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.

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 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?

If you read "High Deductible Health Plan - Rejected" you know that my family got rejected for our new HDHP plan when we tried to switch insurance providers.  This is a brief update on where we stand presently.  If you have found yourself in a similar situation, might find this somewhat worthwhile reading.  The challenge with my current plan is that our provider seems to think that they need not provide us with any prescription coverage unless one of us is rolled into a hospital on a gurney, and then only as long as we remain strapped to it.

My insurance agent is working getting us some air coverage and specifically is researching what's called a critical illness plan.   He has not put anything in front of me to read about these policies, however, I understand that they kind of work like a term life insurance policy with some payout benefits in the event of a major medical situation.   The payouts would be as a lump sum, which, in theory would go a long way toward covering the presumed prescription gap in my HDHP. 

Remember, insurance really should be used for the big stuff.  Part of the reason the cost has gotten so out of hand is that most folks want to use their insurance for every wart and pimple they get.  As comparison, imagine what you would pay in auto insurance if you wanted to cover things like oil, wiper blades, tires and breaks.  It'd cost you a fortune.

My agent called last night and advised he is having some challenges finding a critical care option that will cover my kids as well as my wife and me.   But we'll deal with it and as I learn more, you can read about it here.

Here's something to think about.  When you start looking at high deductible health plans  if they don't you the coverage you need or want exactly, there may be ways to supplement them to get the coverage.  Once again I recommend finding a good insurance agent who knows HDHPs and let them do the heavy lifting for you.  And if they can't, fire 'em and find one who can.  That's one of the great things about consumer directed health.  It's about taking control.  Never forget, you're the boss!

About this time every year employers all over the nation unveil their latest, greatest insurance offerings for the coming year. They've worked over their brokers, agents, and consultants, dusted off a few old tricks and brought a couple new ones to the game.  They've frosted up this package with Betty Crocker's finest, served it up on their finest china, put it on a fork and are now playing the "airplane" game with you.

Now you're probably thinking, "what's this hillbilly talking about?"  Tell me, am I right?  You've got your enrollment package, your employer is patting him or herself on the back at what a great job they did at keeping your premium from rising, or at least rising too much and you're saying, yeh, but what about my co-pays, why do I have to pay more for drugs, what about my deductible?

Health Savings Accounts are still relatively new, having just come into law at the end of 2003.  And every year, more and more employers are beginning to offer them to their employees.  Sometimes as an option for employees and sometimes as the only option for employees.

For the past couple of years, at this very time of year my friends come to me with quizzical and dim looks on their faces and begin asking me about the high deductible health plans (HDHPs) and health savings accounts (HSAs).  My friends are fairly bright folks, but as you know, the subject of insurance is about as exciting as a flat keg of beer at a fraternity band party.

They don't mind asking me about it because

So there's all kind of buzz on the internet today regarding the Doug Holtz-Eakin's conference call on McCain's health plan over the weekend.  Basically, he wanted to set the record straight, or at least defend the McCain plan from the general assault that Mr. Barack Obama and Co. mounted against McCain's health care policy.  If you are like me, you're probably asking, "what is a Doug Holtz-Eakin and what does he know about anything?"

Holtz-Eakin is Sr. Policy Advisor to Mr. McCain, so I suppose that means he knows more about McCain's and Obama's health care initiatives than the average Joe.  On the call he suggested among other things that Obama's recent ad campaigns were "cynical and deceitful."  To read an entertaining overview of Holtz-Eakin's de-bunking of Obama's effort, please click here and enjoy.

Once you read the overview, you might be left wondering, how in the world is McCain going to pay for that tax credit he's proposing as part of his plan.  Good question and worth an answer.  The estimated price tag is somewhere north of a tr-tr-tr-trillion dollars (12 zeros if you are curious) over the next ten years and McCain, Holtz-Eakin and company believe it can be found in extracting efficiencies from Medicare and Medicaid.  They believe the plan can be cost neutral from savings elsewhere.

Now I commend McCain-Holtz-Eakin on creating efficiency.  Bravo I say, but we are all (well I assume we are all) a bit cynical about our Government's ability to create efficiency. 

One thing's for sure on this political issue.  Mr. McCain and Mr. Obama are, for the most part, on different ends of the spectrum on how they would address this big giant purple people eater called health care.  And suffice it to say, health care, regardless of which candidate is ultimately elected, is going to be a tough nut to crack.

Now that is a headline I would like to see!

An article in The Wall Street Journal Health Section on September 22 essentially said, the woes of the U.S Economy are driving people away from healthcare.

When I scanned the article, I had to chuckle because I went to Parents' Night at my daughter's school last night, and her English teacher informed us that kids are reading less than ever, and importantly, that it's going to affect their ability to succeed.  You might argue that with the internet we do spend a lot of time on the internet (reading), however, he pointed out, we tend to scan rather than read.  I guess we are becoming a shallow, illiterate nation but that's a subject matter for another day, for someone else, on another blog.  For now we need to get this example of Adult Attention Deficit Disorder back on track.

While I'm inclined to believe some of what was reported in the article, I'm pretty sure the reporter was trying to scare the crap out of me.  It stated that Americans, in these difficult economic times are holding back on their healthcare.  They are forgoing procedures, medicines, and preventative care.  In a vacuum, this resistance to care will ultimately lead to greater health issues and even higher costs for treatment.  As I read the article, it seemed to me that the writer, for impact was stirring fear rather than exposing the potential upside of this trend.  Benefit, you ask?

Is it possible that an unintentional Peoples' war been declared on healthcare industry?  Perhaps this is also a sign that U.S. healthcare consumers are beginning to vote their displeasure with the U.S. healthcare system by zipping their wallets.  If enough people contract their spending, perhaps the law of supply and demand can begin to force a bit of rationality into the healthcare system.  Perhaps, U.S. consumers, some of the most creative and innovative minds in the world will actually begin to look inward at themselves for their health solutions, rather than outward for the pill, the quick fix, the instant gratification, that has begun to erode our society, and in my opinion has contributed to de-elevated status of The United States in the eyes of much of the rest of the World.

With war comes battles and with battles, casualties.  People who ignore their health while holding back on their care may become casualties, which of course is not good.  That said, I think this is a war worth fighting, but one where we must learn from the casualties.  By fighting with our wallets  we can advance transparency in healthcare, can demand alternative and creative solutions for insurance reform and in the way meds are priced and distributed.  We can first educate and then re-program ourselves to use insurance as a tool rather than an entitlement.  We can re-focus becoming and remaining a healthy nation rather than one which masks the symptoms of our nation's chronic diseases.   We can set our sites on living rather than slowing certain death.   We can welcome in efficiency and usher out deficiencies.

And where do Health Savings Accounts fit into all of this?  Those Americans with HSAs are already soldiers in this war.  Americans moving on their own or at the end of a whip into high deductible health plans (HDHPs) and HSAs, are also being given weapons to improve their health, drive healthcare costs down, and help bring rationality back into a sadly broken system.  

Remember when you were a kid and your parents kicked you out of the house, saying, "run outside and play."  This was good medicine for them and you.  It still is in fact.  With a health oriented mindset and our wallets WE can drive our own Change.  Pretty powerful stuff I reckon.