Does Bush have any policy initiatives that actually make sense?

[BaliBabyDoc]

Yahoo

Bush, in his annual State of the Union speech, urged the expansion of health savings accounts, or HSAs, which allow people to set aside money tax-free for routine medical costs.

Here's one of the oddities with such a plan. People that can set aside money for medical care . . . have EXTRA money. Considering we've got a negative savings rate . . . doesn't look like there's much "extra" money around.

"Most Americans have no idea what their actual cost of treatment is," Bush said. "There's no reason at all to worry about price. Somebody else is paying the bill. ... There's no pressure for an industry to lower prices."

For this reason, we've added a drug benefit to Medicare and we've forbidden the largest purchaser of medication (Medicare) from negotiating prices. We wouldn't want to put any pressure on industry to lower prices.😕

Reid pointed to a study that suggested the number of uninsured, now numbering 46 million, would increase under the plan because employers would respond to the new tax breaks by dropping traditional coverage. Democrats have also said HSAs would mainly benefit the wealthy.

Nissan made more money last year than GM and Ford combined . . . granted that's a pretty low bar. Despite this fact, Ghosn will replace US retiree comprehensive care with a $2500 annual stipend. If Nissan is willing to cut benefits to save money on 500 people (3500 by 2015) can you imagine what larger US companies would do?

His health agenda also includes reining in malpractice lawsuits and letting small businesses band together to buy health insurance at preferred rates offered to larger companies.

The latter makes sense . . . as long as it isn't used to reduce coverage by "leveling" state regulations. The former has long been exposed as a ridiculous red herring.

Deadly errors in the ICU

 

[conjur]

"Most Americans have no idea what their actual cost of treatment is," Bush said. "There's no reason at all to worry about price. Somebody else is paying the bill. ... There's no pressure for an industry to lower prices."


While the 1st part is true of hospital visits, the last part isn't. I've seen hospital bills from my daughter from last year and the discounts afforded to Humana by the hospital are AMAZING! 70-80% discount off the hospital's charges.

Now, someone *without* insurance is going to get hit with the full brunt of those charges. Isn't that lovely?

 

[sandorski]

Don't get sick! 😉

 

[mect]

Originally posted by: BaliBabyDoc
Yahoo

Bush, in his annual State of the Union speech, urged the expansion of health savings accounts, or HSAs, which allow people to set aside money tax-free for routine medical costs.

Here's one of the oddities with such a plan. People that can set aside money for medical care . . . have EXTRA money. Considering we've got a negative savings rate . . . doesn't look like there's much "extra" money around.

Actually, I think most healthy middle class americans would benifit from these plans. I'm far from rich, but I would prefer this along with catastrophic coverage over traditional insurance. My understanding is that most americans aren't living beyond their means, but rather there is a significant group of people living vastly beyond their means. This would suggest that there is still a large group of people who would benifit from these accounts. I agree that a protection mechanism (unfortunately probably government run) is needed for the poor and those with perpetual health problems who can't afford or receive coverage through traditional insurance.

Originally posted by: BaliBabyDoc

"Most Americans have no idea what their actual cost of treatment is," Bush said. "There's no reason at all to worry about price. Somebody else is paying the bill. ... There's no pressure for an industry to lower prices."

For this reason, we've added a drug benefit to Medicare and we've forbidden the largest purchaser of medication (Medicare) from negotiating prices. We wouldn't want to put any pressure on industry to lower prices.😕

I agree it is inconsistant, but don't you want to keep the good sides of the inconsistant legislation and not the bad?

Originally posted by: BaliBabyDoc

Reid pointed to a study that suggested the number of uninsured, now numbering 46 million, would increase under the plan because employers would respond to the new tax breaks by dropping traditional coverage. Democrats have also said HSAs would mainly benefit the wealthy.

Nissan made more money last year than GM and Ford combined . . . granted that's a pretty low bar. Despite this fact, Ghosn will replace US retiree comprehensive care with a $2500 annual stipend. If Nissan is willing to cut benefits to save money on 500 people (3500 by 2015) can you imagine what larger US companies would do?

