Comments on: The GAO Studies Consumer-Driven Health Care

By: artk

artk — Wed, 01 Sep 2010 00:45:50 +0000

Sure Erik, that’s simple. All I need to figure out which insurance deal is better are two or three weeks time of a couple of MBAs to run simulations with complete information on the health probabilities of me and my wife; drug prices; and provider prices. After all, the insurance companies have an army of MBAs and months to figure out pricing.

The essential issue is that all those choices are no choice at all.

By: Erik Ramirez

Erik Ramirez — Tue, 31 Aug 2010 18:18:12 +0000

Here is a true comparrison:

Two Anthem Small Group Plans (CA)

Solutions 2500 PPO
Deductible – $2,500 (2 member max)
Copay Limit – $5,000 (2 member max)
Office Visit – $25
Hospital – 25%
ER – $100 + 25%
Rx – $10/$25/$50 $250 Brand deductible
Cost – (24 employees-age banded) $10,695 per month
Ave – $445.62 per employee

Lumenos HSA 2500
Deductible – $2,500/$5,000
Copay Limit – $5,000/$10,000
Office Visit – 20%
Hospital – 20%
ER – 20%
Rx – $10/$30/$50 after dedcutible ($2,500)
Cost – (24 employees-age banded) $11,756 per month
Ave – $489.83 per employee

What would you buy?

By: Tom H.

Tom H. — Tue, 31 Aug 2010 16:12:54 +0000

The limits on HSA exposure are typically lower than for the garden variety PPO plan. Also, The HSA plans are the only plans that have LIMITS SET BY FEDERAL LAW. It’s amazing to me that so many people (pundits) complain about HSA plans being bad for the poor and the sick when these plans come with more protection than any other plan!

Also, the average employer contribution is $750 a year to the HSA account. That means that the poor person with the HSA enters the market with $750 in hand (and more in future years as balances grow and roll over), while the poor person with a PPO plan has to come up with the first $750 out of his own pocket.

By: R. G.

R. G. — Tue, 31 Aug 2010 14:51:31 +0000

artk, you said, “The problem is that every study has shown that lower income people sicker people have worse outcomes with high deductible policies than they have with low deductible. If you think about it, it make perfect sense, if you’re having trouble keeping up with rent and food, that doctors appointment that might prevent something more serious down the road is more difficult to justify.”

Most HSA qualifying coverage has a “”ZERO”" deductible on preventative services!!

Your petty gripe is over 5 years old. Get a current.

By: Art

Art — Tue, 31 Aug 2010 14:11:19 +0000

Comparing amounts and types of insurance coverage is meaningless, unless one has a base to compare between these amounts and plans.

Until we have a “price list” as most other nations do or unless providers become not-for-profit, the type of insurance coverage and therefore comparisons between them are purely academic.

By: artk

artk — Tue, 31 Aug 2010 12:51:06 +0000

Tom, every health insurance policy I can remember having, regardless of its deductible, has had an out of pocket limitation. The problem is that every study has shown that lower income people sicker people have worse outcomes with high deductible policies than they have with low deductible. If you think about it, it make perfect sense, if you’re having trouble keeping up with rent and food, that doctors appointment that might prevent something more serious down the road is more difficult to justify. If you’re in a higher income group, you have more disposable income so the that doctors appointment isn’t a big deal.

By: Tom H.

Tom H. — Tue, 31 Aug 2010 12:39:29 +0000

Even if the employer makes no contribution to the HSA, sick people are almost always better off than with a conventional PPO. The reason? By law, HSA plans limit the amount of out-of-pocket exposure and this limit is almost always below what you would pay with a conventional insurance plan.

I don’t know why people like artk keep repeating nonsense. These myths never seem to go away.

By: Linda Gorman

Linda Gorman — Mon, 30 Aug 2010 22:58:15 +0000

The Cash & Counseling experiments show that low income sick people do better on HSA type arrangements as well. For one thing, they can use cash to actually access the services that Medicaid has promised them.

By: R. G.

R. G. — Mon, 30 Aug 2010 21:46:12 +0000

Actually, artk, the HSA deductible in 2010 is $1,200 for single coverage that pays 100% thereafter, including Rx. That’s pretty small out-of-pocket that would be “hard” to duplicate with non-HSA coverage.

Remember, sick people would prefer to pay their out-of-pocket with pre-taxed dollars too. There is no FICA tax on employer HSA deposits.

So you are wrong about “sick lower income people do measurably worse,” with HSA coverage. You sound like an uninformed Democrat.

Always remember that HSAs are the ultimate panacea.

By: artk

artk — Mon, 30 Aug 2010 21:09:40 +0000

Actually, Ken, what we know about HSAs is companies pay less; healthy people pay less; sick upper income people do the same; sick lower income people do measurably worse. The main problem with all the high deductible plans is that they disadvantage the people who have the worst access problems and outcomes.