Consumer Directed Healthcare

26 Comments »

1. Comment by Tracy October 26, 2006

   Perhaps the answer to affordable healthcare lies in empowering individuals to manage thier own costs. What are your thought on Health Care Savings Accounts? They seem like the latest wave in healthcare. Any thoughts?

2. Comment by wmrx October 26, 2006

   From a bird’s eye view what are the benefits to a Health Savings Account?

   Also,

   What controls from a Health Savings Account do I really have? Is it really my health ($$$) or just another plot of insurance companies to get my money?

3. Comment by James October 26, 2006

   Health Care Savings Accounts is the latest venue within the Healthcare Delivery System that allows us to consider moving for a “illness” ie you pay a preminum for insurance that focuses on being avaliable when you are sick to a “wellness/preventive” model that allows you to manage your Health. The next hurdle is to provide enough healthcare information to consumers that is useful and easily understandable.

4. Comment by AZK October 26, 2006

   I currently have a Medical Savings Account (MSA) that covers my copays and other non-covered medical expenses. Isn’t that enough? What else does an HSA give me that an MSA doesn’t?

5. Comment by James October 26, 2006

   Health Savings Accounts (HSAs)were created by public Law 108-173, the “Medicare Prescription Drug, Improvement and Modernization Act of 2003″ signed into law by President Bush on December 8, 2003. HSA are designed to help individuals save for qualified medical and retiree health expenses on a tax-advantage basis.(see http://www.ustreas.gov/offices/public-affairs/has/)

   Amounts contributed to an HSA belong to the accout holder and are completely portable. Funds distributed for the HSA are not taxed if they are used to pay for qualitifed medical expenses(see IRS Publication 502)

   Any adult who is covered by a high deductible health plan(and has no other first-dollar coverage)may establish an HSA.

6. Comment by James October 27, 2006

   HSAs are essentially Medical Savings Accounts but with out the restrictions that govern the Archer MSA Demonstration project. Some of the differences are:
   HSAs allow annual contributions to the account up to 100 percent of the annual deductible as well as permit “catch up” or increased, contributions for individuals aged 55 and over.
   Allow both employers and individuals to contribute to the account.
   Place no limits on the total number of accounts and are a permanent feature of the tax code, and
   Allow rollovers from Archer MSAs to HSAs.

   MSAs, by contrast require higher deductibles and tighter restrictions on contributions, are limited to 750,000 people and, as mentioned require annual reauthorization.

   The MSAs was a Demonstration project started in the 1990’s and achieved modest success by the mid 1990’s. In 1996, HIPA established a five year MSA Demonstration project for a select group of individuals-employees of small firms with 5 or fewer workers and self employed individuals.

   This Demonstration project was renewed by congress to continue until December 31, 2002. An additional renewal was authored by congressman Archer, thereby the new name, Archer MSAs, and passed by congress extending the MSA Demonstration until December 31, 2005.(www.cahi.org/cahi_contents/resources/pdf/125HSAQuestion)

   Rollovers for the Archer MSAs are permitted and those who are eligible individuals prior to Dec.31, 2005 may continue with the Archer MSAs if they chose or opt to roll over their Archer MSA balance into a HSA.

7. Comment by Jessic October 29, 2006

   “How Can I Stay Healthy?” and “How can I stay Healthy at a Reasonable Cost?

   I may be the wrong person to ask the first question simply because that is not an exact science and I would like to know the answear too. You need to get good healthcare insurance for it to be at a reasonable cost because if you become diagnoised with somehting before getting it your screwed, especialy once the bill comes.HSA seems to be very benifitial and that way when the bill comes it won’t hurt your pockets as much. correct? I’m all about saving the bucks and an HSA will help me do just that. James, I’m assuming that your roll is to inform people in the easyest of terms. What companies offer HSA? Healthcare insurance agencies or something outside of them?

8. Comment by Janille Thompson October 30, 2006

   As a healthcare professional,I have noticed that these are two important questions that always arise. I can definitely say that the United States does not have the best healthcare system in the world. In school, there were always debates regarding the Canadian healthcare system vs. the United States healthcare system. Now one of the big issues in the U.S. is one’s ability to pay for healthcare. Think of the less fortunate-those who have families and are uninsured. Fortunately there are programs here in DC such as DC Healthy Families which is the free insurance program for DC residents. I am sure there are programs all over the U.S., which is great. On the other hand, what about the college students who are in their junior and senior year of college, over the age of 19 and are no longer dependents on their parents insurance! (I was one of them :)) Remember, most college students are going to school full time or working a 7.00/hr work study job. I believe there needs to be more afforable insurance programs for people in situations similar to the college students.