I would disagree. While traditional insurance coverage would certainly drop, more people would use these accounts so there would be more people with at least some coverage for routine health coverage. Also, I don't think traditional insurance would increase much (again under the assumption that the government picks up perpetually sick cases) due to the competition from another method of health coverage which is controlled completely by the people.

Originally posted by: BaliBabyDoc

His health agenda also includes reining in malpractice lawsuits and letting small businesses band together to buy health insurance at preferred rates offered to larger companies.

The latter makes sense . . . as long as it isn't used to reduce coverage by "leveling" state regulations. The former has long been exposed as a ridiculous red herring.

Deadly errors in the ICU

This article only covers the ICU. My understanding of the situation was that it is primarily gynecologists that are suffering. While this could also be a red herring, there have been numerous reports of states having significant shortages due to doctors leaving the state because they couldn't make it. While this might not affect mainstream health care, it still is a problem that should be reigned in.

So I guess the short answer is that I think that while there are protections that should be put in place, health savings accounts are a great idea for healthy middle class americans.

 

[BaliBabyDoc]

Here's how part of our healthcare system works:

I'm a researcher at an academic medical center. The evil empire (a drug company) wanted to sponsor a trial but only offered a measly 6-grand and free drug. I figured no big deal, we will just bill safety labs to each subject's insurance. An administrative assistant gave me a price list and I told her the numbers were all wrong. I told her there's no friggin' way those prices are right b/c some are over 10x what we pay for our research studies.

"Well, I asked for the price that they charge insurance companies," she said. Naturally my response was, "well no wonder the healthcare system is going to crap."

Every time Bush speaks its abudantly obvious he has no friggin' idea what he's talking about. Healthcare ain't Burger King . . . you can't have it your way. Why not go to BK and ask for . . . the cheapest meat, cheapest cheese, cheapest mustard, cheapest lettuce, and cheapest tomato. What would you get? A cheap arse sandwich. I'm not saying healthcare HAS to be expensive. But their just aren't any "cheap" cardiac catherizations or coil embolizations of aneurysms.

Some health insurance companies have been cajoling medical centers to reduce costs . . . sometimes by excluding the most expensive facilities. IMO, that makes sense. But it's just plain ignorant to think of healthcare as just another consumer product.

You can pick a doctor (pediatrician, neurologist, OB/GYN) but that's just a fraction of overall healthcare costs. No parent in their right mind would have their child get the 1st dose of DTP (diptheria tetanus pertussis) at one place and then go to a different doctor in 2 months to save 10%. Maybe you should hold off on the flu vaccine, it goes on sale next month.😕

Pediatricians perform "well child" visits b/c . . . its much easier (and cheaper) to keep them healthy with regular checkups rather than trying to fix something that's gone wrong. The cheapest provider will HAVE to see the largest number of patients to make up for substantially lower rates. More patients means less time. Less time will often lead to inferior care.

Patients should definitely shop around for meds . . . particularly buying generics. But again that's a case where the "market" has a fighting chance to influence prices. It's just not the case with the majority of our healthcare expenditures unless there's fundamental reform to shift away from interventional care in favor of preventive care.

 

[BaliBabyDoc]

Well its fine to disagree, mect. But you don't know much about the system.

Catastrophic healthcare plans make sense under certain conditions ONLY:
1) healthy
2) can easily set aside several grand each year (rolls over in Bush plan so not too terrible)
3) health plan premiums are relatively low

Curiously, we have a aging, fat, and sedentary population.
50% of the pilot participants in HSAs have set aside NOTHING.
Catastrophic health plan premiums are not cheap.

While some tin ear (and brain) pundits claim all is well. The truth is that the working poor have some company when it comes to worrying. Middle class families with two wage earners are indeed feeling the pinch. Everything has gotten substantially more expensive (mortgage, health insurance, education, daycare, energy). What do you think happens if there's a job loss or illness.

More directly with regards to the overall expense of healthcare. We pay for the care of people with chronic illness. Our healthcare system largely exists to serve these people. Accordingly, having healthy people opt out of typical health insurance does nothing more than make typical health insurance more expensive . . . or worse . . . compel the government to take on care of all chronically ill people.

There's nothing good about Medicare Part D. Some say it provides help for the poor elderly but the poor elderly were dual eligibles . . . meaning they received Medicare AND Medicaid. Curiously, its this population that's had the most trouble with the new legislation. It basically created problems that previously did not exist.

