Wednesday, April 05, 2006

These admin clowns need to manage THEIR own health care

…The WSJ had a profile of Allan Hubbard, the government’s new health policymaker.

…He’s a buddy of you know who from Harvard Biz and now the pitchman for the “pay it yourself so you will appreciate it more” crowd.

…He got in some smackdown with a guy from Tenet Healthcare because Tenet didn’t want to publish its prices, saying the figures are meaningless because insurance companies have contracts with the hospitals to pay only a small percentage of sticker.

…Do these guys even know what insurance they have? Or do their wives hand them a card in case they get a papercut or a heart attack?

…If this guy’s kid got hurt and was bleeding, would he whip out his hospital cost-comparison? “Let’s see, it’s $150 a stitch here, $130 here, Timmy. Calm down, pal, Daddy just wants to shop for health care so market forces can help regulate cost inflation.”

…No! He would go to the hospital on his health card—the one his insurance has approved for his use!

…As for Health Savings Accounts (their little pets, the HSAs), the high-deductible policy is not that much cheaper, some companies won’t sell it to people with pre-existings, you can’t spend the account after a certain age on anything you want (just certain things), and most of the people who are going this route have the high-deductible account, but no savings in there to pay up until the policy cuts in.

…These guys should spend an hour on the phone with their health plan trying to figure out why a deductible was suddenly applied to things where it didn’t apply before.

…No, make that six hours, over several days. Here is the sequence you are waiting for: “Deet, deet, deet, if you’d like to make a call…”

…Sure, you have to work, but so does everyone else.

…We can read those sheets the insurance company sends—we know the whole cost. We don’t really think a trip to the doctor costs $20. What are we, idiots?

…We just can’t afford our part, much less the whole ride.


Bill Thomasson said...

Let's look at this from a different point of view. Let's say it works as designed: People establish health savings accounts and buy catastrophic insurance. And let's assume the money in the account that you don't spend one year is in one way or another available to you the next -- I don't think anyone is proposing "use it or lose it." What does it actually encourage people to do?

It encourages them to skimp on the small, routine health expenditures that will come out of the HSAs. On preventive care and on early treatment for things that may, after all, go away on their own. If people are smart (Huh?), they will realize this increases their risk of serious illness. But from a purely financial point of view, it doesn't matter to them: If they get something really bad that costs a heck of a lot of money, the catastrophic insurance will pick it up. Financially, not their worry.

The bottom line? Health care costs for society as a whole go up. I wonder if that's the idea.

Star said...

I don't know if that's the idea, but to me basically HSAs are a way of saying pay for it yourself. That's fine if it's reasonable--but my sister's hip replacement was $64K for 4 days. The hip itself was $40K or something. This is in the realm of ridiculous, Kafka-esque.

I had a friend with an accidental gun shot to his hand--$500K by the time the state of AZ paid all the hand surgeons. He was not working at the time.

Skipping small things does not always lead to something bad. I skip stuff to the biggest extent possible bec trips to the doc are usually amorphous, indeterminate and time-consuming. I am not better, yet I don't feel worse, move on.

Yet, things are getting worse. My niece told me today that at Chase Bank there are sharps containers in the bathrooms bec so many people have diabetes.