Every Blue down in Blueville liked Healthcare a lot...

But the Pinch, who lived to the left of Healthcare did NOT!

The Pinch hated Healthcare, the whole Healthcare system!

Just don't ask why, only he had the wisdom.

 

It could be his head was screwed on to the left,

It could be his ears were plugged up and deaf.

But I think the most likely reason of all,

Was that he thought the Blues brains were much much too small.

But whatever the reason, his head or his ears,

At enrollment season, Pinch took glee in their fears.

Staring down from his Tower he took some delight,

As they worked through enrollment and pondered their plight.  

"They're struggling, their choking," he coughed with a sneer.

"The deadline's approaching.  It's practically here!

Then he growled with his tiny heart nervously pumping,

"Each year they get an insurance thumping!"

"With enough pain in Healthcare, they'll eventually see...

The only way to Healthcare is directly through Me!

But every year undeterred, the Blues found their way,

To Healthcare solutions and new ways to pay.

HSAs, HRAs, an alphabet soup,

Consumer Driven Health made the Pinch feel like poop!

 

Then his brain started working, he came up with a thought.

A horrible, dreadful and awful old thought!

"I'll run for office, then they can be bought!"

"I'll promise them Healthcare.  Every man, woman, child.

We'll tell them it's FREE, he said with a smile. 

So he threw on his coat, and dragged along Mrs. Pinch,

With his trusty bullhorn, this would be a cinch.

 

A tight message, Ms. Pinch, and his bullhorn in hand,

He blazed into Blueville with promises grand.

FREE healthcare for all, if you all vote for me,

They lined up with big smiles and voted with glee.

Every Blue man and wife, cast their ballot for Pinch,

He won by a landslide, by more than an inch.

He cleaned out the Cabinet as quick as a flash,

Put them all in a bag and out with the trash.  

Into his new post, he jumped rather nimbly,

And anyone in his way, he rammed up the chimbley.

But while bagging and ramming, he heard a small coo,

He spun quickly around and there stood a Blue.

A wee little Blue, named Sweet Mary Lou.

 

"Is this some sort of micro, terrorist," he thought?

"Or maybe a rodent that needs to be caught?"

Without batting an eye, he asked, "What is it dear?"

"I'm here to take care of you, you have nothing to fear."

Then Mary Lou Blue, this sweet little tart

Looked straight in his eyes, then pulled at his heart.

"All the Blues, here in Blueville love you so much,

They want you to help them, but not be their crutch."

She said, "Dear Mr. Pinch, please don't act as our Mother,

Please stand beside us and be like our brother."

We want you to help us with Healthcare that's true,

There are so many, so many, things you can do.

Insurance companies need to be rid of their greed,

With some of their excess to help those in need.

Reward, those who are healthy with lower cost plans,

And breaks on their taxes, and more tools in their hands.

And what about good people whose health is not great,

But do all they can with what's on their plate?

They could use tools and insurance for sure,

But going broke in the process isn't the cure."

 

Then she paused for a moment and breathed deep some air.

Taken back by such wisdom, Pinch simply stood there.

But she was not through, little Mary Lou Blue,

The little Blue girl who was no more than two,

"Let all the Blue people, Blue employers and you,

Stand together and work all of these healthcare things through.

You see Mr. Pinch, the Blues are all very smart,

 And if you will work with them and for them, they'll all do their part."

 

With that Mary Lou Blue, walked out of the place

Mr. Pinch stood there standing, a strange look on his face.

For awhile Pinch stood there, with no place to go,

But he had an idea and it started to grow.

And what happened then...?

In Blueville they say

That Pinch realized Government healthcare was not the way.

That the Blues down in Blueville were pretty damned smart

And when faced with a challenge did take it to heart.

If all of the Blues worked together he knew,

That healthcare would not be reserved for the few.

So with newfound leadership they developed a plan,

That with carrot and stick brought healthcare to the land.

And when it was done, and the plan was released

He.....HE HIMSELF....

Got himself into shape, and Mrs. Pinch was well pleased.  

Dan Crowell represents the changing face of health and healthcare in America.  Dan is the street superintendent for the city of Lafayette, Indiana.  Now I don't know Dan but I read about him JConline.com, the online edition of the Journal Courier Newspapers of Lafayette and West Lafayette Indiana.

Both cities, faced with ever rising healthcare costs have joined together to save money on health insurance and to promote healthier employees.  One of the keys to their strategy is through employee engagement.  This goes beyond the health risk assessments that most city employees participated in this year, and  includes the formation of a joint city committee comprised of city employees to analyze the data from the risk assessments and then collaboratively determine which health issues to focus on through to promote more healthy lifestyles.