Personally, I would like to see the drug benefit repealed. To replace it the government could spend a couple of billion on efficacy studies . . . basically large head to head comparison studies to determine which drugs work best and in which population. The best drugs will get favored status . . . which by definition means they are cost effective. Manufacturers of weaker performers will have to dramatically cut prices. And of course drugs that don't work will be removed from the market by FDA. In sum, better and more appropriate use of the medications that actually work.

The article discussed ICUs in particular but there's nothing better known in the medical community than the impact of medical errors. It's a fact of life so much so that virtually every department has weekly M&M (morbidity and mortality) where we talk about who fudged up and why.

Here's a tip . . . don't get sick in early July or go in for elective procedures . . . there's a new crop of MDs fresh off the plantation.

 

[mect]

Originally posted by: BaliBabyDoc
Well its fine to disagree, mect. But you don't know much about the system.

Catastrophic healthcare plans make sense under certain conditions ONLY:
1) healthy
2) can easily set aside several grand each year (rolls over in Bush plan so not too terrible)
3) health plan premiums are relatively low

Curiously, we have a aging, fat, and sedentary population.
50% of the pilot participants in HSAs have set aside NOTHING.
Catastrophic health plan premiums are not cheap.

While some tin ear (and brain) pundits claim all is well. The truth is that the working poor have some company when it comes to worrying. Middle class families with two wage earners are indeed feeling the pinch. Everything has gotten substantially more expensive (mortgage, health insurance, education, daycare, energy). What do you think happens if there's a job loss or illness.

More directly with regards to the overall expense of healthcare. We pay for the care of people with chronic illness. Our healthcare system largely exists to serve these people. Accordingly, having healthy people opt out of typical health insurance does nothing more than make typical health insurance more expensive . . . or worse . . . compel the government to take on care of all chronically ill people.

There's nothing good about Medicare Part D. Some say it provides help for the poor elderly but the poor elderly were dual eligibles . . . meaning they received Medicare AND Medicaid. Curiously, its this population that's had the most trouble with the new legislation. It basically created problems that previously did not exist.

Personally, I would like to see the drug benefit repealed. To replace it the government could spend a couple of billion on efficacy studies . . . basically large head to head comparison studies to determine which drugs work best and in which population. The best drugs will get favored status . . . which by definition means they are cost effective. Manufacturers of weaker performers will have to dramatically cut prices. And of course drugs that don't work will be removed from the market by FDA. In sum, better and more appropriate use of the medications that actually work.

The article discussed ICUs in particular but there's nothing better known in the medical community than the impact of medical errors. It's a fact of life so much so that virtually every department has weekly M&M (morbidity and mortality) where we talk about who fudged up and why.

Here's a tip . . . don't get sick in early July or go in for elective procedures . . . there's a new crop of MDs fresh off the plantation.

I understand catastrophic insurance only works under certain circumstances. However, I think that there is a significant portion of the population that fit these circumstances and would therefore benifit from health savings accounts to complement catastrophic insurance. I agree, it isn't for everyone.

If there is a job loss or illness and they are no longer able to cover themselves, then they would go on welfare. What else would they do? What kind of plan other than completely socialized medicine would help in such a situation?

As far as the chronically ill and the elderly, I admit this is tough. By leaving them on, you drive up health insurance costs beyond the reach of many americans (even with traditional insurance). If you turn them over to the government, well, you have the government involved. Either way, if you believe that everyone should have access to health coverage, you end up with people relying on the government for coverage.

I don't know whether it would be a good idea to repeal the drug benifit or not. As you mentioned previously, it is cheaper to keep the people healthy than to treat them. I don't know whether senior medications currently due a good job of that or not. While more research funds are always a good thing, they will not adress current problems, and it is difficult to judge how big of an impact more research funds will have. While opinions seem to vary, there are a lot of critics who think that the basic approach to drug research needs to be changed. (I've only read a handful of papers on drug research, and may be wrong, but I got the impression that combichem was still the major tool).

Again, I freely admit you know more about the subject than I do. I may be wrong on a lot of different areas, but unfortunately I can only make judgements based on my knowledge. I appreciate any critiqueing you have of what I say, as it helps me be more informed.

