quinnscommentary

According to a new survey from Towers Perrin, employers are not prepared to absorb additional costs that may result from health care reform.  That of course is no surprise as (contrary to political rhetoric) costs for large employer self-insured plans have been rising just as fast as insured premiums.  Hey, it’s not the insurance companies this time?

Where's the cash?

Cutting back benefits is on the employer strategy list and guess what that means, higher out of pocket costs for workers.  The idea that somehow we can have  reform that amounts to little more than a giant shell game (or perhaps Ponzi scheme) of moving costs around without addressing the underlying causes is laughable. 

Well it would be if it were not so serious and so expensive to learn this lesson.

The idea that what what is being done will make health care affordable is absurd.

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How to control health care costs; the ultimate question. If you look at the various bills pending in Congress and if you listen to the politicians (but not anyone who knows what he or she is talking about), you will see that paying for wellness and preventive services is claimed to be a big part of controlling health care costs.

In fact, the pending legislation requires 100% reimbursement for many such services. While obtaining such services may be a good idea for the individual, they in fact add to health care costs.

An article in the November issue of Bloomberg magazine notes there are no studies showing savings from general use of screenings and preventive services. While there may be savings on health care for one individual found to have a disease early, so many people have to be screened to find that person the cost of screening exceeds the savings.

Even employers have bought into the idea of wellness and preventive services as a cost saving tool sometimes paying employees to change behavior. It all sounds good until you look at the facts. Employers have the additional disadvantage of not even being sure the employee is still employed if there are any benefits to capture in the years ahead. And that is one of the catches, it takes years, perhaps a lifetime to reap any benefits of a healthy lifestyle.

As Princeton’s Uew Reinhardt says, early intervention is desirable. It just won’t cure the chronic problem of rising health care costs. But if you listen to the politicians on both sides of the aisle you will repeatedly hear them claim that requiring insurance companies to pay for things like mammograms will save money. 

So it is with many elements of health care (insurance) reform, unsubstantiated claims, generalizations and pie in the sky assumptions from all sides.  In addition, there is complete disregard for the fact that it is as the name implies, insurance.  We fail to question why routine screening, flu shots, even contraceptives are covered by health insurance at all.  They are predictable, manageable costs not insurable risks.  They are too expensive for many people to afford you say?  Well, they are expensive because somebody else is paying for them and we don’t care what they cost.  They are covered by many insurance plans because they were mandated by state  politicians and guess what, all those mandates are a major factor in making health “insurance” unaffordable.  And what do the people in Washington do, they do more of the same, create the impression that not only do people have the right to such coverage but that insurance companies are the very devil if they try to take it away.  In NJ one candidate running for governor who opposes these mandates is being eaten alive by his opponents campaign ads and being accused of not caring about women because he is against insurance mandated coverage.  But there is nary a word about why health insurance in NJ costs so much…scratch that, it is those insurance companies raising premiums that cause health care to be so unaffordable.

So how much does a mammogram cost, between $80 and $120 with an average of $102.  How does that stack up to say a manicure or perhaps a cut, color and blow dry?  Well, a manicure can range from $12.00 to about $40.00 and taking care of hair; for that I went to a discussion group for women and here is what one woman had to say:  “I pay $35 for my cuts, but can’t get out the door if I get a partial foil for less than $100. A normal full visit for me is about $150 including tip…this is also why you can see my roots! Lucky for me, my hair grows slowly and I don’t color drastically!”

So, we need insurance to cover a mammogram once a year or less, but we find the money to pay for a new look every three months or so…go figure.  Is there a new untapped insurance market out there?

Is a bad hair day an insurable risk?

No matter, we will continue down the current path just the same.  Reforming health care has become so distorted nobody knows what is going on anyway.

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