The city managers are looking at other ways to reduce costs and improve overall employee health, and have added HDHPs with HSAs as an insurance option for their employees in 2009.

This brings us back to Dan Crowell.  You see, Dan Crowell, Lafayette's Street Superintendent, is one step ahead of the game and is the city poster boy for what can be.  Dan, over the past couple of years dropped 100 pounds through regular exercise (and I would guess a more healthy diet, but the article didn't say) which he maintains to this day. 

Some folks can get motivated on their own, and others need a little help.  But in order for us to drive our healthcare costs down and our health up, it will take collaborative efforts between employees and employers, between insurance companies and individuals, between the Government and all of us.  Dan and the cities of Lafayette and West Lafayette, get it and are doing their part to become part of the healthcare solution.  A tip of the hat to them.

  One thing everyone agreed on regarding the Obama presidential campaign was  that he picked his messages and stuck to them.  And one of the ones that stuck to me, in fact, with all the media coverage I felt like it was nailed to me with a hammer and sixteen penny nails, was the notion that if you liked the health plan your employer offered you could keep it, but if you didn't you could have the same insurance federal employees enjoy.  And for employers if they didn't provide insurance for their employees, they would have to contribute to a medicare type plan to cover the uninsured.

As I tried to read the tea leaves of Obama's healthcare reform, being the conservative guy that I am and generally distrusting of the U.S. Government, my interpretation of the above campaign message was that it cloaked  of a movement toward government run healthcare.  After all, healthcare in America is a multi-trillion dollar industry, power follows money, and the Government loves power.  Being somewhat cynical, I figure the underlying message of the stated policy was that if the new administration could get some traction around healthcare reform, it would make employee sponsored insurance so untenable for employers they would be forced to pay into the Government sponsored plan, and that would be the end of healthcare as we knew it.

But there is another possibility here, one that a conservative and somewhat cynical blogger hadn't really given much thought to.  There is an article in the November 17^th edition of Business Week entitled Heath Care-Immediate Relief From Rising Costs which made me wonder if rather than putting so much pressure on businesses their only option is to default into the Government plan, the Government might create enough incentives for employers to cover their employees meaning that less of the insurance market and burden would fall to the Government.

Personally, I think we need to tools to rely on ourselves when it comes to healthcare.  The Government needs to be an advocate for us, not control us or our employers.  Consumer Driven Healthcare, and specifically High Deductible Health Plans (HDHPS) and Health  Savings Accounts (HSAs) are tools the Government has given us.  Could they be better?  Absolutely, they are far from perfect.

Ron Klar, a guy way smarter than me when it comes to healthcare, the healthcare debate and fixing the problems related to our Nation's ills, wrote a terrific article just before the election entitled, AmericarePlans: A McCain-Obama Hybrid Proposal posted on Health Affairs, The Policy Journal of the Health Sphere.  Being the last guy on the grape vine, it took awhile for me to intersect with his article. 

I'm not going to regurgitate the article here as it is much better chewed, swallowed and ingested in its original form.

Klar points out, that one of the greatest challenges in any health plan, be it driven McCainanites or Obamians, is coverage for high risk individuals or those with pre-existing conditions.  He then goes on to outline a solution that, as the title of his article suggests is a Hybrid of both the Republican and Democrat healthcare platforms.

The thing I really like about Klar's plan is that he points out (without pointing it out) that we need to be aware that while we have been presented for months with but two options, we should not be bound by either the right or the left, but we should be unbound by our creativity.  We should be unbound by solutions.  We should be unbound from the box which politics so often seems to want to put us into.

It's a thoughtful and hopefully thought provoking read.  Check it out if you can. And if you want to learn more about Health Savings Accounts and High Deductible Health Plans, it's all right here at HSAeducator.com. 

If you are one of those folks who dreads the open enrollment period for your health benefits, who puts their heads inside of their shell and basically runs and hides, I'm sorry to say, you are the hunted.  If you simply sign up for whatever you had last year (but likely at a higher price, and possibly with reduced benefits) without doing your homework, you are the hunted.  If you haven't figured out things like HSAs, HRAs, or FSAs, then you are the hunted.  If you simply do what your office "best friend" does, then unless they are a hunter and your family situation mirrors theirs exactly, then you are the hunted.

