Happy and Blessed Holidays From the Folks at HSAeducator.com

 

....and don't forget to open your HSA before 12/31 and fund it before 4/15/09 to take be able to take the tax deduction.

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.

About the only things I know about Massachusetts have to do with beans (Blazing Saddles), a bunch of whiteys dressed up as Indians (wonder if they were wearing wigs?), and burning witches at the stake (now that's hot).

 Being from the Deep South, my purview of the rest of the country is somewhat narrow, and I suppose for every one of us, there is enough history, news, and politics in our own states to keep up narrowly focused and narrowly minded for a lifetime.  Thank God, I never had to spell Massachusetts in a spelling bee growing up, because that would have for sure thrown me out of the saddle.

Being interested in healthcare, I have been hearing for a couple of years about this movement by the state of Massachusetts to mandate health insurance for all of its citizens.  Besides finding the idea of it generally suspicious, I've really not paid much attention to it.

I stumbled across an article online in The MetroWest Daily News, written by guest columnist Jon Kingsdale.   Being from the South, I had no clue what market this paper served, so I checked the obituaries for the paper and saw such locals as Sudsbury, Falmouth, Framingham, and Rockland, Westborough, and Westchester.  While I didn't know the people or places, I figured out pretty quickly they weren't  from around here.  This was confirmed when I saw many seemed to have died in various branches of the U Mass Hospital system.

I suppose if I were some policy wonk, I'd also recognize the name of Jon Kingsdale, but I didn't and had to look him up too.  But not in the obituaries.  Turns out he is the CEO of the Massachusetts Health Connector.  Didn't know what that was either so I had to look it up too....

Honestly, I don't know how you folks in Massachusetts keep up with all this stuff, but the Health Connector is the state run agency that is in the middle of making sure all the good citizens of that state get health insurance or get fined.  Don't you just love Government?

Anyway, the short story on Massachusetts health policy is that pretty much all adults in the state have to have health insurance in 2009 or face fines.  I'm not sure about kids, but presume they have to have coverage too, but I'm guessing it would be difficult to collect fines from them.  And the fines are not small.  They could exceed $900 per year.

Citizens of Massachusetts can't just have any old insurance coverage, they actually have to have policies that provide them with certain standards of coverage.  As an aside, it is sad that there are policies out there that purport to provide coverage, but that in fact are crap and will do nothing but make an individual health crisis worse in the event it ever had to be used.

So where is the The Gradock Bulletin going with all of this?  We can read policy geniuses comment on this all day long, but our attention spans are too short.  We want your input.

We want to hear some normal people's perspective on this state mandate. Either individuals or employers trying to provide benefits to their employees.

Is it working?  What is it doing to healthcare costs?  Is it being administered efficiently?  Is it better than what was in place before?  Who is getting rich off of it?  Things like that.  

We have put up a discussion forum on the subject at HSAeducator.com in their Forum section and invite real people to share their experiences.  To tell the rest of the world, the real story.

And for all of us outside the great state of Massachuttes, to ask questions about the program.   Why?  Because it or some version of it could be "coming to a theater or drive-in near you."

To give those outside the state an idea of what those in Massachusetts must have in their insurance plans to avoid penalties, below is the list:     

• A comprehensive set of services (e.g., doctors visits, hospital admissions, diagnostic surgery, mental health and prescription drug coverage).
• Doctor visits for preventive care that are not subject to a deductible.
•  A cap on annual deductibles of $2,000 for an individual and $4,000 for a family.
• For plans with up-front deductibles or co-insurance on core services, an annual maximum on out-of-pocket spending of no more than $5,000 for an individual and $10,000 for a family.
• No caps on total benefits for a particular illness or for a single year.
•  No policy that covers only a fixed dollar amount per day or stay in the hospital, with the patient responsible for all other charges.
•  For policies that have a separate prescription drug deductible, it cannot exceed $250 for an individual or $500 for a family.

Folks, we want to know The Good, The Bad, and The Buttugly of healthcare in Massachusetts today.  Click Here to get to the Forum   -  You will have to register when you get there if you are not already.

....NOT! 

I saw a humorous YouTube video which led me down an interesting path of reflection and reinforced the extremes in thinking some people have on healthcare in America.   Healthcare is a complicated social issue, and to the best of my knowledge there is only one only perfect solution.  And that's  perfect health.

I've included the video here as it is humorous, but I present it with a large caveat.  Health insurance in America is indeed less than perfect.  It is kind of like owning a used car.  Most of the time it works and gets us where we need to go.  It might have a few accessories like power locks and windows that provide us with some creature comforts, but overall it's just not that pretty.  Sometimes it breaks down and unexpectedly costs us more than we have on hand expect to make it work which can be frustrating but not devastating.  And on rare occasion something major happens and the clunker leaves us high and dry, in the middle of some barren desert, without a chance of survival.

