| Author |
Message |
    
themp
Supporter
Username: Themp
Post Number: 2559
Registered: 12-2001
| | Posted on Thursday, February 16, 2006 - 9:58 pm: | 
|
You show up, you got a traditional plan, you got your down payment, you pay a little co-pay, but you have no idea what the cost is. Somebody else pays it for you. And so there's no reason at all to kind of worry about price. If somebody else is paying the bill, you just kind of — hey, it seems like a pretty good deal.
....For many routine medical needs, HSAs mean you can shop around until you get the best treatment for the best price. In other words, it's your money; you're responsible for routine medical expenses....And so you — you talk to your doctor, you say, can't we find this drug at a little cheaper cost? Or you go to a specialist, maybe we can do this a little better — old Joe does it for X, I'm going — why don't you try it for Y?
G W Bush 2/15/06
Oh, yeah, sign me up, as long as I get to worry about costs. |
cjc
Citizen
Username: Cjc
Post Number: 5203
Registered: 8-2003
| | Posted on Thursday, February 16, 2006 - 10:07 pm: |
|
That's quite a revealing statement you've made about yourself there themp. |
Andrew N de la Torre
Citizen
Username: Delatorre
Post Number: 445
Registered: 2-2003
| | Posted on Thursday, February 16, 2006 - 10:50 pm: |
|
I attended a lecture today by a healthcare management expert. Interestingly, he first told us he was a traditional republican, mostly because he hates taxes. He stated HSA's are best suited for the top 15th percentile of income earners. Older and middle income people get very little benefit from these types of programs. |
themp
Supporter
Username: Themp
Post Number: 2560
Registered: 12-2001
| | Posted on Thursday, February 16, 2006 - 11:13 pm: |
|
Yes, that I can spot a political dog. |
tom
Citizen
Username: Tom
Post Number: 4368
Registered: 5-2001
| | Posted on Thursday, February 16, 2006 - 11:14 pm: |
|
Me, I'm just DYING to have another thing in my life get more complicated and be more work. Negotiating for health care? Bring it on, baby. Next time I've got an inner ear infection or something and I'm screaming in pain I'm gonna just DIG the extra fun part of trying to knock the price of antibiotics down too. |
mjh
Supporter
Username: Mjh
Post Number: 380
Registered: 5-2001
| | Posted on Friday, February 17, 2006 - 7:26 am: |
|
Good one tom. I was thinking along the same lines. Gee, I just found out I have cancer. Nothing I'd love more than to call around looking for the cheapest chemotherapy and radiation. I love to shop when I'm sick.
I predict HSA's will go the way of the big plan for SS "reform". Lead balloon. |
Bob K
Supporter
Username: Bobk
Post Number: 10716
Registered: 5-2001
| | Posted on Friday, February 17, 2006 - 7:47 am: |
|
Actually HSAs make some sense when used in connection with a medical plan.
Insurance, especially for routine things, is a dollar trading game with a big portion of the dollar going for the insurers administrative, claim handling and sales expenses. I don't know about health insurance, but in casualty and property insurance these expenses can run over 40% of the premium.
Large companies have self-insured a significant amount of their esposures for years, even without the tax break the Bushies are proposing for the HSAs because of the expense load. This kind of confirms Dr. DLT's consultants remarks btw.
There is an issue in that health insurers control the charges doctors and hospitals get reimbursed for. If you are trying to do this on your own, forget about it. There is no way you can figure out what a "reasonable and customary" charge is for a procedure. |
mjh
Supporter
Username: Mjh
Post Number: 382
Registered: 5-2001
| | Posted on Friday, February 17, 2006 - 9:40 am: |
|
"...in casualty and property insurance these expenses can run over 40% of the premium"
And therein lies the biggest problem with health care costs, IMHO. Medicare and the VA do much better with admin costs. How many pieces of paper from the insurance company are generated for every doctor visit? Add to that the fact that these communications are generally incomprehensible. Add to that the first few pieces of mail generated try to make you believe you will have to pay for something that they are obligated to pay.