• On the other hand, if you read the insurance materials from cover-to-cover;
• If you know which doctors come with which insurance plan;
• If you understand the difference between the various premiums as well as the deductibles;
• If you understand the difference between HSAs, HRAs, and FSAs and fully utilize them within your plan;
• If you understand the differences between the drug coverage offered;
• If you know what you spent on health care in the current year for yourself and family including premiums, medications, OTC costs, and doctors visits;
• If you spent every nickle out of your FSA or made the maximum contribution to your HSA;
• If you understand the tax benefits of an HSA (if you have one or are considering one); then you are definitely the Hunter.

If you are the Hunted, it may not be too late and you still have a chance.

Hunters, to the extent you can "kick ass" when it comes to making healthcare decisions, you do it!!  

 When I was a kid, up until the age of about eleven, my Grandmother used to conduct Doctor Jekyl-like experiments on my hair with her handy scissors.  I was a total toe head and when she was done they could have slapped me on the side of a paint can and called me the Little Dutch Boy.

I revolted at eleven and began a 30 plus year quest to find the perfect barber.  Recently though, in my quest to save more money into my health savings account I decided to give Betty, my barber, a little vacation and let my wife cut my hair.

The first haircut she gave me was disasterous and fully documented in an article on this site entitled "Hair Savings Account,"  and the second haircut, well that one was nearly apocalyptic and covered in "Health Savings Accounts and my Left Ear."

Because of the partial skinning I received last go round, it has taken longer for my hair to recover.  My wife, on the other hand still hasn't.

Still looking for ways to save, after considering allowing my teenaged daughter to have a run at it, or maybe that lady who I see walking around my house once a month reading the meter, I decided to take matters into my own hands.

I got out my Conair turbo pet grooming sheers, dropped a number 7 on them and let her rip.  It was absolutely exhilarating.  As a guy I felt like friggin' Rambo.  In control, self sufficient, even able to give himself his own haircut.  Now I did have to deal with hair pretty much everywhere. It was kind of like being in a New York tickertape parade.  Hair flying in my ears, all over my face, I was just covered up.  I was spitting out hair the whole time and I'm pretty sure it was multiplying as it fell toward the ground. 

Now, you may be thinking, big whip, he just shaved his head.  Hardly.  Cut and style baby, and if I say so myself it looks good.  Real good.  Well at least the parts I can see.

Are self haircuts a good idea?  Well, finding creative ways to save more money into one's Health Savings account is a good idea.  If I could figure out how to get my wife to do her own hair; now that would be big bucks but I don't see that happening.  With the right tools, a good vacuum cleaner, independence and creativity, you will be amazed at how you can save more into your HSA.

I have an HDHP.  When I go to the Doctor to have them look at the creatures crawling around in my throat, causing me to itch all over, or making my hair fall out in clumps, I am expected to pick up the full tab until I hit my deductible.   I even have a little stash of money, called an HSA to pay for it.  BUT, I don't pay a nickel when the Doctor is done with me.  Not immediately.

The Doctor has to put in a claim to my insurance company, the insurance company tells the Doctor how much they are going to pay, they then tell me how much I am supposed to pay, I then send the Doctor a check, the doctor tells the insurance company they received the check, and then insurance company tells me that the Doctor told them that they received the check.  If this laser-like process of precision breaks down in any way or God forbid, I don't send the check, honestly, I have no clue what happens.

For the past year, I have been writing for the Gradock Bulletin about health savings accounts, high deductible health plans, consumer driven health, healthcare and wellness and pretty much anything else that comes to mind that might be educational, worth a rant and/or is somewhat entertaining.

With that said, I have compiled Gradock's "Top Ten Reasons Why Healthcare Is So Friggin' Expensive!"  This is a very unscientific survey of one, but it points to a the gaggle of reasons that collectively (along with a few others I'm sure) that cause you and me to pay more when we go to the Doctor and put health insurance out of the reach of millions of Americans.

10.) We can't figure out how to spell "healthcare."

The fact that sometimes it is spelled as two words (health care) and sometimes as one scratches at the surface of inefficiency (it takes more keystrokes and kills more trees when spelled as two words)

9.) The right hand don't know what the left hand is doing:

See paragraph #2 above

8.) Americans are fat slobs:

Which makes us loveable and friendly, but contributes to chronic illness like heart disease, hypertension, and diabetes which cost us billions if not trillions of dollars a year in healthcare costs.