Edit: and I'll be sure not to get sick in early july

 

[techs]

Originally posted by: BaliBabyDoc
Well its fine to disagree, mect. But you don't know much about the system.

Catastrophic healthcare plans make sense under certain conditions ONLY:
1) healthy
2) can easily set aside several grand each year (rolls over in Bush plan so not too terrible)
3) health plan premiums are relatively low

Curiously, we have a aging, fat, and sedentary population.
50% of the pilot participants in HSAs have set aside NOTHING.
Catastrophic health plan premiums are not cheap.

While some tin ear (and brain) pundits claim all is well. The truth is that the working poor have some company when it comes to worrying. Middle class families with two wage earners are indeed feeling the pinch. Everything has gotten substantially more expensive (mortgage, health insurance, education, daycare, energy). What do you think happens if there's a job loss or illness.

More directly with regards to the overall expense of healthcare. We pay for the care of people with chronic illness. Our healthcare system largely exists to serve these people. Accordingly, having healthy people opt out of typical health insurance does nothing more than make typical health insurance more expensive . . . or worse . . . compel the government to take on care of all chronically ill people.

There's nothing good about Medicare Part D. Some say it provides help for the poor elderly but the poor elderly were dual eligibles . . . meaning they received Medicare AND Medicaid. Curiously, its this population that's had the most trouble with the new legislation. It basically created problems that previously did not exist.

Personally, I would like to see the drug benefit repealed. To replace it the government could spend a couple of billion on efficacy studies . . . basically large head to head comparison studies to determine which drugs work best and in which population. The best drugs will get favored status . . . which by definition means they are cost effective. Manufacturers of weaker performers will have to dramatically cut prices. And of course drugs that don't work will be removed from the market by FDA. In sum, better and more appropriate use of the medications that actually work.

The article discussed ICUs in particular but there's nothing better known in the medical community than the impact of medical errors. It's a fact of life so much so that virtually every department has weekly M&M (morbidity and mortality) where we talk about who fudged up and why.

Here's a tip . . . don't get sick in early July or go in for elective procedures . . . there's a new crop of MDs fresh off the plantation.

As a former executive at a health insurance company I can pretty much vouch for what BaliBabyDoc is saying.
The difficulty with health insurance is that its not "traditional" insurance. Traditional insurance is a way to spread the risk of infrequent bad occurences like a ship sinking (the original insurance was for ships) but health insurance is a way to also cover routine health care. So a part of health insurance money is just money you would have to pay yourself to doctors for routine health checkups which now goes thru a third party. And in effect the third party (the insurance co.) can more effectively negotiate lower prices which makes it worthwhile for the individual to go thru them.
While people without health insurance compain they don't get the lower prices afforded insurance companies, the fact is they tend to not utilize health services as much.
Since the cost of providing health care, doctors overhead, hospital overhead receives less from these people when these people get sick they are, some would argue, only then being billed a fair amount for keeping these facilities going.
The best solution, imo, is some sort of base national health care coupled with incentives to individuals to utilize health care in the best possible way, with incentives to get routine checkups that are mostly paid for by the individual.

 

[charrison]

Originally posted by: conjur
"Most Americans have no idea what their actual cost of treatment is," Bush said. "There's no reason at all to worry about price. Somebody else is paying the bill. ... There's no pressure for an industry to lower prices."


While the 1st part is true of hospital visits, the last part isn't. I've seen hospital bills from my daughter from last year and the discounts afforded to Humana by the hospital are AMAZING! 70-80% discount off the hospital's charges.

Now, someone *without* insurance is going to get hit with the full brunt of those charges. Isn't that lovely?

Similar discounts exist for cash payment as well. This year we opted for lower premiums and more out of pocket costs. There is an advanage for docs to not work with insurance companies. The average company spends 7-8k per employee on health insurance. An HSA only costs about 2K year for a family. This really could work out well for the employee without it costing any extra from the employer.

 

[conjur]

Any proof for those cash payment discounts? Would you mind sending that proof to an ambulance company billing me $1800 *after* insurance has already paid?

