Saturday, January 28, 2017

Health Care Reform

Two quick things...and I'd love to learn from anyone who has insight on these two issues:

1) Insurance premiums will not decrease until the cost of claims and the number of claims come down. That will only happen if there is competition in health care systems (see point 2) and we as a population remain as healthy as we are now. Insurance premiums have been increasing steadily for 40+ years; it's only in the last 10-15 years that it's gotten painful because companies see the benefit as a significant portion of compensation (approaching 15% for married-with-dependents employee). Companies started shifting to high deductible plans to reduce their costs and share some of the burden with the employees (Health Savings Accounts--HSAs--were around long before ACA--Obamacare.) Now many individuals are feeling the pinch as health care costs go up.

2) Proponents of reform talk about choice, but health care is the only expenditure we have (outside of utilities) that we cannot compare prices. Providers cannot tell you what any procedure or visit will cost because they don't know what the negotiated rates are for all the different medical procedure codes. We as consumers cannot see the 'sticker' price, know the negotiated discounts and make informed choices on options for providers or procedures. For example, I know someone who went in for physical examination (covered by insurance 100%) but asked the physician about a condition under discussion from a previous visit. Boom! A different code--diagnostic in nature rather than preventive--was applied and the deductible now was considered in the physician visit payments. The cost of the visit doubled because it became 'two' virtual clinic visits. Was there a sign saying what the price is? Did this person know the 'you break it, you buy it' clinic policy on asking questions? No!

No comments:

Post a Comment