Rant over. |
cjc
Citizen
Username: Cjc
Post Number: 5204
Registered: 8-2003
| | Posted on Friday, February 17, 2006 - 9:44 am: |
|
Bob K -- that's easy for you to say. As we've been shown right on this board, what about the lazy? What about the clueless? Man...talk about unfeeling.
|
themp
Supporter
Username: Themp
Post Number: 2561
Registered: 12-2001
| | Posted on Friday, February 17, 2006 - 10:44 am: |
|
"old Joe does it for X, I'm going — why don't you try it for Y?"
I'm sorry. Your bypass surgery is going to be 12 thousand dollars.
"But old Joe is a large animal vet, and he pretty much promised he could do this for $6 thousand if I do it standing up in the stable."
I don't recommend that. You have substantial blockage of four major arteries.
"Yeah, but I pissed away all my HSA money on that kidney stone thing last June. Thought I was living high there for a while. Maybe if I cut down on fats I can skip the whole thing?"
You will be dead by summer.
"Get on the horn with the hospital and lowball em for me. I'll given em $4000 plus my 96 International Harvester combine." |
cjc
Citizen
Username: Cjc
Post Number: 5206
Registered: 8-2003
| | Posted on Friday, February 17, 2006 - 3:21 pm: |
|
After you meet your deductible you'll probably have that covered. And if you've been saving in your HSA's for years with it rolling over and no unused funds confiscated by the government, you should have a nice little stash there.
You can also buy different levels of insurance with varying deductibles and coverage associated with these vehicles, and the vehicles will no doubt evolve.
Given similar outcomes, can you make the call between someone charging 10K and one charging 80K? I realize that's hard for some.
With all your fears (or maybe you're just fearing for the classic "I know a guy..."), I'd be curious to know your investment choices and strategies.
The allure of not caring or worrying so long as 'someone else' is paying for it -- like your children -- is understandable. |
Innisowen
Citizen
Username: Innisowen
Post Number: 1548
Registered: 3-2004
| | Posted on Friday, February 17, 2006 - 3:31 pm: |
|
but Merrill or Fidelity or Vanguard, Legg Mason, or T Rowe Price will still make a nice fee managing all those HSA accounts. Boy, that's found money if there ever was any.
So I get to read the performance report each quarter and the end of year summary to see how my account is doing, in addition to negotiating with the doctor about how much CJC's frontal lobotomy is going to cost (I think we could get it done more cheaply at the clinic in Botswana, by the way), and trying to decide if I really need Hyzaar at that price or should I wait the two months until the price may come down and buy a dosage then?
But Merrill is happy, T Rowe Price is doing fine, and Legg Mason is deliriously awash in fees. Oh, how did the account do? Well, we believe that we indicated that the Dow and NASDAQ would decline this year by a thousand percent, even if our start of year assumptions were a lot more rosey.
Looks like you have enough left in your HSA for a bottle of Nyquil and a box of J&J bandaids.
That's the way the cookie crumbles, you know... |
themp
Supporter
Username: Themp
Post Number: 2566
Registered: 12-2001
| | Posted on Friday, February 17, 2006 - 3:46 pm: |
|
And that's when you knock on "Old Joe's" door. He is very reasonable. |
malone
Citizen
Username: Malone
Post Number: 306
Registered: 5-2001
| | Posted on Friday, February 17, 2006 - 4:03 pm: |
|
Perhaps someone who actually has as HSA would care to enlighten the ignorant? |
tjohn
Supporter
Username: Tjohn
Post Number: 4063
Registered: 12-2001
| | Posted on Friday, February 17, 2006 - 4:23 pm: |
|
I looked into the HSA option. At my company, it was associated with a high deductible health plan. It appears to be an excellent deal if you are very healthy and have the money to put into the HSA. If you have a lot of medical expenses every year, you won't be carrying any money forward from year to year unless you pay out of pocket.
