[Vision2020] UI Health Insurance

[Paul Rumelhart]

Ron Force wrote:
> I do remember at that time that in the wider world, conservative 
> economists blamed the rising costs of  health services on insurance 
> that was too generous, so that people overused health services, 
> running to the Dr for sniffles, etc. They reasoned that if people had 
> to pay more up front out-of-pocket, they'd consume less, lowering 
> demand, and thus, prices (or the organization would pay out a lot less 
> for health insurance).  That's the logic behind Plan H: if you don't 
> pay out from the HSA, it's your money, so you're less inclined to seek 
> treatment for every little thing, and that's why the system is 
> designed to encourage everyone into Plan H.  It's this philosophy that 
> I think was behind the change.

Doesn't that make sense to some degree, though?  If it's your money, 
you're less likely to allow the kinds of crap that doctors pull on the 
insurance companies.  Tests that aren't needed, the most expensive of 
everything, etc.  The health care industry because of the insurance 
industry is a bloated mess, at least what I've seen of it.  Anything 
that brings the market to bear, at least a little bit, should be helpful 
to everyone in the long run.

>
> Sandra's already pointed out the problems with this approach: many 
> poorer people can't afford to put much away. If you have a chronic 
> condition, you need care, and your HSA never builds up.  If you're 
> young, healthy, and relatively well off, Plan H is a sweet deal, even 
> more so since the HSA dollars are pre-tax and worth a lot more to 
> those in the upper brackets.  So the young and healthy go to plan H, 
> and those who use more services choose the PPOs, which drives up their 
> price even more.

Perhaps those problems can be solved in other ways without going back to 
the old system that the State's health care is representative of.  If 
it's a problem that the choice dollars are figured on individual annual 
salaries, and I can see how that can be, then perhaps they could be 
averaged over the total population so that everyone's choice dollars are 
the same.  That way, those in the upper brackets pay more and those in 
the lower brackets might even make money, depending upon the numbers.

 From everything Saundra wrote, it seems to me that the problem is the 
pricing for Plan A, not the existence of the HSA.  I like the fact that 
you can pay much less if you are healthier and don't need the extra 
care, and not only because I fall into that demographic.  That's a 
benefit to everyone, really, because the healthy are less likely to go 
to the doctor for a common cold if they've dialed down their insurance.  
Maybe I'm old school, but I find it amazing that people buy saline 
solution and whatnot with their insurance, and that they go to the 
doctor when they think they're coming down with a cold.  To me, 
insurance is there for when you get hit in the face by the good old 
Stick of Fate.

That's just my opinion.  I had a close family member with a chronic 
disease who eventually died from it.  Insurance is for them, and for us 
when we break a leg or come down with pneumonia or whatever.  Of course, 
this is coming from someone who did come down with pneumonia and made 
one trip to quick care after finally coming to terms with something that 
really was dangerous and after finally realizing that I was in need of 
professional care.

Paul