7.) State Mandates:

Did you know that your state may require insurance companies to cover certain illnesses no matter whether you are at risk of it or not, whether you are healthy or not, whether you care about the illness or not.  So for example, if you are a single male living in Arkansas or any of the other 20 states that require maternity coverage, you are paying, in your premium for someone else to have a kid.  Or if you live in Connecticut or any of 9 other states you get to pay for wigs.  Or if you are a non-smoker living in Maryland, you are paying for some lung burning smoker's, smoking cessation treatment when you pay your insurance premium.

6.) The uninsured and non-critically ill in hospital emergency rooms:

Emergency rooms, by their name and nature are set up to deal with emergencies, not the coughs of the illegals and uninsured, or the weekend colds of the insured.  This mindset may be compromising emergency rooms, and certainly is driving the cost of healthcare up for all of us.

5.) Regs on Meds:

My insurance company will not pay for, nor will they allow for money I spend on meds that come from Canada to count against my deductible.  Now some of this is to protect me from witch doctors, voo doo priestessesire and shady drug companies whipping up toxic drugs in oil drums on the streets of some third world country, and I understand that.  But part of this is driven by drug companies desire to tamp down competition.

4.) Three Card Monte Mindset:

Or in other words lack of transparency in healthcare.  Healthcare is set up so that we do not know what procedures, tests, and treatments cost, leaving us to guess where the most cost effective care is to be found.  And it is almost impossible to find the best doctors at the best prices in this environment.  There is some progress being made in this area with the establishment of minute clinics and services like outofpocket.com that are exposing the cost of healthcare which can help create more competition and ultimately drive costs down.

3.) "The Doctor's Handwriting" and malpractice law suits:

If the Pharmacist can't read the Doctor's hand writing and mis-dispenses meds or has to spend more time figuring out what the thing says, then we are talking time and money.  Or if the Nurse in the hospital gives the wrong dose or the wrong medicine to a patient, that can be a bad day.  Do you know that if a drunken, illegal alien with not a nickel to his name rolls into the hospital with his arm half cut off and doesn't like the way the attending surgeon sewed it back on, he can sue the surgeon?  Now I believe the guy has a right to sewing but not suing, unless there is horrific and obvious gross negligence.    

2.) Cleanliness is next to godliness:

Now I'm not a germaphobe but do realize how much stephastrepasyphacoctolis gets spread around because folks don't practice basic hygiene.  That lands folks in clinics all the time with preventable illness and, yes, drives the cost of healthcare up.

1.) What about executive compensation?

We can't let that one slide.  I'm all for people making money and if they make armored cars full of it that's fine it they are truly responsible for creating most of the value.  But I do have a tough time with guys who get paid huge sums of cash for what sometimes ends up to be short term value, or get paid huge sums of money when they screw up and get fired.  Hey, I could screw up any big publically traded company for way less than these guys get paid.  And what kind of money are they making?  Well I took a look at the AFLCIO database on executive comp and here are a few examples:  In 2007 the CEO of Abbot Labs was paid $33 million in total comp; the CEO of Aetna got $23 million total comp; the CEO of Merck got paid $20MM in total comp; the CEO of Humana got $10 million in total comp: the CEO of UHC got $13 million in total comp and the CEO of Cigna got $26 million in total comp.

These were the ten I was able to rattle off without too much difficulty and I know there are many more.  Feel free to comment on this article with additional reasons.  Maybe we can compile it and share it an another article or post it on this site's forum.

I came across an article in Wednesday's (10/29) edition of Workforce Management Magazine which was extracted from a presentation made by Maureen E. Sullivan, SVP Blue Cross Blue Shield Association at the National Consumer Driven Health Summit on October 20.  The name of the presentation was called Health Plan Initiatives, Trends and Research in Consumer Driven Care.   If you want the full download please click on either of the links above for loads of relevant statistics related to Consumer Driven Health Plans.

If you are in a hurry and trust me, the answer to the question in the headline is, YES!  Well, statistically speaking that is ,when HSA eligible enrollees are compared with non-CDHP enrollees.

If you've read this far, and need a little CDHP or HSA education click on either link and learn a little.

If you want to know the characteristics of a 2008 HSA eligible enrollee keep reading.  If you are wondering what the definition of an "HSA eligible enrollee" is; the research sample was derived from Blue Cross Blue Shield HDHP plan members who either had opened an HSA or were eligible to open one.

