Regular readers of Healthy Blog know you’re a quiet bunch. Our stats tell us we have between 400-600 unique visitors a day — insiders, outsiders, and betweeners. A good sized readership, yet comments are infrequent. We would like to change that — in the interest of triggering a more robust conversation about the progress of health reform and more.
Regular readers also know there’s a lot to Chapter 58. Often, there are so many things going on, we struggle just to keep up with reporting them. We know the regular media pays sporadic attention, as best they can, within time and space limitations. It’s worrisome there’s so much going on, we miss important details and nuances.
Two cases in point — both from recent postings:
October 20th: …the Connector expects to solicit three options from each insurer consisting of low/medium/high options with premiums covering 60-65%, 70-75%, and 90-95% of a typical person’s medical costs. Kingsdale would not be tied to any specific numbers for coverage levels. He said they will defer to the board whether there will be guidance for the plans about deductibles or coinsurance…
So what do we think about plans the cover only 60% of a “typical person’s medical costs”? Leaves a lot of potential bills to be paid by someone in a marginal economic circumstance. Anybody have the chance to read the stunning article in Sunday’s New York Times about the family with a young daughter with about a dozen severe mental illnesses? What does being a “prudent consumer” have to do with them? We need public discussion of these issues and we need it soon.
And a second item:
October 12th: …Insurance Commissioner Julie Bowler wanted to make sure that high deductible and non-managed plans remain available as a way to attract young healthy individuals. She decried the impact of the 1996 non-group coverage reforms, which she said drove out many plans to the detriment of the insurance market. Companies like MEGA Life and Golden Rule, for-profit indemnity insurers, are attractive to many and have a role to play.
From our perspective, the departure of Mega Life and Golden Rule from the Massachusetts insurance market was a cause for celebration. They only functioned in Massachusetts to the extent they could do what’s called “medical underwriting” or rating persons according to health risk. So stay healthy and pay lower premiums — have a cancer episode and watch your premiums go up 500%. Health insurance for when you don’t need it. Good riddance.
What do you think? Are we off base? Are these good ideas put forward by Kingsdale and Bowler? Let’s get some conversation going, please.
Is a plan that covers 60% of health care costs a good thing?
It’s better than no plan, which is what many future beneficiaries of the law now have in place. We also aren’t going to have a single payor system dropped from the sky anytime soon.
So, within the realm of what’s possible in Massachusetts in the next year, I’d say it’s potentially a good thing if paired with a well-designed and apropriately-utilized health savings account.
I haven’t figured out whether the after-tax costs of limited health plans plus HSAs make the package a good deal if fully understood and approriately utilized by consumers, but let’s assume that such a thing is possible. The effort needs to be put into making sure that they are fully understood and properly utilized by consumers. That effort needs to begin sooner rather than later, because (a) the financial services industry is getting into the HSA business in a big way (bigger for the plan years starting in 2007) after the IRS cleared up some HSA issues a bit a couple months back (see my post on the subject at http://healthblawg.typepad.com/healthblawg/2006/08/irs_guidance_on.html) and (b) consumers need all the help they can get untangling this mess (see my post at http://healthblawg.typepad.com/healthblawg/2006/10/cdhps_and_hsas_.html).
If you want to know about MEGA Life, read today’s Globe about the AG’s complaint against the company.