Now that I think about it, the smart thing for a wealthy individual would be to fully fund an HSA but never draw it down. So, instead of using the HSA to pay deductibles and incidental costs, you would pay them out of pocket. The tax protected HSA would grow over the years and would actually have some substance by the time you retire. |
Robert Livingston
Citizen
Username: Rob_livingston
Post Number: 1577
Registered: 7-2004
| | Posted on Friday, February 17, 2006 - 4:39 pm: |
|
Yet another attempt by Bush to rob from the middle class and give to the rich.
Companies like American Express are already adding a credit line for HSA accounts, so when you're over the limit for that colonoscopy you've been hankering for, they'll give you an instant loan for the difference. At a nice rate, of course.
And your company already dropped their regular health plan, saving them millions. But now you're in further debt. |
sylvester the investor
Citizen
Username: Mummish
Post Number: 110
Registered: 6-2004
| | Posted on Friday, February 17, 2006 - 7:38 pm: |
|
gee......so you are given an alternative to pay less premium out of pocket, save money in an account that can grow and search out the best priced alternative (if you so choose).
What do all you socialists want. FREE HANDOUTS. Lets make the government or the employers pay for everything. Go to Canada, I hear its free up there if you can stand to wait for months to be seen. |
Innisowen
Citizen
Username: Innisowen
Post Number: 1552
Registered: 3-2004
| | Posted on Friday, February 17, 2006 - 7:59 pm: |
|
oH, SYLVESTER,
Put a sock in it for a while, will you?
As soon as anyone raises an objection to one of the numerous hastily crafted back of the envelope Bush White House ideas, you immediately go into anti-socialist mode.
What you are seeing on this board is a dose of healthy scepticism towards a typical Bush administration slap-dash, latest-big-idea-while-sitting-on-the-White-House-toilet plan.
Can you blame anyone? After the horrendous Seniors' Prescription drug plan, the bull-in-a-chinashop Iraq fiasco, the Katrina hurricane failure (not to mention the horrendous post-Katrina lack of planning and execution)? And that just names a few of the hare-brained, amateurish initiatives hatched at 1600 Pennsylvania Avenue since 2000, and whose only real results have been bloated government expenses?
Sylvestor, given all that, why would you grudge us the right to be doubtful or even highly suspicious of initiatives from this administration? |
sylvester the investor
Citizen
Username: Mummish
Post Number: 113
Registered: 6-2004
| | Posted on Friday, February 17, 2006 - 8:17 pm: |
|
how about democracry being spread across the globe. Women being allowed to vote (you are a lib, you are for womens rights...oh I forgot, your party only pretends to care so that you have the koolaid drinkers who will vote your way). No terrorist attack on US soil since 9/11. Inheriting Clinton's recession and giving tax relief to the poor and middle class (not the rich as you want us to believe)...propelling the economy into the greatest expansion it has seen in decades. Battling through the inherited recession to create millions of jobs.
Taking the bull by the horns to offer choice and alternatives to a doomed social security system that was derailed because your party couldn't come up with a solution for the entitlement that they need to claim as theirs. They had no option but to destroy it, can't let the republicans take credit for fixing something the dems created.
Now there is an alternative (note the word ALTERNATIVE........can we say that..sound it out) to the current health care crisis. Is the the only solution. NO. Is it a start. AbsoFinglutely. What solutions are you and your party putting forward. That's what I thought...nothing.
Show me a single idea that the democrats have put forth to solve any of the problems that we have. You can't and they know they cant, so what do they do, they use smoke and mirrors, scare granny tactics to throw a red herring into the mix. They figure if they can shout loud enough no one will ever realize that they don't have any of their own solutions. It doesn't work, hence the reason you can't get elected.
