tag:blogger.com,1999:blog-14442178.post114612171511449015..comments2024-03-25T08:08:23.132-07:00Comments on Who Has Time For This?: Mark: My WordDavid Cowanhttp://www.blogger.com/profile/13075075203254308405noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-14442178.post-1153947399032312122006-07-26T13:56:00.000-07:002006-07-26T13:56:00.000-07:00The Dems only hope (IMHO) is a Red-State governor ...The Dems only hope (IMHO) is a Red-State governor who is not hostile to religion and strong on national defense. The current crop (Hillary, et. al.) have allowed themselves to be pushed into a (left) corner (weak on defense and "family values") by both Republicans and their own far left (Karl Rove is smiling).<BR/><BR/>The last THREE Democrat presidents were from what are now "red" states.<BR/><BR/>As for HSAs... most good ideas are opposed by government types, go figure?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-14442178.post-1147242306035975682006-05-09T23:25:00.000-07:002006-05-09T23:25:00.000-07:00Hmmm..A VC as President?? Perhaps he will charge a...Hmmm..A VC as President?? <BR/><BR/>Perhaps he will charge a 2% management fee on the US goverment budget and a 20% carry on tax increases? <BR/><BR/>Where do I sign up?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-14442178.post-1147042470336559732006-05-07T15:54:00.000-07:002006-05-07T15:54:00.000-07:00Oren,"Unfortunately, that information is not yet t...Oren,<BR/><BR/><I>"Unfortunately, that information is not yet there."</I><BR/><BR/>Check out Healthia.com (where I serve on the board). Healthia's vision is to precisely fill the information gap for consumer directed healthcare. There is obviously a lot more information to provide, but Healthia is adding it fast. I expect others will as well. <BR/><BR/><I>"Providers still charge arbitrarily unreasonable fees for anyone who is not part of the "network""</I><BR/><BR/>Like Russia in the dawn of capitalism, there will be, er, discontinuities as the marketplace finds equilibirium. Eventually consumer choice will force prices down to their real value. In the meantime, Healthia offers victims of over-pricing a service to redress charges above market prices. <BR/><BR/><I>"Doctors, meanwhile, do their best to dispense medical advice, but they are not necessarily trained to dispense economic advice"</I><BR/><BR/>Certainly insurance companies aren't either. Isn't is self-evident that the proper process is for doctors to explain the risks and costs, and let the patient decide?<BR/><BR/><I>"When we see an easing in the demand for talent, we'll see an increase in companies willing to force people into HSAs"</I><BR/><BR/>Only inertia, not cost, slows down HSA penetration. HSAs cost the employer less than traditional insurance plans. In total out-of-pocket expenses/deductibles/premiums, HSAs also cost the employee less than traditional insurance plans. The only loser is the insurance company. <BR/><BR/>Thanks,<BR/>DavidDavid Cowanhttps://www.blogger.com/profile/13075075203254308405noreply@blogger.comtag:blogger.com,1999:blog-14442178.post-1147017907413331822006-05-07T09:05:00.000-07:002006-05-07T09:05:00.000-07:00Loved your post, up to the point where you attibut...Loved your post, up to the point where you attibuted Warner's dislike of HSAs to "naivete, partisan politics, or simple pandering."<BR/><BR/>I've been president of a company that provided outsourced benefits administration services and software to dozens of companies like Google, JDS Uniphase, and 24 Hour Fitness. HSAs were introduced during my tenure there, and our company was among the first to jump onboard and offer them to our employees. So I have some fairly deep experience here, and am qualified to say...<BR/><BR/>HSAs are a great step, but they are not a panacea, and reasonable people can agree that the current system is broken, but believe reasonably that HSAs are not the cure. The basic premise sounds great - your trusted doctor, not some insurance company, dispenses your medical advice, and you look for information on "the internets" to help you make these critical decisions. <BR/><BR/>Unfortunately, that information is not yet there. Providers still charge arbitrarily unreasonable fees for anyone who is not part of the "network", leaving people with a stack of medical bills that they have to negotiate after the fact. As an example, a family member recently had a series of X-Rays taken for which we received a bill for $1432.25. But in our PPO, the charge was reduced automatically to about $130, a "savings" of 90%+. Like it or not, having a professional negotiator - which is what the PPO's act as - on your side can be useful, especially for your average consumer who haven't learned the negotiating skills you and I have.<BR/><BR/>Doctors, meanwhile, do their best to dispense medical advice, but they are not necessarily trained to dispense economic advice...and the threat of malpractice always looms over any decision that would suggest skipping a particular test or procedure that another doctor might later say was "clearly indicated".<BR/><BR/>All this while medical care is getting more, not less complex, and profit-driven companies have a strong incentive to get information which would improve their market share on to the internet, at the top of Google search results, and in the hand of "consumers" doing "research". The current situations of drug companies spending billions to "educate" doctors with years of training to improve their fortunes; getting their "message" out to individuals facing serious medical challenges for themselves or their family would be trivial. Heck, they're already doing it.<BR/><BR/>The current approach to HSAs is an "all or nothing" approach - cut the cord on a familiar system and jump into the world of high deductibles and individual responsibility to conduct research and undertake financial negotiations. But people don't yet understand them or trust them, and so most companies are finding it hard to boost participation rates. In this climate, the relatively few people who have opted for them are like the early adopters of any technology you might invest in or I might ask you to invest in - those who have taken the time to figure it out and use it to their benefit. <BR/><BR/>Meanwhile, we are in a tight hiring market, so you're not going to see companies that must compete for talent eliminating traditional health plans anytime soon. When we see an easing in the demand for talent, we'll see an increase in companies willing to force people into HSAs, but I predict we'll begin hearing "HSA Horror Stories" just like we heard "HMO Horror Stories" when HMOs emerged as the savior of the health care system way back when. <BR/><BR/>HSAs or something like them can be a component of healthcare reform, but on their own they are just another means of shifting healthcare risk from the employer to the employee. Now, we can debate whether the employer should be the provider of healthcare in the first place, but I think that's best left for another day. Meanwhile, as a Democrat who agrees with pretty much everything else in your post, I say to Mark Warner, "good for you". And I say to you, our host, that if you came away from meeting Governor Warner and opposition to HSAs was one of the only bones you had to pick with him, I'm encouraged. Thanks for sharing the experience, and for supporting Democratic candidates.Anonymousnoreply@blogger.com