HSAs Aren't the Answer

Don't get me wrong, I think HSAs are the best thing going right now. But they are not a solution to this country's healthcare problem like this administration claims they are. HSAs are a great alternative to traditional healthcare if you have the money to pay the premium and still have extra money to invest. If this works for you, great!
But if so, you are not the type of people that are part of the growing healthcare crisis. There are nearly 45 million Americans that are uninsured. I agree that some of those uninsured just have their priorities mixed up and may have plasma TV's and iPod's at the same time they "can't afford" health insurance. But most of those 45 million really can't even afford the premium for an HSA qualified high deductible health plan, let alone the extra money to invest in the health savings account.
Our government needs to think of a real solution to this healthcare crisis soon (other than slashing Medicare). But as soon as any other ideas are mentioned, critics start screaming "national healthcare". They claim that any type of national healthcare program would increase the already inflated tax burden on families and businesses. This message is so loud because the insurance industry is providing the megaphone.
I'm the only health insurance broker I've seen that isn't screaming about how HSAs are the magic bullet for everybody's needs. For our clients in upper income tax brackets, I am saying that. But health insurance companies and brokers are acting like the healthcare crisis in this country is now fixed because of HSAs. Mainly because they fear that helping the uninsured with anything that smells like national healthcare would put them out of the job.
Actually, it's their idea to look the other way that's going to put them out of the job. As more and more people can't afford health insurance and aren't paying premiums, they're still getting necessary medical services and eventually aren't able to pay the doctor or hospital. The doctors and hospitals need to shift those costs and charge more to paying clients, or the insurance companies. This, in turn, increases the premiums for everybody with health insurance and will cause a few thousand more to be unable to afford their health insurance anymore. And that cycle will continue to accelerate and is just about to explode in our faces.

Humana Creates RightSource

For mail order prescriptions, Humana has been using Walgreens. They must now feel they can do a better job with customer service and probably cut costs a little by doing it themselves, because they just created RightSource. RightSource is their own prescription drug facility. Starting September 1, they will start moving the mail order prescriptions of their clients' from the Walgreens mail service to RightSource. If you are a Humana mail order customer, you shouldn't notice a difference.
Humana mail order clients can now receive a 90 day mail order supply. Humana claims that the new system will cut costs and offer more generic alternatives and discounts, saving their customers money. Humana will also notify the clients when they receive their order and when they ship it, and customers will also be able to speak directly to a pharmacy technician.if they need help.

Humana finally offers a high deductible - high deductible health plan

For several years, Humana has been one of our "go-to" plans at Insurance Shoppers when it came to high deductible health insurance plans. But lately, plans from Anthem Blue Cross Blue Shield of Colorado and United HealthCare have offered more choice by having the more desireable deductible for people looking for that type of plan.
If somebody is looking for an HSA qualified High Deductible Health Plan (HDHP), they understand that they can save a lot of money by self-insuring non-catastrophic events. The highest deductible Humana had was $2,650 for individuals or $5,150 for families. The niche of people looking at plans like this really want to save money and they can already find plenty of other plans to compare with this deductible. When they do compare, the 100% coinsurance is going to be more expensive because it offers less of an exposure and the 80% coinsurance is right in line with a lot of plans that can offer more benefits - like non-HSA qualified plans.
Well, now you can actually find a Humana HSA qualified plan with a $5,000 deductible for individuals and a $10,000 deductible for families in Colorado and Texas. For more information about these plans, visit the Humana page at Insurance Shoppers.

Mergers limiting choice - Part II

5 days ago, I made a post about the latest mergers of health insurance companies doing business in Colorado. The gist of it stated that new supercompanies of Anthem Blue Cross Blue Shield and United HealthCare were formed. The United HealthCare merger gulped up 4 companies that were once competing and combined them into 1 - this reducing your choice as a consumer. Another thing this would create is a company with such a large market share in Colorado that it would have unfair leverage when negotiating contracts with doctors and hospitals. A small family practice probably can't afford to lose all of it's clients that belong to such a large company.