Until you and your party can offer soltuions you should just shut up and sit back. We are more than willing to hear yours plans if you could ever develop one.
|
Grrrrrrrrrrr
Citizen
Username: Oldsctls67
Post Number: 280
Registered: 11-2002
| | Posted on Friday, February 17, 2006 - 9:50 pm: |
|
Robert Livingston is back! hallefuckinlujeah! |
kendalbill
Citizen
Username: Kendalbill
Post Number: 98
Registered: 6-2002
| | Posted on Saturday, February 18, 2006 - 3:50 am: |
|
Most of the discussion here has been about the financial implications of the HSA, and usually to the writer. Great. If the goal is enrich Sylvester or cjc or tjohn, it becomes an easy discussion.
But the goal has to be how do we develop a plan to ensure health care to the most Americans in the most cost efficent way. Right?
And if that is the case, splitting up the risk pool to seperate unhealthy people from healthy people can only be disastarous. Healthy and wealthy will get many many benefits and anyone else will get nada.
It seems that every new health fix that comes along creates new layers. And before I'm accused of being partisan, that absolutely includes Hillary's plan but was brought to the height of cynical complexity in the Prescription drug plan.
In all of this, why is a single payer govt health plan always discounted? The few cases where the US govt runs such a plan (like the VA) it works very well. The administrative costs are a fraction of what we deal with now in an insurance paid culture.
Before we get to HSAs, donut hole policies, $5000 deductibles can't we at least talk about it? Why is it the one structure we dismiss out of hand? |
Bob K
Supporter
Username: Bobk
Post Number: 10730
Registered: 5-2001
| | Posted on Saturday, February 18, 2006 - 5:45 am: |
|
Sylvestor, a few points if I may:
1. Recessions are inevitable. This one was longer and deeper than most. If this was because of the Bush policies or 911 is an open question. The expansion, which my portfolio is benefiting from, helps some of us. However, the majority of Americans still poll that the economy is bad. Job creation has been lower than in other recoveries.
2. Bush never offered an alternative plan to save social security. He just outlined the problem. While I agree the Democrats didn't offer alternatives, GOPers such as Lindsay Graham who did were roundly booed because it involved increase in the social security tax to fund the trillions of dollars the changeover would cost. Adding these costs to the national debt, except for those who expect the rapture shortly, is not an alternative.
3. Most of us who are lucky enough to have health insurance, a minority in the US I believe, are in some form of HMO or PPO plan. We slap down our copayment and that is it and we have no idea of the costs involved. Because of a billing error I got a lab bill for standard lipid profiles and a liver test in connection with changing cholesterol medication. The bill was over 800 bucks, which would have put a real hole in an HSA. |
Andrew N de la Torre
Citizen
Username: Delatorre
Post Number: 446
Registered: 2-2003
| | Posted on Saturday, February 18, 2006 - 7:21 am: |
|
If one looks at what large corporations are doing with HSA's it really amounts to cost shifting. In most situations where HSAs are started, employees aren't getting anything, other than the option of starting these pre-tax accounts.
If you live in Maplewood, chances are your in the top 15% of income earners and probably would do OK with an HSA.
Just keep in mind 50% of bankrupt middle income families occur as a result of a catastrophic illness. HSA's will do nothing to change this.
HSA's will not help the 40,000,000 uninsured.
HSA's will not help the 40,000,000 to 60,000,000 underinsured.
The problem with HSA's is it assumes 85% of the population has funds to start these accounts. However, most people in the middle income bracket don't have these funds, because most of these people live week to week in terms of their finanaces. Unfortunately, those in the middle income bracket in the US continue to live more and in debt with less savings.
It boils down to the concept of what health insurance was originally meant to provide. Initially health insurance was meant to prevent the loss of one home should a given individual was stricken with a catastrophic ailment. The whole concept of HMO's changed what health insurance was meant to provide. HMO's introduced the concept of getting something for nothing with the obvious limitations of which doctors and facilities could be used.
I think we need to re-think what medical insurnce is for.
