeon offering coupons. Now when he was a fat, sloppy, sedentary man dodging the draft . . . an HDHP would have been good for him b/c it might have motivated a change in his behaviors . . . maybe. But the primary benefit during his early years would have been financial . . . regardless of his health behaviors. It's the natural market for HDHPs b/c they only work as "healthcare" if people aren't actually sick.

This argument is simply not valid. There is no risk to pool at the mainenance end of health care. Having someone else pay for evey visit to the doc no matter,, every prescription drug or what medical ailmnent no matter how minor does not make any practical sense to be included into health insurance.

Fundamentally, our system of care and financing must be reformed to REDUCE the consumption of interventional care and INCREASE the utilization of prevention/health maintenance. As luck would have it . . . the very act of doing the latter will produce favorable future outcomes in the former. Some HDHPs take that approach but you don't need HDHPs to improve prevention and health maintenance. Further, for the millions of people with chronic medical conditions (that make up the bulk of our healthcare costs) . . . HDHPs actually discourage proper health maintenance.

And you dont need insurance companties involved in health care maintenance as well

I'm not a fan of Romney but MA's approach is at least a step in the right direction. The emphasis is on prevention which often has upfront costs but overall costs will fall due to savings on the back end. As for the presence of insurance companies, even a leech (or maggot) can have medicinal utility . . . but only if used as a means NOT an ends.

[/quote]

I can tell you think right now. You are going to be sadly disappointed that Romney plan is going to cause faster adoption of HSAs as they are going to be the cheapest option available for employeers to pick.

 

[TXHokie]

1st child, 2000
Company paid all insurance premium, $300 out of pocket

2nd child 2003
Paid $200/monthly health insurance premium, $600 out of pocket

3rd child 2006
Paid $520/monthly health insurance premium, $3500 out of pocket and bills still a comin'

See the trend? (btw, vasectomy next week)

 

[Zebo]

Originally posted by: glenn1

You right humans are not cars and risk should be pooled. But htere is very little risk pool at the maintenance level as most people require that on a regular basis. So there is no point in covering reguluar maintenance as it only adds costs to the system.

However like it or not it appears those with HSAs are following the docs orders better and doing better because of it. Lets face it a little pill may lower blood pressure or cholestrol, but i am sure you wuld not disagree it is not a replacement for diet and exercise.

So far a in few short posts you have gone from only a few percent of the population uses most of the medical. ANd that major care is covered by HSAs. And then you switch to you wanting insurance to cover everything, which no type of insurance will excel at. You want medical care to be an all you can eat buffet whth someone else footing the bill.

Not to mention that the OP's perception seems to be that "to hell with what would be better for the vast majority of people, we have to build our healthcare model around the 4% outlier population."

If it's going to acutally protect you we do since everyone will enter that 4% sometime in thier life.

 

[Zebo]

Originally posted by: TXHokie
1st child, 2000
Company paid all insurance premium, $300 out of pocket

2nd child 2003
Paid $200/monthly health insurance premium, $600 out of pocket

3rd child 2006
Paid $520/monthly health insurance premium, $3500 out of pocket and bills still a comin'

See the trend? (btw, vasectomy next week)

Yup same here - I'm just looking forward to being on medicare/medicaid like 50% of the nation who has better heath insurance than we do.

I only pay $343 a month for a family of 6 but it used to be zero.