*High Deductible Health Insurance products were designed for the healthy. The product was created to allow those in good health, who felt they would remain in good health, to have "catastrophic" coverage at a cheaper rate. It's important for us to remember this because the product has become more complicated and its general purpose is often put on the back burner as it is sold to the bargain shopper in us all.
* Less coverage less cost: As consumers we hate thinking about insurance and typically we don't unless it's benefits election season. We read the brochures of new health plan options and go straight to the bottom line--high deductible plans are cheaper.
* Nothing new for insurers who want maximum premium minimize coverage for greater profit: Less coverage, less cost does not mean your premiums don't rise. In 2008, the facts start trickling in, first, high deductible plans see increases in premium rates comparable to the rate of increase in other health insurance plans. (http://www.startribune.com/business/17324849.html) Chen May Yee reports what should have been pretty obvious to consumers: Premium rises in high deductible plans are comparable to the rate of increase in other health insurance plans.
* In the early days, advice concerning high deductible health insurance plans reminded consumers that the plans were workable for the young and healthy. This was important because it limited those who would consider the plans as an option when it really isn't a good option. If you are not young and healthy, this option is not for you, that's what we were advised and if we were not young and healthy, we stayed away from these plans. (for example, http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=274007).
* Flexible Spending Accounts: The Cafeteria Plans US Code 26 Section 125 Insurance companies love high deductible plans because they cover less. It feeds the trend to provide less coverage for more dollars. So how can you push the product to people who aren't young and healthy? Incentives and the laws to support them. Start with employers and have them offer it to employees with Flexible spending accounts. Well this is good, more people took the "option" of cheaper health insurance with tax free savings to pay for it (Employers don't pay FICA taxes on the money they hold in these accounts, more win win for employers and insurers and lose for consumers)! Ah, but problems remained, like the fact that employees lost the balance in these accounts if they didn't spend it (the worse level of insurance was not even a close second to the "money savings" of the high deductible plans).
* Medicare Prescription Drug Improvement and Modernization Act of 2003 created the opportunity for the health savings accounts of today. And the shift in the penny conscious employer and consumer was used by health insurance companies to continue to push the high deductible product.
The health savings account addressed the concerns of losing the balance of your account through employer cafeteria plans by "empowering" consumers to fund these plans by themselves thereby allowing the balance of their pre-tax dollars to be carried forward. And our fate was sealed. The ever penny conscious consumer no longer remembered the purpose of these plans, catastrophic coverage for the young and healthy, as they sought to sock away pre-tax dollars in their HSA's. The fact that they might never reach their deductible, the fact that the insurance product to which these plans are partnered are often a worse version of already bad existing options of HMO, PPO or Point of Service Plans, hasn't stopped us. And the rich saw a new tax shelter...as a matter of fact, these plans went from being a choice for the young and healthy to a choice for the young, healthy and rich.(http://www.selfemployedweb.com/hsa-tax-shelter.htmand)
* The insurance companies love this product, less coverage for more dollars. How to keep pushing it? It's better than nothing. And now, as prices rise because we've done nothing to improve the cost of health insurance by reducing fraud, increasing audits of health insurers to discover and prevent fraud, support legislative mandates that require certain basic coverages from all policies, limitations on rate increases, and because we've done nothing to control the cost of medical services including reducing fraud, reducing reimbursement rates for medical services performed by non physicians, mandating physician participation in some minimum number of health insurance plans, we've reached the latest stage of our scam, selling high deductible health insurance as "better than nothing." (http://www.usnews.com/blogs/on-health-and-money/2008/4/17/high-deductible-health-plans-for-many-too-costly.html.
* High deductible plans are a variant on inadequate health insurance products that are going to distract us from the core issue of deciding whether health insurance is the appropriate vehicle for consumers to use to obtain help in paying for needed medical services. Until we refocus our goals we will continue to see a perpetuation of the scam, raising amounts you can put in your HSA (playing to that greed thing which will not pay off once you have to pay increased premiums and health care costs from these accounts), rises in copayments, rises in exceptions to coverage...the entire litany of health insurance company tools for scamming consumers.
* But are health insurance companies really scamming us? Aside from the shift in language they're using to sell us the high deductible health insurance plans, when it comes to a better than nothing standard, isn't that what it means when a plan is recommended for the young and healthy? Of course, so it is up to us to remember that high deductible insurance is a sow's ear, not an insurance product that was ever intended as a substitute for non- high deductible insurance coverage. As we scramble to fund our HSA's and enjoy the "tax free" potential of the same, as we get sold all the "empowerment" of managing our own health care costs remember, high deductible health plans are the sow's ear and as the saying goes, you can't make a silk purse (even with all that money you'll be saving tax free) out of a sow's ear. Affordable access to quality health care...all three are necessary to address the health services crisis and without cost controls on premium increases and medical costs, consumers will continue to pay for a system that puts their needs last.
