My son has this flattened stuffed hippo called Flatso, who has been a close family friend for many years.  As an aside, I wonder if the phrase "creature comfort" is derived from these affections we had for these stuffed critters when we were kids.

When my son was three years old, we were eating dinner at Col Poole's Bar-B-Que joint up in the Georgia hills on our way home from a weekend in North Carolina.  Poole's is famous for four things; Pig Hill, politicians, pigs and more pigs.  First: Pig Hill, as it's name suggests is a large hill behind the restaurant on which there are thousands of cut out pigs, in various colors nailed to sign posts plunked in the side of a hill.  Collectively, they are placed in the shape of a giant pig which can be seen from great distances. Second: Politicians, as they are want to do in the South, have frequented over the years for a free meal and lots of rhetoric. Third: Pigs; A mechanical pig greets customers outside the front door, an antique from the hey day of Piggly Wiggly and a delight to small children because they can sit on it and it actually works.  Fourth: More Pigs; and lastly, on the inside of the restaurant, loads of collectible pigs of every shape and size lining a ledge that runs along the walls.

On this fine Sunday evening, my three year-old son, never the shy one, spotted a pig on the ledge o' Pigs  that looked eerily similar to his Flatso.  With great energy, excitement and a pointing finger, he started shouting, "Flatso! Flatso! Flatso!"   Now this would have been fine under normal informal dining circumstances, but at that very moment of outburst a rather rotund employee  passed by between my son's pointing outburst.  My three year old was clueless, however my wife and I turned as red as the pigs on Pig Hill.

The above confessional has nothing to do with neither Health Savings Accounts, the usual fare of this blog, nor does it have anything to do with  HIPAA, the subject of this article, but it was one of those embarrassing moments that my wife has managed to keep me from blabbering about  for many years.  Until now that is. 

So what is HIPAA?  Definitely not a three year-olds play creature.  You have probably heard the term used in and around healthcare and you may know it has something to do with privacy.  Specifically, it stands for the Health Insurance Portability and Accountability Act.  Huh?  Me too; that's why we're covering it here at The Gradock Bulletin.  In short, it is the legislation passed several years ago that makes it illegal for doctors and hospitals to provide your private medical information to third parties without your consent. 

It's bad enough, the humiliation, doctors and hospitals put us through when we go in for a visit.  Imagine if the back of your hospital gown was open for the world to see.  HIPAA is designed to protect you from bearing your backside and the rest of you to the world.  That's HIPAA in a nutshell.  Or should I say, buttshell?

 For starters, she speaks our language.  And that is the language of Consumer Driven Healthcare.  A brief expose' of her positions are outlined in the December 22 edition of Business Week and worth a read.   If time is tight, keep reading below for a summary and maybe even a few thoughts of our own (maybe).

Regina Herzlinger is a professor of Business Administration at Harvard Business School and she advocates neither government nor employer based healthcare.  Branded a heretic by some, she advocates a free and open healthcare market that is totally focused on you and me.  Also known as the patient and the consumer.

Her position is that there should be total transparency in the healthcare space.  In otherwords if doctors, hospitals, and insurance companies all had to compete openly in the marketplace for yours and my healthcare dollars (that we controlled) we would have economic environment not unlike the retail sector.  Those that provide us with health related services would compete like crazy, drive prices down, and we could make our own and hopefully better decisions about our healthcare.

In her model, the government's role is really four-fold:  mandated (a word that frightens me generally) coverage for every American, strict oversight to ensure fairness in terms of price/coverage, a national database of pricing and quality, and lastly tax breaks and subsidies depending on income.

She agrees with the folks at the Gradock Bulletin, that HSAs are not the silver bullet to healthcare reform, but rather part of the solution.  We believe an important part.

Sounds good, no?  Here's the rub.  Those who disagree with Ms. Herzlinger do so because they think we are too stupid to fend for ourselves.  That there is no way we could possibly sift through all the choices and make informed healthcare decisions.  To that I respond, ptuey.   We go to the grocery store, there are tens of thousands of items, all with different prices, different sizes and with different nutritional values.  It is a virtually transparent marketplace and because it is, we are able to make informed decisions.  We are neither chimps, nor chumps.  Education, information, transparency can lead us to meaningful reform.

 

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.

Last month we posted an article that hit on the "Unscientific Top Ten Reasons Why Healthcare is So Expensive."  Today we are here to offer you unscientific reason #11.

The U.S. Government doesn't trust you any further than they can throw you.

HDHPs and HSAs, by nature should save you money over traditional health insurance. BUT, the Government in all its wisdom/paranoia does what they can to undermine their efficiencies.

In this case, they passed some legislation (IRS Notice 2008-104) awhile back mandating that in order for (FSA and HRA) healthcare debit cards to be acceptable forms of payment at certain merchants, those merchants were required to only be able to accept your card for what the government has determined is a "qualified medical expense."  The government says this is to help you out because the card issuer will be able to provide you/your employer with a consolidated back up report of your qualified medical expenses that you can then use as backup to your FSA and HRA disbursements.  Sounds good, right?  Well, maybe so until you walk into your local Walgreens, put a bag of cough drops and a bottle of shampoo on the counter and then have to pull out two different credit cards to pay for your $2.57 worth of stuff.

There are those in Congress who would like to extend this concept to your

Health Savings Account.   Which is redundant and ridiculous.  You see, by law, you are required to keep up with your qualified medical expenses and be able to provide them as backup to your taxes.  The IRS, if they don't like what you have submitted, has the right to audit you, which, I've heard is worst than a visit to the proctologist.