So, and HSA eligible enrollee:

• is more likely to be offered an incentive to open their HSA
• wants more control over their healthcare costs
• is more cost conscious and cost driven
• is more engaged in tracking their healthcare expenses
• is more engaged in understanding their healthcare costs prior to treatment
• is more engaged in healthcare screening, exercise, nutrition, and health coaching
• uses more preventative services but no less necessary care services than non-CDHP enrollees (they are no more inclined to skimp on things like inpatient/outpatient procedures, diagnostic imaging, ER visits)

So, to say it again, if you are part of the HSA nation, there's a pretty good chance you are indeed an HSA savvy shopper.  But you knew that already didn't you?

"A Thrifty Man Is A Free Man"  Advice from my fortune cookie March 1982

Good advice during these strange and troubling economic times.  Good advice anytime and way cheaper than a fortune teller (unless of course, the fortune teller is your crazy aunt Zelda).

The October 20^th edition of Business Week offered up a timely article entitled, "The New Age of Frugality" by Steve Hamm.  It discusses the tightening of spending by Americans with our contracting economy.  Many people are getting a crash course on saving right now.  Now this may suck if you are a spender, it's good for self-discipline, a good motivation for correcting bad habits, and can maybe heighten our appreciation for things we took and take for granted.   This article may help you out if you feel all alone in this new world or if you are looking for ways to save. 

I'm a guy who believes there's no end to a tube of toothpaste.  I think finding ways to save may be part of my DNA.  So for me, Health Savings Accounts make sense and I'll bet early adopters of HSAs share that same mentality. 

 "HSA" does have the word "Savings" in it, which is to a thrifty person as the strip is to a gambler in Vegas.

HSAs are not just about putting money aside for a rainy day.  There is far more to them than that.  They create tax advantages three different ways.  They're tied to high deductible health plans which involve lower premiums which means you get to keep more of your own money.  Because HSA account holders have greater financial responsibility for their own healthcare they can motivate them to be more motivated about their health both in terms of how they shop for healthcare and how they take care of themselves.

So, anyone who has taken the initiative to learn about HSAs already has a savings mindset, and anyone directed to an health savings account by their employer has a great opportunity and a tool to develop a savings mindset.   Adopt a savings mindset, with your healthcare and with your life and it will help pilot you through these challenging economic times.

You've just been enrolled in an HSA for the first time huh?  You might feel like you just hooked a big nasty line pulling pike.  That sucker is and bad and feels like he's pulling you all over the place.  How in the world are you going to deal with it?

If you have the right gear to reel it in, and maybe a cold Budweiser, you might just get him in the boat.  Except for the chilly beer, that's what HSAeducator.com is all about; having the right gear.

If you feel like your line was hit hard by this new HDHP/HSA insurance plan, or maybe you are the pike on the line and your employer just rammed turned you, HSAeducator.com can definitely help you out.

As an opinion maker of uno, I recommend you look at your new insurance and savings plan you have as a gift.  I believe high deductible health plans when combined with health savings accounts can be a major part of America's solution to healthcare.  While they turn a lot of the responsibility for our health and healthcare over to us, they give us control too, and control is power.  You may not know it yet but dude (and fisherdudesses) with your HSA you've got the power.   

But you are new to the HSA fishing tournament and, I'm getting ahead of myself.  Before you can harness the power of your new HDHP and HSA, you've got to learn the language. 

It all starts right here.  HSAeducator.com starts by answering the basic HSA questions.  Things like:

• Ÿ How much can I contribute to my HSA each year?
• Ÿ What can I spend money from my HSA for?
• Ÿ Can I buy fishing lures with money from my HSA or maybe a new boat?
• Ÿ What happens if I put too much money into my HSA?
• Ÿ Do I have to use the bank my company is pushing for my HSA?
• Ÿ If I change jobs what happens to the money in my HSA?
• Ÿ What if I don't spend all the money in my HSA each year?
• Ÿ Should I try to spend the money in my HSA every year or let it pile up for something major?
• Ÿ Can I pay my HDHP premiums from my HSA?
• Ÿ Can I take my HSA contributions off my taxes?
• Ÿ Can I spend my HSA dollars on a back snapper?
• Ÿ Is an HSA the same as my FSA?

Good questions and they're all answered on HSAeducator.com.  Plus, if you have really specialized questions you can check out the health savings accounts discussion forum , ask your question and they'll give you an answer or maybe or someone else with an HSA can give you some guidance 

One more thing that makes HSAeducator.com different from say, that slick brochure your employer gave you, is that it's written in English.  Not the Queen's English, but plain old every day conversational English, not something that looks like it was written by a the U.S. Congress or some lawyer.   So while it is no your favorite "fishin' magazine," it's a damned sight closer than the Harvard Law Review.