This video, if viewed in a vacuum suggests that health insurance companies are the cause of the problem, spawn of the Devil, the root of all evil (and healthcare problems).  The creators of the video would like us to buy into this premise and then blindly accept their healthcare dogma.

....But the video is funny.  Just take it with block of salt.

After watching the video I followed the link and landed on the Health Care for America Now website.  I felt compelled to read their story, which at an ideal level has some merit (qualitiy, affordable healthcare for all Americans), but at a practical level takes the incredibly arrogant, and naïve position that they are right and anyone who disagrees with them is wrong.  Their truth is a manipulated and contradictory truth at best.

Remember the video?  The one above that makes insurance companies to be the spawn of the Devil, if not the Devil himself?  Health Care For America disdains insurance companies, yet they basically suggest that if you are satisfied with your insurance you can keep it.  That suggests to me that they have either overstated their cause "insurance is not affordable for families...etc." or their true agenda is something else.

This organization states:

"Our government's responsibility is to guarantee quality affordable health care for everyone in America and it must play a central role in regulating, financing, and providing health coverage by establishing:...."

Aha, their agenda....

The thing that really annoys me about this organization is not their desire to improve healthcare for all Americans, but their suggestion that this is a problem for which the bulk of the responsibility for fixing it falls to the Government.  I love it that they are trying to expose social injustice and health issues, but it really frosts my gonads that they fail to suggest that Americans themselves are part of the problem.  That State and The Federal Government are part of the problem.  That healthcare practitioners are part of the problem.  That attorneys are part of the problem.  That big business is part of the problem.  The list goes on, and we nibbled around the edges of this a few days back in our article "The Unscientific Top Ten..."  Yet the face they put on it is one of insurance company greed; part of the problem for sure, but a small part of the problem.

 Government owned, run, and mandated insurance is a slippery slope.  In the end, if the Government is true to form, like that old used care, it will leave us broke and disheartened. 

What frightens me about Health Care For America Now is their proposal rings of the entitlement bell shrouded in the guise of a right.  Unfortunately, rights are entitlements the minds of many.  If healthcare is a right, then it needs to come with an enormous amount of personal responsibility, accountability and some level of sacrifice.  We need to take care of each other.  If we believe  the Government cares a rats about us, I believe we are sorely misguided.

We should treat healthcare must be treated as a privilege for there are people in this world far less fortunate than us who drink dirty water and live in homes with dirt floors and minimal shelter.  Our focus should be on health first and then on healthcare.  For more thoughts on this please read, "Mountains Part Deux."

I think the solutions to our healthcare challenges need to be more collaborative.  I believe organizations like the Healthiest Nation Alliance are healthier at their roots than say Health Care For America. We've shown this video before, but it is worth another look. 

If you have read this far, then you are thinking.  That's good.  Now think a little more about how you can change the world.  Too big?  Then think about how you can change your world or maybe your child's world.  Start with your own health and you will be on your way to better, more affordable healthcare. 

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.

.......it's actually harder.

Remember a few years ago when this outfit called the X Prize Foundation paid $10 million for the first privately funded manned space flight?  Quite a contest.  Quite a feat.

Well yesterday, WellPoint and the X Prize Foundation announced a new competition offering $10 million for solutions that can impact positive change in health care cost and quality.

Nice prize.  Tall order.  But just damned cool.

Now if you are itching to sign up and want to know the details (read the rules-no doubt some lawyer is having fun with those), you'll have to wait until early 2009.

Just think for a moment.  Imagine if you will.  Here is a contest that embodies CDH not GDH.  Consumer Directed Health as opposed to Government Directed Health.  It recognizes that we are smart enough, creative enough, and have the ingenuity to tackle and solve some of the largest issues that confront us today.  We don't have to sit back and pray to Government for the answers.  I like that.

Generally speaking I don't care for films that have subtitles.  First of all, reading in the dark goes against, well,....... all the rules of reading.  I mean, when you were a kid your mom or dad didn't come into the room when you were knee deep in a good book and say "hey, it's too bright in here, you need to turn out the light."  Quite the contrary of course.  Secondly, those films are generally distracting because in addition to having to read you generally have to deal with people running all over the screen while at the same time jibbering away in another language.  So basically you have to watch two things at once and listen to a bunch of jibberish.   Nonsense.

BUT.

Today we have a brief but powerful film on Health and Care. Two words that go together like Swiss and Cheese, Rock and Star, Ice Cream and Cone, Captain and Tennille (well, maybe not the last one, if you have read this far, but you get the picture).   The grass roots health alliance, formally known as the Healthiest Nation Alliance recently posted (I assume they posted it) this video on YouTube. 