 

[charrison]

Originally posted by: conjur
Any proof for those cash payment discounts? Would you mind sending that proof to an ambulance company billing me $1800 *after* insurance has already paid?

Just what my pocket books. However I have only had to deal with doctors and dentists and not hospitals and ambulances.

 

[keird]

I wanted to chime in, too. I've worked in the health care industry for a while. An ER visit will end up being a bill for $300-$400 just to see the MD around here. The cost of staffing a place where RNs making $30/hour, MDs making $80/hour as well as ancillary staff (radiology techs/respiratory therapists/medical assistants/lab techs/janitors/etc...) can be a staggering overhead. Couple this with patients that don't have any health insurance (due to reasons already discussed) it ends up being a net loss for a hospital. My state's subsidized health care plan (MassHealth) is a perfect example of this loss. I don't quite remember the exact figures, but ball-park; we get reimbursed for 50% of the claims we make when we see their patients, of that 50% we receive about 70% of what we claim. It's always a loss with that form of insurance and subjectively speaking, I think it gets abused. Frequent ER visits because it's more convenient than seeing their primary care physician, narcotic seeking individuals looking for a prescription, malingerers seeking notes for work. This isn't the majority, but I just want to describe a subset that abuses it.

That being said, litigation took its toll, too. There was a 300% increase of administrative staff in the 80's-90's. This was the result of insurance. We transitioned from a fee-for-service industry to bargaining with insurance companies for their business. Here's a constant truth: Hospitals blame their woes on the insurance companies and their patients, patients blame the insurance companies and the hospitals, insurance companies blame the hospitals and the patients.

I speak with a physician on occasion (I dated his assistant for a bit) who has been in practice for years. In the 70's he charged $5 per visit. Insurance wasn't wide-spread then and it usually just covered services like operations. He did a lot of OB/GYN, as well. He was doing very well at the time, too.

Now an OB/GYN MD is forced out of his profession because of the staggering litigation threat. It costs about $200,000/year for malpractice insurance in our area! An OB/GYN can be sued for any perceived cognitive impairment until a child is 18 years old. That's crazy! I have a distant family member who is mentally retarded as a result of a major hypoxic insult during childbirth. Her parents won the law-suit. But being in that field is a no brainer to me. Don't go in to it.

If we were strictly a fee-for-service industry with patients having some form of catastrophic health care coverage, I think we'd be in better shape.

 

[BaliBabyDoc]

Not to get too sidetracked with medmal but 200k for OB/GYN is the exception not the norm.

Rates have skyrocketed for several reasons; one of which is purely market-based . . . few insurance providers + captive market = charge whatever the market will bear.

But without a doubt OBs (not GYNs) have taken it on the chin. Compensation for baby catching has never been great but its relatively easy to do and you can do a bunch in a day. Ironically, the more deliveries you make the better you are but more deliveries means eventually you will have some bad outcomes.

Litigation can be mitigated by hospitals and provider networks but small office/single MD practices don't have that kind of cheddar.


As for charrison's contention about cash payments, it's not an uncommon phenomenon outside of Medicare. IIRC, the government has rules that basically prohibit such arrangements. I don't know the rationale.

MDs definitely like it but its a small town, single practice kind of thing. No hospital would dare "cash" operations.


As someone earlier noted, the purpose of insurance is to spread risk. HSAs do not spread risk, they create an incentive for those with the least risk to opt out of typical health insurance plans. This increases the risk for everyone that remains. In essence, the goal appears to be . . . . cripple employer-provided or broad insurance programs. Terrible public policy . . . but that's Bush's forte.


Bush is a moron so he will never understand that our primary problem is how we "consume" healthcare . . . not necessarily how its purchased/reimbursed. He applies his simple cognitive skills to infer that changing how we pay for healthcare will change how we consume it. Truth is that indeed happens but those patterns are typically harmful NOT helpful.

1) If you jack up copays for brand name drugs and discount generics . . . people buy more generics. That's good public policy and a nonfactor for healthcare.
2) If you just jack up copays . . . people don't buy the drugs, half-dose, or skip dose. That's bad public policy and terrible healthcare.

There are tons of examples but for the sake of brevity, our country needs a frank AND open discussion about healthcare. What we should do? What we can afford to do? And what we definitely cannot afford to continue?

