High-Deductible Plans and HSA's Not Gaining Traction

The post below is from one of my favorite places to peruse, The Health Care Blog. Really a quality site for wonks (or those of us who try to be). This particular post piqued my interest because it touches a nerve for all providers, like myself, who deal with both patients and policy.

My feelings about HSA's and high-deductible plans are mixed. Yes, they can allow for easier access to health insurance among the uninsured, especially small business owners. They do fill a niche but that might be all. If I did not have good benefits through my wife's job this is actually the type of plan I would have to consider. However, this again reflects a policy trend that allows HMO's to provide a lot less coverage for only slightly less premium cost. Which means...you got it...much more profit for the HMO. After you're done paying the high deductible and higher co-pays you pretty much lose the advantage of slightly lower premiums. If you do the math that can be a bad deal and I think that's why people are not taking to them. Also, people simply do not trust HMO products anymore. Especially the new ones that are promoted as "consumer oriented." It's not consumer oriented if the consumer pays just a little less but gets A LOT less in return. That is a sham. Then again, it might be the better sham for you and your family. You decide.

If you can deal with my typo's (typing while dealing with a 2yr old can be a test) you can read the comments myself and few others exchanged by going to the site and clicking on "comments" at the end of the post.


From http://www.thehealthcareblog.com/

POLICY: Low prices ain't cheap enough

Mercer says that the number of small businesses offering health insurance to workers went down last year despite the greater and easier availability of high-deductible and HSA plans.
Fewer small employers offered health insurance this year, despite the widespread availability of new, lower-cost high-deductible insurance plans, a survey released today by benefit firm Mercer shows. Advocates of the high-deductible plans touted them as one solution to the growing number of uninsured, expecting the plans to appeal to small employers, who would continue to offer health insurance as a result. "That's not happening," says Blaine Bos, a Mercer partner and one of the study authors. "In fact, the reverse is happening."The study of nearly 3,000 employers found that the percentage of employers with 200 workers or fewer offering any kind of health insurance fell to 61% this year from 63% in 2006.That drop came even as the cost of high-deductible plans with tax-free savings accounts averaged $5,970 per worker per year. That was $700 less than a comparable plan without a savings account and far lower than the $7,120 for the average HMO, the study says. HSA/HRA type plans are growing in the market, but not as fast as employers are dropping coverage.
Continue reading "POLICY: Low prices ain't cheap enough"

Cigna Unfazed by '08 Election (and the need to pitch in?)

Cigna's just kinda laying it out there, huh? See the article below captured from the Hartford Courant website. I love how they tell us it's a good thing that patients will pay more out of pocket. In this article they help answer the question "where's all the money in health care?" 10% growth no matter how desperate the country is to lower costs? They do recognize that funnelling patients to doctors that do a good job clinically and help lower costs is part of their plan. I give them that much credit. The chiropractors have been suggesting that for 15 years. However, will they share their "savings" with employers and patients? Um, well, they're more likely to keep it all and then report it to Wall Street as 10% growth...which is pretty much what they are telling us here. Please correct me if I am wrong.

"LITTLE ROCK, Ark. —NEW YORK — - CIGNA Corp., the U.S. insurer specializing in employer-sponsored health plans, expects net income to grow an average 10 percent a year regardless of who wins the 2008 elections, the company's chief executive said.The Philadelphia-based company will gain under any of the health care plans being offered by candidates for president, CEO Edward Hanway said Friday at an analysts meeting in New York. CIGNA will emphasize high-deductible health plans that give policyholders incentives to control costs, guide them to preferred doctors and offer preventive advice, he said.Voters have put health care reform high in polls for the presidential campaign agenda, and candidates are outlining plans to provide benefits to some or all of the 47 million uninsured Americans. CIGNA will capitalize on that, expanding sales of plans to individuals and families and to the elderly through the U.S. Medicare program, Hanway said.
The 10 percent gain in net income forecast for the next three to five years will translate into earnings per share of 12 percent to 15 percent, according to the forecast."