Apparently, a hospital chain as large as HCA can. While contract negotiations between the two sides have been going on for months, United HealthCare released a statement today saying:

"While these discussions are ongoing, HCA has sent UnitedHealthcare a notice that would terminate the UnitedHealthcare contract in Tampa and South Florida on August 29, 2006 and in Denver on August 31, 2006. Golden Rule is mailing notification to insureds in those markets today."

The following Denver, Colorado area HealthOne (HCA) hospitals & ambulatory centers will be affected by the termination of the HCA contract:
Hospitals
North Suburban Medical Center
Presbyterian/St Luke’s Med Ctr
Rose Medical Center
Sky Ridge Medical Center
Spaulding Rehabilitation Hospital
Swedish Medical Center
Med Center of Aurora

Ambulatory Surgery Centers
Centennial Medical Plaza
Centrum Surgical Center
Clear Creek Surgical Center
Lakewood Surgical Center
Lowry Surgery Center
Med Center of Aurora North – IP
Midtown Surgical Center
North Suburban Surgery Center
Rocky Mountain Surgical Center
Rose Surgical Center
Sky Ridge Surgical Center

Bad advice

Below is a funny letter to the editor from the Indianapolis Star - view the original

The Aug. 1 editorial, "Do-it-yourself fixes for high health costs," neglected one significant step consumers can take to hold down costs: If you are relatively young and healthy, don't buy health insurance. Learn to distinguish between the cost of health insurance and the cost of treatment, and be aware that for the large majority insurance premiums are approximately five to 10 times the actual cost of medical care in any given year. For a family of four, the break-even point is about $4,000 to $5,000.
James Huston
Rushville

This advice works just fine if you can see the future. The problem for most people is that, they can't. If you don't have any health insurance and have over $4,000 to $5,000 worth of medical expenses, you're not going to be able to get health insurance. It's like trying to get homeowners insurance after your house burned down or auto insurance after you've totalled your car.
The best solution for the young and healthy is to get catastrophic health insurance that will give them an exposure similar to what James was talking about (between $4,000 to $5,000) in deductible or deductible/ coinsurance mix. Tonik from Anthem Blue Cross Blue Shield is targeted right at that age group. The only problem with the Tonik plans is that they don't cover brand name prescriptions, but that is usually the lowest probability for that age group. It's all a gamble in the end.

Mergers limiting choice

At the end of 2005, Anthem Blue Cross Blue Shield merged with Wellpoint to become the largest health insurance company in the nation. Although that merger didn't remove any competing health insurance companies from the Colorado market, it did give the smaller companies even more of a competitive disadvantage.

The real mergers limiting choice over the last 2 years are when PacifiCare merged with American Medical Security (AMS), United HealthCare merged with Golden Rule, then PacifiCare/AMS merged with United HealthCare/Golden Rule. This will effectively take 4 competing health insurance companies out of the Colorado market and replace them with one super company the size of Anthem/Wellpoint. I'm sure smaller companies like Celtic, Time, IAC, etc, are feeling the pinch and also discovering a need to merge with somebody to stay competitive. Hopefully, Kaiser or Humana won't feel a need to merge with anybody in the near future.

Just think if [Anthem/Wellpoint] and [PacifiCare / AMS/ United/ Golden Rule] were allowed to merge??

The Impact on Doctors

Not only are these mergers taking a toll on the choice health insurance clients have in Colorado and the benefits the competition creates for them, but doctors and hospitals realize a huge disadvantage in their negotiations with these insurance companies. If you belong to a managed care plan like a PPO, the health insurance company will tell you which doctors and hospitals are "in-network" and you will go to those to get the in-network benefits. Before these mergers, United HealthCare (for example) might have come to me (as a doctor) with a contract that would pay me very little for my services. I might have been okay not agreeing to the United HealthCare contract because I would still get plenty of business from being in-network for other companies like PacifiCare, AMS, or Golden Rule. After the merger, the new company of [PacifiCare /AMS /United/ Golden Rule] will have a lot more bargaining power knowing that I might not get enough business without their clients.