Category Archives: health savings accounts

HuffPo & Public Radio praise free market health care solutions.

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Two traditionally “left-wing” media outlets publish article on examples of how free market solutions can work for patients and doctors.

from Huffington Post 5/26/2011
Direct Primary Care: Skip The Insurer, Get Better Health Care?

Health insurance costs have skyrocketed, making preventative care a near-impossibility for many Americans. But a unique system has sprung up, skirting around the insurance industry entirely: direct primary care practices. And the impact, proponents say, isn’t just financial. Direct primary care clinics could dramatically increase the quality of health care, too.

The idea behind direct primary care practices (DPCPs) is that patients pay a modest, monthly fee (often adjusted according to age and existing conditions) and receive direct access to their doctor.

This means practices generate revenue directly from fees and not from billing insurance companies or ordering tests.

So what are the health implications of these plans? Proponents say they are plentiful.

Because the fee model limits the amount of time doctors have to spend filling out insurance paperwork or battling over coverage, they have more time to devote to patient appointments.

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from Minnesota Public Radio 6/20/2011
Doctor as renegade — accepts cash, checks, eggs or pie, not insurance

Osakis, Minn. — Dr. Susan Rutten Wasson sits on the corner of a bed in the cramped bedroom of Alice Johnson, a 91-year-old Osakis resident everyone calls “Grandma Alice.” She’s examining Johnson’s arm, which is swollen, she’s determined, because of a tight sleeve cuff.

Also in the room are Alice’s daughter, Ione, and granddaughter, Anne, who lives downstairs in the farmhouse Johnson has occupied for decades. A Rottweiler mix as big as a Shetland licks the face of 18-month-old Sarah, Rutten Wasson’s daughter, who sits on the doctor’s lap.

It’s more a scene from the days of frontier medicine than from the modern health care system. And that’s because Rutten Wasson, 42, is a throwback to a time before HMOs, electronic health records and hospitals with fountains in their lobbies. She sees patients the same day they call if she’s not booked up, spends at least a half-hour per visit — compared to the more typical 15 minutes — and usually charges only $50 for a consultation. She takes cash or check, but no insurance — and sometimes accepts gratuities of a dozen fresh eggs or a pie.

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Some good news on health financing

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Florida Governor Charlie Crist got the legislature to approve—unanimously—innovative reform that could dramatically affect Florida’s number of uninsured, now running at 21% of the population, the fourth highest rate in the nation.

The “Cover Florida” plan will allow insurers to offer plans exempted from the 50-some mandates that Florida imposes. The new plans will cost as little as $150/month, or less. Plans will enroll only those who have gone without coverage for six months. It also creates a clearinghouse through which small businesses that can’t afford coverage can offer their employees similar plans (Wall St J 5/29/08).

In New Jersey, Republican Assemblyman Jay Webber of Trenton will introduce legislation, modeled on the Shadegg plan, allowing any state resident to buy low-cost insurance from any registered policy in any of the 50 states. A family health plan that costs an average of $5,799/yr elsewhere costs $10,398 in New Jersey.

Democrats, however, are rallying behind a plan to require every uninsured person in New Jersey to buy a plan from a new state-administered program. “So a state that is already so broke that its politicians are contemplating mortgaging its highways might now add a $1.7 million health subsidy (Wall St J/ 5/29/08).

Massachusetts should have tried a similar idea, suggests Greg Scandlen. The average cost in Commonwealth Care is $4,994 per person. Next door in Hartford, Conn., the most expensive policy for a 35-year-old male, for a zero-deductible, zero-coinsurance HMO, is $2,744. Other plans cost half that, or less. “Massachusetts would have been better served if it simply allowed its residents to buy coverage next door and paid all of their premium” (Consumer Power Report #130, 6/6/08).

Manitowoc County, Wisconsin, saved the taxpayers nearly $2,600 per family plan by providing its employees a high-deductible health plan (HDHP) with a health savings account (HSA). The county fully funded the $3,000 deductible, and eliminated more than $4,000 in employee costs for premiums and copayments (ibid.).

State governments, including Georgia and Indiana, are beginning to turn to HDHPs and HSAs, to the consternation of opponents such as Niko Karvounis. He writes: “HDHPs and HSAs are actually thriving—and in fact penetrating our health care system at a relatively brisk rate.” This is a problem because “their proliferation weakens the political viability of the health reform we really need” (Consumer Power Report #128, 5/21/08).

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