Unfortunately the spiraling problem of health care cost is also linked to the use of advance technology, which is very expensive.
It becomes a codundrum, in that we want the technology that enables us to cure disease, but the cost is making healthcare as a whole unattainable to too many.
A similar codundrum exists with middle income families in that there is so much focus on a growing economy, to keep it growing, people continue to save less or spend on credit. It's an unsustainable system. Once interest rates really start to rise, there's going to be a lot of hurting families and more bankruptcies; a fiscal Katrina... |
Dr. Winston O'Boogie
Citizen
Username: Casey
Post Number: 1931
Registered: 8-2003
| | Posted on Saturday, February 18, 2006 - 8:35 am: |
|
why is anyone even bothering to argue with a person who calls employer-paid health insurance a HANDOUT? (unless I missed something and corporations have started giving out health insurance for people who don't work for them)
|
Bob K
Supporter
Username: Bobk
Post Number: 10733
Registered: 5-2001
| | Posted on Saturday, February 18, 2006 - 9:05 am: |
|
Dr. O'B, these costs directly effect the bottom line and reduce shareholder value, as such they are anticapitalistic. I thought everyone knew that.
Look how Walmarts stock price has gone through the roof over the last few years because of their tough stand on employee benefits.
|
Dr. Winston O'Boogie
Citizen
Username: Casey
Post Number: 1932
Registered: 8-2003
| | Posted on Saturday, February 18, 2006 - 9:11 am: |
|
I thought health care insurance was the labor market at work. in order to attract and keep talent, corporations offer compensation packages that include benefits.
but hey, maybe I'm wrong and all those Fortune 500 CEOs are just a bunch of old softies, or even worse, godless communists. |
Innisowen
Citizen
Username: Innisowen
Post Number: 1555
Registered: 3-2004
| | Posted on Saturday, February 18, 2006 - 11:33 am: |
|
Dr Winston:
If a corporation is outsourcing your job to India, the Phillippes, or somewhere else, why does it need to bother with competitive compensation packages? with health benefit packages?
The only ones who will wind up getting such packages are the top executives that move your work off-shore at far lower pay, at least for the next 8-10 years. |
Dr. Winston O'Boogie
Citizen
Username: Casey
Post Number: 1933
Registered: 8-2003
| | Posted on Saturday, February 18, 2006 - 11:37 am: |
|
that's a different issue entirely.
I'm just pointing out the ludicrousness of someone calling employer provided health insurance a FREE HANDOUT. |
kendalbill
Citizen
Username: Kendalbill
Post Number: 99
Registered: 6-2002
| | Posted on Saturday, February 18, 2006 - 11:41 am: |
|
The good Dr. Winston:
Times have changed. Even the best companies are fighting to keep their health care costs down and are passing mush of the increased costs to their employees. It has become a monumental struggle. I often talk to financial people in these big corps, and individually they wish the govt had a stronger role in providing health care. Requiring a big corp to play that function is not only becoming more difficult but it is cutting into corporate growth. Even die hard Republicans seem to entertain the idea that there is a better way than a version of what we have now.
|
Andrew N de la Torre
Citizen
Username: Delatorre
Post Number: 447
Registered: 2-2003
| | Posted on Saturday, February 18, 2006 - 12:06 pm: |
|
Walmart is a classic example is cost shifting to the government, or the tax payers. At a recent healthcare lecture it was noted 40-60% of children of Walmart employees qualify for Medicaid. In fact Walmart tells it's employees to apply for these types of benefits, which include food stamps. You save 50 cents today, but you'll be spending $50-100 more in taxes to fund these programs |
Dr. Winston O'Boogie
Citizen
Username: Casey
Post Number: 1934
Registered: 8-2003
| | Posted on Saturday, February 18, 2006 - 12:08 pm: |
|
kendalbill,
no doubt. but yet again, I'll say it. no corporations give health insurance as a freebie to people who don't earn it. |
Closed: New threads not accepted on this page