   A person can stay healthy simply by living a healthy lifestyle. Its as easy as that. With the proper diet and exercise, one can live far beyond the years of life expectancy.

   As far as staying healthy at a reasonable cost, if one lives healthy and is free from any disease or illnesses they only have to worry about the usual check-ups. However, for those diagnosed with type 2 diabetes, heart disease and other conditions, I am afraid I do not have an answer for this population. This is the reason why we see that seniors can not afford their prescpitions and why people to not go to the physician in the first place. They simply cannot afford the healthcare costs.

9. Comment by James October 30, 2006

   Great questions!! HSAs will give consumers more choices before they are diagnosed with a health problem and will provide insurance for protection after they are diagnosed with a problem through the high deductible PPO Insurance policy everyone has to have to purchase a HSA.

   HSA product is targeted at the value driven discretionary oriented segment of the market. The rand corporation say this is 70 – 80 million employed Americans. People who want Healthcare information that will allow them to seek and find ways to stay healthy and when the do need a physician or a hospital can find information that shows them which hospital or physician are “quality” providers.

   Starting in first quarter of 2007, you can utilize the NEOS Healthcare site to decide if a HSA is right for you (www.neoshsa.com )prior to that, there are a number of site on the internet that provide this information. Most insurance companies provide a HSA eligible High Deductible PPO.

10. Comment by James October 30, 2006

    Janille;

    You have raised a great point. I think the inventory of Health Care Programs for individuals in this “in between” category need to be increased.

    These individual can use Health Savings Accounts. In recent years, the healthcare marketplace has experienced a trend toward more individual financial responsibility known as consumer-directed healthcare. This model of care provides financial incentives to consumers to reduce unnecessary health care utilization by increasing their financial risk. Health Savings Accounts (HSA), one component of consumer-directed healthcare, allows consumers to OWN and CONTROL their heath care spending and SAVE for future healthcare care cost with tax-free interest until retirement.

    In most states, high deductible PPO Health Plans are very reasonable and can be as much as 50 -70% cheaper than other health plans. These High Deductible PPO health plans will cover you for major health events once you have met the deductible and will provide all “wellness” visits at no charge to your deductible. These High Deductible PPO plans combined with Bank and HSA administrator are proving to be popular in the market place. In September 2004, The AHIP survey reported some 438,000 individuals were enrolled in HSAs; as of March 2005 AHIP member companies reported this number has grown to more than a million. You can find a number of High Deductible PPO Health Plans policies from a variety of healthcare carriers on http://www.ehealthinsurance.com.

    We need to develop greater tools for consumers to utilize in their education/decision support issues. We need to continue to find out what consumers need that will affect their behavior and move the healthcare delivery system more toward a “wellness” model as opposed to a “sickness” model. We must continue to create incentives for individuals to focus on staying Healthy.

11. Comment by AZK October 31, 2006

    I think there is some misconception with regards to being “healthy” and the numbers of times you go the the doctor’s office. Many of my friends and family correlate being healthy with the fact that they haven’t been to the doctor in a long time. Herein lies the problem.

    Let’s use myself as a classic example. I am a male in my mid-thirties and I have a shared contribution PPO plan for which both my employer and I contribute to. While I SHOULD be proactive with my doctor visits and routine tests, I find little incentive to do so. The fact of the matter is that I am more concerned with the copay amount should I decide to go to the doctor, mainly because I have already shelled a monthly amount equal to 10 copays.

    The answer to “How can I stay healthy?” is simple. As previously mentioned, diet and excercise are key. But equally important is recognizing the importance of preventative checkups and taking care of yourself. Educate yourself on what you need to do for a healthy lifestyle for yourself as well as your family.

    After reading more and more about consumer directed healthcare, it just makes sense. From a finacial aspect, but also from a personal standpoint. I WANT more control over my healthcare dollars.

12. Comment by Donn November 2, 2006

    I need to learn more about HSAs, where can I access further information?

13. Comment by James November 2, 2006

    There are a number sites for information on Health Savings Accounts. I would recommend starting at http://www.treas.gov/offices/public-affairs/heatlh.
    This is the U.S. Treasury site with basic information. I would then recommend google search on HSA Accounts to find out whom is selling what. An finally, armed with solid information, I would recommend a google Blog search on HSA to see the type of dialogue that is transpiring in the Healthcare market place about future of Health Savings Accounts.
    As well, your question(s) can also be addressed here at the health-care Blog.