A new law (currently buried in committee) would put another layer of oversight by the government over your life, and puts an unnecessary level of infrastructure expense on merchants and debit/credit card issuers. 

Hey, if the merchants and issuers believe they can create a competitive advantage for their product, by being able to provide you with this level of reporting, then by all means, I say let them spend the money.  However,  mandates create costly inefficiencies, and I'm guessing this one, requiring merchants to be able to accept or deny a card based on the specific item purchased and them provide a report of those expenses at year end would cost somewhere in the hundreds of millions of dollars to execute.

This is a good question and varies based on your specific needs, which, by the way will change as you accumulate money into your HSA account. 

If you would like to start a discussion on this topic, we invite you to start a thread on the HSAeducator Forum, you can click here to get there and start a conversation based on your own needs.  You will need to register on this site to participate, but it only takes a few seconds, and you are already here.

As an alternative, if you want to read another thread on the topic(in the spirit of Miracle on 34th Street, we found a pretty good discussion going on at bogleheads that you might want to have a look at as it may address some of your questions and help sort things out for you.   We are all about HSA education, so when we find good stuff out there that might help you out, we want to do all we can to help you make informed decisions. 

P.S.  If you want to get in the Holiday Healthcare Spirit, please be sure to read "How The Pinch Stole Healthcare"  

 Now there's a seemingly dry topic for an article on HSAs but guess what?  It is one of the top keyword searches driving individuals to this site.

And since we are all about HSA education, it seems only fitting that if you blasted through cyberspace and somehow landed on this page reading this article, and this sentence specifically, it seems only fair that we get you to a place that can get your question answered.  If you will click right here you will be shot through cyberspace just a little bit further into this site and where your question will be answered.

It's all pretty much laid out on one page to keep from putting you to sleep, but as you read it, should you want to learn more about high deductible health plans or anything else related to HSAs just click to the next page and read ‘til you feel like an HSA expert.

Oh, and one more thing, there is a pretty good starter page of frequently asked questions about HSAs if you have a question.  If you can't find the answer, just post your question on the HSAeducator forum (you will have to register) and one of our experts will try to answer it for you.

If you have read the last two postings ("What the Heck is E-Health" and "E-Health and Health Savings Accounts") you know what e-health is.  Now the question is,  where is it going?

There's a good article in the December 8^th edition of Business Week on E-Health.  Love ‘em or hate ‘em, Wal-Mart (who began offering Health Savings Accounts in 2006 as a means to provide health benefits to its 1MM+ employees) will offer its 1MM benefits eligible employees the opportunity to log on to the company intranet site and from there download and print medical records their physicians may require.

This is potentially a good tool for Wal-Mart because it supports their cultural core of driving down costs.  In this case both healthcare and health insurance costs.  This is significant because if Wal-Mart and other large corporations like AT&T Intel, and Pitney Bowes can successfully adopt e-Health and prove that it actually does lower costs, then more folks will adopt it and affect real change in healthcare.

Check out the article.  It's a good read.

If you read the last article in the Gradock Bulletin or if you're already well informed you know what the concept of "e-health" is (and if you didn't read it, it is right below this article).  You might even be asking yourself what's in it for you?  And more specifically, how does it relate to CDH, HSAs and HDHPs?

Good question.

Imagine if you had a secure place where you could input basic health information about yourself and your family that could also be overlaid with accurate information related to your health from your doctors, your pharmacist, dentist and other healthcare practitioners who have provided treatment for you. 

Arguably, the best person to track your health is you.  And the best person to monitor your health is you.  And the best person to monitor your Doctor is you.  If the information in your health records is accurate, then the doctor is less likely to screw up diagnosis and treatments for you, which can impair your health and cost you and your insurance company money.   And if there are less screw ups and better treatments offered due to better information, then that drives the cost of healthcare down for everyone.

So if I lay down on top of my computer, is it somehow going to make me healthy?  Or maybe if I spend 8 hours a day doing health related Google, Yahooo, MSN or some other search engine searches, will that make me more e-healthy?  Perhaps if I stick my hand in the VCR and push play, that will give me a nice jolt of Electronic Health?

The answer is "D." None of the above.

E-health is one of those terms we hear all the time, but maybe aren't quite sure what it is.  The expression driving me nuts lately is "filibuster-proof Congress," which has something to do with the Democrats picking up Senate seats in Georgia and Minnesota and as a result generally being able to kick the Republican's butts all over the place, but beyond that, I'm clueless.

So what is E-Health? Simply put, e-health is just digital medical records.  Oh, and by the way, we'll de-mystify "HIPAA" during the course of this rant as well.

And why should we care about e-Health?

A couple of reasons.  On the positive side; Efficiency.  E-health, well executed can reduce administration time of health records and also improve the accuracy and breadth of records which will generate time (=cost) savings and cost savings from improperly administered health care (screw-ups by doctors, nurses, pharmacists and other healthcare practitioners).  Reduced screw-ups also lead to healthier you and me's. 

On the negative side; Privacy.  A person's health records are very personal.  When digitized and floated out into the great and vast cyberspace you want to know they are secure.  Hey, it's uncomfortable enough when you go to the doctor and basically have to expose yourself.  The last thing I want to have happen to me (with the possible exception of being coated in honey and dropped on fire ant mound in the hot summer Georgia sun) is to have my every tick, rash, and phobia exposed for the world (including insurance companies, hospitals, employers, friends and freaks) to see.

So what is HIPAA?  HIAPA stands for Health Insurance Portability and Accountability Act.  Huh?  You probably hear this bandied about in the context of your medical records and what it is, is legislation that makes it illegal for doctors and hospitals to provide private medical information to third parties without your consent.

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.