 

[techs]

Originally posted by: keird

I speak with a physician on occasion (I dated his assistant for a bit) who has been in practice for years. In the 70's he charged $5 per visit. Insurance wasn't wide-spread then and it usually just covered services like operations. He did a lot of OB/GYN, as well. He was doing very well at the time, too.

Most young people don't remember that doctors fees and hospital fees were covered under two separate health insurance plans.
In New York, like many states, there was one company that had almost all the business (in many states by law).
The Blues. Blue Cross for hospital bills and Blue Shield for doctors bills.
Many people only had Blue Cross. Doctors bills were still reasonable and individuals could pay out of pocket in most cases. When doctors bills rose too high more and more people needed and received Blue Shield from their employers (so much for paying out of pocket keeping costs down theory).
In the 1980's many states were lobbied by private insurance companies to open up the market to for profit and other non-profit companies. After that the market fragmented. This caused hospitals and doctors to gain the upper hand since they weren't dealing with only one company that covered all or most of the people.
Doctors and hospitals went wild with their bills. And the new health insurance companies just kept raising premiums.

 

[Genx87]

We implemented an HSA at my work and my work is kicking in 1000 a year. Our plan includes a single yearly checkup and anything else will be paid through the HSA account.

Our deductible went from 0 to 2500 for a single or 4K for a family. My company kicks in 2500 into the HSA account for a family.

This concept is interesting as it forces the consumer to actually shop doctors for medical care or end up burning through the HSA account and into the deductible. It also reduces the amount of times I want to visit the doctor because I dont want to burn through the account. If I dont use the balance it is carried over to the next year. In theory if I can get the balance above the deductible I have nothing to worry about out of pocket. Once my HSA account hits the 2K threshold I am free to invest it into mutual funds that have a rate of return. If I leave my job and go to another company that doesnt have an HSA I can keep the money until age 65 and cash it in.

I have mixed feelings about this because if you burn through the account then I have lost money. But if I dont then I can come out ahead of the program.

It will be interesting to see how if this becomes a common practice affects pricing in the healthcare industry. It is clear the current system has in no way curtailed rising costs of healthcare. I believe we are seeing double digit increases year over year for everything.

 

[EatSpam]

Originally posted by: Genx87
We implemented an HSA at my work and my work is kicking in 1000 a year. Our plan includes a single yearly checkup and anything else will be paid through the HSA account.

Our deductible went from 0 to 2500 for a single or 4K for a family. My company kicks in 2500 into the HSA account for a family.

Sounds like a decent implementation. Unfortunately, most HSA plans will start with $0 and probably stay there.

 

[Train]

Originally posted by: EatSpam

Originally posted by: Genx87
We implemented an HSA at my work and my work is kicking in 1000 a year. Our plan includes a single yearly checkup and anything else will be paid through the HSA account.

Our deductible went from 0 to 2500 for a single or 4K for a family. My company kicks in 2500 into the HSA account for a family.

Sounds like a decent implementation. Unfortunately, most HSA plans will start with $0 and probably stay there.

My job started an almost identical program,

EatSpam why do you say it will stay at zero? the Account is basically a mutual fund managed by a large investing firm (ours is Wells Fargo) and thier returns over the last few years average 8.5%

 

[EatSpam]

Originally posted by: Train

Originally posted by: EatSpam

Originally posted by: Genx87
We implemented an HSA at my work and my work is kicking in 1000 a year. Our plan includes a single yearly checkup and anything else will be paid through the HSA account.

Our deductible went from 0 to 2500 for a single or 4K for a family. My company kicks in 2500 into the HSA account for a family.

Sounds like a decent implementation. Unfortunately, most HSA plans will start with $0 and probably stay there.

My job started an almost identical program,

EatSpam why do you say it will stay at zero? the Account is basically a mutual fund managed by a large investing firm (ours is Wells Fargo) and thier returns over the last few years average 8.5%

Well, if you don't have money to deposit to begin with.... 🙂 Not everyone can afford it.

 

[Darkhawk28]

Originally posted by: EatSpam

Originally posted by: Train

Originally posted by: EatSpam

Originally posted by: Genx87
We implemented an HSA at my work and my work is kicking in 1000 a year. Our plan includes a single yearly checkup and anything else will be paid through the HSA account.