14. Comment by Carla November 2, 2006

    I think the fundamental idea of HSA’s is good for those that can afford it but there is a segment of society that, for whatever reason, may not have access to such a program. Now for the basic questions, How Can I Stay Healthy?” and “How can I Stay Healthy at a Reasonable Cost? In my experience, as a mother and as a patient at one time or another, I have found that the best way to maintain good health is to be proactive when it comes to your healthcare. As much as possible, you have to make an effort to understand your body and be in tune with the signals that it gives you and if there is a problem, then you have to research symptoms and treatments. And yes, it takes some effort on your part but isn’t your life and the quality thereof worth it? When I am faced with a medical issue I resort to resources such as but limited to, the following links.

    http://www.drkoop.com/
    http://www.ahealthylifestyle4u.net/index.htm
    http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

    Then I go to examinations armed with information so that healthcare professionals and I are in a dialog about the medical issue and we discuss the treatment options. I also found that it is better to be prepared when talking to healthcare professionals because you also will have a better understanding of what they are saying and then you can explore treatment options that best suit you. Now the question might be why do I have to go through such extremes? And the answer is because if you want to stay healthy, you have to educate yourself and be an informed consumer. It is like anything else, you would not drive a car without learning how to drive first so why not take the same approach about your health. You have to stay informed about illnesses and treatments and that way you become an active participant in maintaining good health.
    Now, the cost is another issue. I think that costs are out of control and given there are so many models available both nationally and internationally I am not sure why we as a society have not discovered a system that is more conducive to our societal needs. We should understand by now that a healthy society is important to its survival/productivity and a system should be in place that serves the needs of its members not just those who can afford it. Perhaps an overhaul of our system is necessary and I know this is a major political issue as well but hopefully it will be addressed soon given the various healthcare crisis’s that we are experiencing seemingly quite frequently as of late.

15. Comment by JP November 3, 2006

    The focus of healthcare is the “business” of healthcare. Quality at times takes a back seat to “cost”. Change will come about when we as consumers decide that we want a health care delivery system that focuses on providing “good quality care” instead of a great “return on investment”.

    We are not likely to get healthcare reform in the near future based on polotics and healthcare as big business, but it would add confort if we could at least move the system in the “right” direction with incremental reforms. Such as measuring the cost-effectiveness of different test and treatment, putting a pay for performance system for providers and looking at ways to “seriously” cut administration cost.

16. Comment by Erick November 3, 2006

    As I read the nature of this blog I immediately was drawn to a response for each question. In sequential order the first was as easy or hard, depending on your own disciplines, as making the decision to eat more healthy, excercise and make sure you get your regularly scheduled check-ups. The second question, however, is just as easily complex. For it focuses on the price’s cause and effect of the longevity of performing the answers to number one.

    I have recently made the decision to lose 60 pounds by my b-day in april, thus requiring me to eat better and excercise. Although the continual rise of the costs of eating more healthy organic foods and acquiring good running shoes, now requires a loan application from several banks to finance such decisions, I am managing. I however, haven’t not been to my own personal doctor for a check up since I started working for myself and it is that third part of question one’s succession of answers that brings us to this discussion today.
    For we must understand and admit the first question is only posed to raise the importance and highly controversial nature of the second. In other words they are both one in the same, just with different emphasis. We read the first question and although we acknowledge the how with concrete solutions, it is the pronoun ‘I’ that get’s the full brunt of the responsibility. It is my responsibility to take charge of my health! However it is the questions answers that point us back to the beginning of the question to which now the emphasis is on the HOW. Yeah I can eat better but HOW can I afford it? Of course I can exercise but HOW can I afford the gym membership or at-home equipment? I will go to the doctor for check-up but HOW can I afford them? With this in mind a further nuance is added to the discussion. Politics. For the subject of Healthcare Provision is such a political issue. Let me define that a bit further so that I am a bit more clear for myself. The process by which we provide resources and multifaceted opportunities to attend to the well being of our involuntary and voluntary bodily functions is what most congress men and woman strategically position themselves on in order to win votes.

    Now don’t get nervous for this is not an “blame everything on the government” position. I merely need to set the context of the questions I plan to pose, for if it is truly the “questions that we seek” then surely we cannot afford to stop at two!

    Like my father, I am a pretty smart man and although I used its political antithesis just a few sentences ago, there was a word in the original post that caught my attention…”Delivery”, which is the caveat of these to follow…

    If the government’s expressed responsibility is not to “Provide” Healthcare but to “Deliver” Affordable Healthcare, what are the affordable opportunities available for those who are positioned to be accountable for their own healthcare provison? Who get’s to define affordable? How has the political process either aiding to or robbed the ability of healthcare companies to “Deliver”
    “affordable” healthcare options in our “Bottom Line” economy?