While it does not pack the action of a $100,000,000 Tom Cruise MI film, it does spare the jibberish and annoying actors noted in the commentary above.  And its message is pretty much in your face. 

If you can't see the video because youtube has taken it down, please click one of the Healthiest Nation in this posting and then click on the "What's Happening" tab when you get to their site.

I spent a bit of time at the Healthiest Nation Alliance's website and while I was a bit cautious at first due to some of the players,  I was struck by the mission and the organizations' simple desire to be known as an organization that "values health and well being."  I was struck by the lack of partisanship in their model for health improvement. 

To solve our health issues at both a local, national, and global level will require an unequalled level of collaboration;  between individuals and institutions, governments and businesses, great minds and greater actions.  Watch the video again, and then if you are inspired, scared or otherwise motivated, begin to think about your own model for health improvement.  As we have said on many occasions at The Gradock Bulletin, "Change one thing.  Then change another and then another."  You will be on your way to being a part of the solution.

If you've entered the world of Health Savings Accounts (HSAs), knowingly or not ,you've also entered the world of Consumer Directed Health (CDH).  You now have a platform for taking better control of your healthcare dollars.  And this is a big part of the equation.

We've stated our opinion here before that we not only have to take care of our precious healthcare resources but we must also look at the other precious resource; our own personal health.  That's the other big part of the equation.

I read the first paragraph of an article in a magazine today which was espousing the benefits of some whole grain diet program.It reminded me of all the diet "fads" that have come and gone over the years plus those that have been around long enough to have gone from fad to mainstream.

Now I'm not big into these named programs ,but it seems to me like there was one where you could eat all the red meat you wanted (cooked of course), another that involved gallons of vegetable juices, others that were basically TV dinners,  the snarlesdale diet, the nutri-this and the slim-that diet. 

My cousin, Bobby-Earl lost 10 pounds on the pork rind diet, and  I have plenty of friends that lived on diets of beer and Krystals.  An ex-roommate of my sister's was into the "finger down her throat" diet (hers, not my sister's).  I recommend and advocate neither the beer, the Krystal nor finger diets.  All very bad.

I am a big proponent of the "whatever-motivates-you-to-take-action" program.  What works for one person, won't work for everyone.  Brilliant, huh?

Anyway, I have a friend, who when it comes to fitness says, "calories in, calories out."  I like that quote, and thankfully, I didn't have to pay a personal trainer thousands of dollars to acquire that piece of wisdom.  Although I do appreciate the little bit of "value-add" I got for her investment in her personal trainer.

If you are thinking about diet and fitness, keep the idea of "calories in, calories out" top of your mind.   Combine this with action and you'll be able to balance what you eat with what you burn.  And you will be protecting a valuable resource...YOU! (and your HSA, of course)

At $3.66 per gallon for the "cheap stuff," gas is at an all time high.  And I'm not just talking about the stuff that goes in the car.  Although $3.66 gas is a primary cause of my other gas problem of late.  But is it really a problem?

Sure, world energy consumption is going through the roof, speculators are driving the price of all sorts of energy products sky high which drives up transportation costs, manufacturing prices, agricultural prices, pretty much everything.  Throw in a bunch of either, very greedy or very stupid banks and some very gullible and ill-informed consumers and you get a mortgage melt down for which we are all going to be paying.  The "R" word is being tossed around like it is the end of the world.  It is a wonder we all don't have gas.  And while the other "R" word, "Rolaids" might help, (and might also count as a qualified medical expense, and as such could be paid for from your Health Savings Account), we might want to think about other ways to perfume this swine.

I'm not an economist but I do know

I really want to do an overview on John McCain's Healthcare plans, but honestly Hillary Clinton's, "The American Health Choices Plan" pretty much sucked the life out of this kid.  The sixteen or so blogs addressing her views on healthcare was a bit more than this A.D.D. boy can handle and possibly more than the average HSAeducator blog reading visitor could handle as well.   It's something we are going to have to work up to.

Now this doesn't have anything to do with healthcare, wellness, HSAs, high deductible health plans, CDH, HRAs, IRAs, FSAs or any of the rest of the Acronym Soup that makes up our health insurance world today but I was listening to some talk radio show a couple of months ago and I got a chuckle when I heard John McCain compared, metaphorically speaking, to......Yosemite Sam.  I parked that nugget in my percolator and today took a looked at some old clips of the great Mr. Sam.    Now I don't (yet) know too much about his healthcare policies, but I think he may be pretty good on defense!

 

What do you think?