Our deductible went from 0 to 2500 for a single or 4K for a family. My company kicks in 2500 into the HSA account for a family.

Sounds like a decent implementation. Unfortunately, most HSA plans will start with $0 and probably stay there.

My job started an almost identical program,

EatSpam why do you say it will stay at zero? the Account is basically a mutual fund managed by a large investing firm (ours is Wells Fargo) and thier returns over the last few years average 8.5%

Well, if you don't have money to deposit to begin with.... 🙂 Not everyone can afford it.

Exactly, people are going to be visiting the E.R. more OR not getting any preventative care leading to more expensive problems down the road.

 

[Train]

Originally posted by: EatSpam

Originally posted by: Train

Originally posted by: EatSpam

Originally posted by: Genx87
We implemented an HSA at my work and my work is kicking in 1000 a year. Our plan includes a single yearly checkup and anything else will be paid through the HSA account.

Our deductible went from 0 to 2500 for a single or 4K for a family. My company kicks in 2500 into the HSA account for a family.

Sounds like a decent implementation. Unfortunately, most HSA plans will start with $0 and probably stay there.

My job started an almost identical program,

EatSpam why do you say it will stay at zero? the Account is basically a mutual fund managed by a large investing firm (ours is Wells Fargo) and thier returns over the last few years average 8.5%

Well, if you don't have money to deposit to begin with.... 🙂 Not everyone can afford it.

I put $0 into it, no problem affording that. my company puts in $2500 a year. Some people add up to the maximum $2500 a year. Thats $5k a year, compounded, it can become pretty large.

its probably not a good choice for older people who already have high medical bills. But if you start young, a few years of compounding interest, and throw in a few bucks on your own, and eventually your set for life. If i leave my company, its just like a 401k, I can roll it over into another company's HSA or just maintain it on my own.

 

[Engineer]

My company started an HSA this year with catastrophic insurance. You can place $5,000 per year (which is the deductible) into the account tax free. However, this is no premiums at all for the catastrophic insurance. At over $200 per month plus deductibles, copays and 80/20 after that for the best plan, it's tempting to just do the catastrophic plan as over half of the $5,000 could be met with the over $200 per month premiums of the regular account. I've been debating it...maybe next year I'll see if it's worth the risk or not.

 

[charrison]

Originally posted by: EatSpam

Originally posted by: Genx87
We implemented an HSA at my work and my work is kicking in 1000 a year. Our plan includes a single yearly checkup and anything else will be paid through the HSA account.

Our deductible went from 0 to 2500 for a single or 4K for a family. My company kicks in 2500 into the HSA account for a family.

Sounds like a decent implementation. Unfortunately, most HSA plans will start with $0 and probably stay there.

Why do you think that? Good companies will continue to provide worse coverage than their current options?

 

[1EZduzit]

Yeah, things are out of hand. People are even getting health insurance for their pets these days because of the high costs. Soon I won't even be able to afford to go to a Vet.

PetAssure

 

[EatSpam]

Originally posted by: charrison

Originally posted by: EatSpam

Originally posted by: Genx87
We implemented an HSA at my work and my work is kicking in 1000 a year. Our plan includes a single yearly checkup and anything else will be paid through the HSA account.

Our deductible went from 0 to 2500 for a single or 4K for a family. My company kicks in 2500 into the HSA account for a family.

Sounds like a decent implementation. Unfortunately, most HSA plans will start with $0 and probably stay there.

Why do you think that? Good companies will continue to provide worse coverage than their current options?

Yeah, that's the trend. Employers are increasing copays, deductables, and premiums. Sounds like worse coverage to me.

 

[charrison]

Originally posted by: Engineer
My company started an HSA this year with catastrophic insurance. You can place $5,000 per year (which is the deductible) into the account tax free. However, this is no premiums at all for the catastrophic insurance. At over $200 per month plus deductibles, copays and 80/20 after that for the best plan, it's tempting to just do the catastrophic plan as over half of the $5,000 could be met with the over $200 per month premiums of the regular account. I've been debating it...maybe next year I'll see if it's worth the risk or not.

That sounds like a good deal.