    What methods of delivery are in motion for the workin poor, those who don’t qualify for government assistance and are forced to choose between purchasing health insurance and meeting basic survival needs?

17. Comment by MedicalDeviceGuy November 3, 2006

    Rising Healthcare Costs Hurting Household Savings

    Americans struggling with rising health care costs say these increases cut into personal savings and impact household finances according to the results of the 2006 Health Confidence Survey (HCS) released by the Employee Benefit Research Institute and Mathew Greenwald and Associates, Inc.
    As health care costs continue to rise, Americans who experienced higher health costs report these increases negatively affect household finances. Thirty-six percent say increased healthcare costs result in a decrease in savings for retirement, up from 25 percent in 2004, while 28 percent reported difficulty in paying for even basic necessities, up from 18 percent. It seems to me that these new, more cost-effective consumer directed plans (HSA) have the potential of addressing, even reversing runaway cost for families.

18. Comment by Janice (JT) Wash,DC December 9, 2006

    How Can I stay Healthy? How can I stay healthy at a reasonable cost? These are two compex questions that I really feel that there is no “real answer” for either. Staying Healthy is a juggling act of diet, exercise and mental wellness. Eating right, and being consistant with one physical activity,at least three times a week contributes to staying healthy. I don’t feel the average citizen can stay healthy at a reasonable cost, because the healthcare industry has out priced themselves. During the month of November, my job conducted an “open season” to expose the employees to “better” health care. I read 9 Health Care packets and they all were a matter of $10-$15 difference in price. It all boils down to Service. We have allow the Healthcare industry make a mockery out of the closing Hospitals because people could not afford to pay. I say open free clinics. Who will pay for them? That’s another blob at a later date. I pay a large monthly premium and my government agency matches it and it is still not enough. My co-pay is 20.00 a visit. For example, one visit to the doctor cost $80.00. I had concerns about 4 minor illinesses that I felt should to be treated. They wrote me a pile of paper work and $20.00 for each referral. I say eliminate co-pay and I will began to feel healthier already. The health industry should start negociating with agencies to build clinics on site. I would be able to use my health card at work and lose less hours for doctor visits. How can you stream line the paper work, create longer hours, and still be reasonable? What is the alternative to the vision and dental plans which are not included with the healthcare packages. It’s difficult to stay healthy, when our society is not promoting financial plans to pay for the high cost of health care. It’s stressful to think about reasonable cost for everyone. What’s the alternative?

19. Comment by Pat, Baltimore, MD December 9, 2006

    How can I stay Healthy? One solution to staying healthy is eating three meals per day and being consistant with the time frame. Try not to eat After 6:30pm and this contributes to a healthy diet.
    How can I stay healthy at a reasonable cost? Meal planning will lower the cost of food and assist me in maintaining a healthy diet. This will eliminate the need for unecessary visits to the doctor. Try to stay proactive and aware of medical conditions.

20. Comment by JP December 11, 2006

    The key to staying healthy will begin to occupy more and more of our time as we begin to take responsibility for our Health. We need to take the responsibility for our health, then seek out the right tools that allow us to make good on our promises. The economy runs on Americians continuning to endulge in unhealthy behavior and continuning to consume to “excess”. We as a society will not change our behavior until there is “money” on the line. We will not change our behavior until it has a direct, do not pass go impact on our pocketbook!! The heathcare economy has a major investment on people being sick, staying sick and getting care.

21. Comment by Ann December 19, 2006

    I think that this is truly a great blog! It is refreshing to have a place to come an have your questions answeared. My Question is do you think that we as americans will ever enter a system to where we are fully covered for healthcare no matter our status of lower class, middle class, upper class? Or in a sense is it our responsibility to be fully coverd.

22. Comment by Health Advisor January 27, 2007

    Please help me provide health resources for medically underserved populations and also works to build the health care workforce and maintains the National Health WBR LeoP

23. Comment by Deductor February 3, 2007

    What is meant health protection? It is necessary to increase deductions from the budget in free-of-charge medical clinics. WBR LeoP

24. Comment by JP February 3, 2007

    I do not think we will get to a single healthcare payor system in the near future. We as consumers need to push the sense of wellness and focus on us taking care of our own health instead of looking to the government to save us one our health is no longer good.

25. Comment by Prescriptions Man February 4, 2007

    What is meant health protection? It is necessary to increase deductions from the budget in free-of-charge medical clinics. WBR LeoP

26. Comment by Idetrorce December 15, 2007

    very interesting, but I don’t agree with you
    Idetrorce

RSS feed for comments on this post. TrackBack URL

Leave a comment