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Moderating The Death Panel

Thu, 10/01/2009 - 12:38pm

 

By Carrie Ellis, Editor, Chem.Info

Appropriately, I write this blog from the comfort of bed — pillows stacked up behind me, tissue on my right, orange juice on the left, laptop whirring on my arched legs in the beautiful Gaylord Hotel in Orlando, FL. Considering that I flew here specifically to be at the Emerson Global Users Exchange (in amazing Floridian weather whilst my native Wisconsin is getting pummeled by rain and even hail), I couldn’t help but think what a waste.

And when I say that, I by no means mean the event itself, which is proving to be quite valuable, but the fact that I’m here and sick, and not operating at 100 percent, but still expected to perform even if it is my own expectation.

It got me thinking about health care, as well as other health-related proposals both politicians and companies are throwing at the wall, much like spaghetti, just hoping that something eventually sticks. Companies seem to be getting more and more involved in such debate as they realize how important employee health is to their productivity and even overhead as far as health insurance.

Politicians also can’t help but be involved, however preposterous their ideas. I recently read that a Republican senator is pushing an amendment to the current health care bill that discounts private health insurance up to 50 percent for people who lead healthy lifestyles. To that I say, what’s the point of having health insurance then? Some people can’t help their health history — what about them?

Another possibility that has been not only lip service, but also put into play is that companies become more involved in your personal health care issues and affect your health resolutions by incentivizing healthy decision making. Other companies are simply just handing their employees access to services and/or equipment that makes healthy living easier, such as smoking cessation support, fitness programs and gym memberships, etc.

One such example is Bison Gear, an Illinois manufacturer that was just recognized as the “Healthiest Company in America,” winning an award that illustrates its commitment to employee health and well-being with innovative health and wellness initiatives that actually yielded measurable employee health improvements.

Health care is an enormous, overarching issue that I’m afraid only some are interested in enough to do the research, while others rely simply on what is regurgitated through the local evening news. Every company and individual will be affected by what is decided upon — even if nothing comes to fruition, it will affect you. If we do nothing, we’ll sink further into complacency, debt and sickness as a nation. If we do something, we just don’t know what will happen, which can be scary in and of itself.

As of now, one American dies every 12 minutes from lack of health care, according to David Himmelstein, an associate professor of medicine at Harvard. And it doesn’t look good for employers either. An article by the Associated Press states, “Costs for employer-provided health plans are expected to rise more than 10 percent within the next 12 months, a jump workers may feel in their paychecks or through changes to their insurance coverage.”

You see it everywhere, whether for or against or for modification in favor of or opposed to — it’s health care and everyone has an opinion. And each thinks his or her opinion is better than the next. But it’s not important what I think, nor is it important what Republican Joe Wilson thinks. It’s important that you at least think.

Where do you stand on the topic of health care? How involved do you want your employer to be in your health issues? What do you think of preventive medicine? How about incentivized health care?

Sound off by sending me an e-mail at carrie.ellis@advantagemedia.com.

Comments:

You asked for opinions / ideas on health care? Here goes:

Insurance is a big part of the problem. As most insurance is currently structured people don’t have an incentive to keep costs low. If a deductable is $30, no matter if the Dr. (or medicine) costs $50 or $500, why does the employee care? Why does any Dr. charge the lesser amount? Over time people want more services and aren’t interested in what it costs – rates and total services provided escalate. For many big employers the insurer is actually just an administrator that works on a percentage of total cost. So, the more spent, the more the administrator/insurance company ‘earns.’ The incentive is not structured properly.

The best improvement I have found is that represented by John Mackey (the Whole Foods guy) who was boycotted for his editorial in the WSJ by supporters of a public funded system. In his concept, health care accounts set up for each individual employee are used for all small to moderate needs, including all discretionary items such as glasses vs. eye surgery. People then try to shop and save to make the funds go further. Only very large expenses, such as care accidents, cancer, expensive chronic conditions would be covered by insurance. In my opinion the patient should pay a small percentage, perhaps 2% (or a sliding scale say 3% down to 1% above very high values, but not a fixed deductable) of the major expenses, so that they have an incentive to keep even those costs down.

Mr. Mackey doesn’t just advocate the program of health care savings accounts; he has implemented this for his ~50,000 employees. He covers most or all of his employees, when most grocery store chains do not. This was also detailed on a John Stossel ABC News program.

Similar and much more detailed answers are explained by David Goldhill in ‘The Atlantic.’ His article is titled How the American Health Care System Killed My Father from a month or two ago is the best I have seen. He addresses the incentive issue and several other concepts to improve the system.

Employers should be encouraged to convert their health care plans to a similar concept. A system of similar incentives could also be phased in for people entering public programs such as Medicare and Medicaid. If most people care about cost for each service they need, the whole pricing structure of the health care system would become cost conscious. That would be a big step toward long-term sustainability, and would allow for better care for more people.

Without cost containment (which should use the patient’s incentive as a major part), fewer and fewer companies will be able to offer an affordable program, and those that do, will have the wages for their employees suffer. Public programs will consume an ever larger portion of our tax dollars. These and other reform steps that recognize incentive can greatly improve our system going forward.

Scott


I totally agree with what you have stated. 


I don't reply to articles, but decided to respond to you because health care is a very big issue.

America needs some overhaul of the health care industry, but I personally don't believe it needs a government run system.

As you stated, a lot of lip service has been performed, but little positive action.

The problem as I see it is that greed has had it's way in health care as it has in the financial system I work for a company that is self insured. They set the rules (prices/coverage). Since switching to self insured, the price went up and the coverage went down. Why do I think they self insure? To make money off the employees. As we move from a manufacturing country to a "service" country, the business people are all becoming banks and insurance companies. They know that better than manufacturing because that is what they study to become a MBA to achieve promotions.

Politicians "think" they are the experts in many fields including this one. But stop to think what qualifications are needed to become a politician.

1.) enough money to run

2.) Enough votes to win.

Not many other minimum qualification except citizenship in some cases.

Does this make them businessmen/women or experts? I say no, and maybe exactly the opposite. They are far removed from the realities of everyday life.

If what they propose will work well, why do they exclude themselves?

It's reported that 9 out of 10 people are insured and pretty satisfied with their health care. If that is so, why such a big plan for 10% of the population? Why not just ensure that the 10% has somewhere to go "when they need it". Seems like this would cost less that $900 Billion.

As with the financial system, health care needs some guidance, but not a government takeover.

Thanks,
Howard


I'll try to be brief.

The health care system is not broken.  I'm quite happy with what I have, and I really don't want the government messing with it. 

Yes, the pundits will say that Medicare is government run health care and that is true.  But I also pay a lifetime of earnings into that program with no choice about it.  I'd be just as happy if they returned all my Medicare deductions with interest to be put into a health savings account just for that purpose.

I'm also familiar with another form of government run health care having served 11 years on active duty and I am currently in Reserves.  The care was generally adequate, but it could vary considerably depending on location or doctor.  I will say the services have come a long way in improving health care to the military over the 24 years I've been associated with the service.  It used to be that the military rules did not require state board certified doctors, sooooooo those who couldn't pass a state board could work for the prisons and the military.  Nice.  No longer true today, thank God. 

Health costs are rising very quickly.  True as well, BUT the care we get today is absolutely phenomenal compared to 20 or 30 years ago.  Also, the availability is astounding.  I can see a doctor today, and get an amazing MRI scan tomorrow.  You will not find that kind of responsiveness in other countries with so-called "socialized medicine".  Also, they are fixing things today that our parents "just had to live with."  As with everything else, you get what you pay for.  I don't want the government telling a business how much they can charge.  It's never worked before, it won't work now.  Would you want a job where the government told you how much you can earn? 

Health insurance, it is not.  What we have today are health maintenance contracts.  It was not always this way.  The unions are the ones who started this mess and it quickly moved into the corporate world as a perk to attract talent.  I remember back in the 60's, going to the doctor and my parents paid in cash or with a check at the end of the visit. Period.  No billing, no extra staff, no huge corporations for the express purpose of writing the doctor a check.  Two people worked in the practice:  the doctor and his nurse who handled the front desk and the shots and assisted the doctor with stuff.  Health insurance back then meant spending significant money before the benefits kicked in.  THAT, was health INSURANCE.  This method of paying for health care has bloated the whole system beyond belief.  Can you imagine paying a monthly premium so someone will change the oil or replace the tires or brakes in your car?

With these paid health maintenance contracts, what incentive do people have to conserve resources?  If it's free or damn near free, people will use it willy-nilly.  And they do.  A $20 co-pay is a joke.  People spend more than that feeding their kids at McDee's.  No wonder why our premiums have sky-rocketed.  Incentivized care (the buzz-word of the day) works better.  In exchange for premiums that are $150 per month less than traditional programs, my company "gives" me and my family $2,000 for health care costs (doctors, hospital, prescriptions, whatever) to be paid at 100%.  Once I reach the $2,000 limit, I have to pay out-of-pocket the next $1,600 in health care costs.  Once I reach a total of $3,600, the "traditional" insurance of 90%-10% kicks in.  At a much higher level, then it goes 100%.  By the way, the $150 per month savings "pays" the $1,600 "bridge" money over the course of the year and then some.  Here is where it gets good.  If I don't spend all of my $2,000 annual allotment, it rolls over to the next year.  Now I have a reason to be circumspect about how I use health care, because I can "save" for the things that really are important.

We need to get away from the notion that "someone else" pays for my health care.  Only then can we control costs.


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