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Hoosiers Health Savings Plans

cpwill

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well well well, whattya know? the market, allowed to function, reduces costs and raises quality.

gee wiz, after only 300 years of modern economic study, you'd have thought we would have figured that out.

In Indiana's HSA, the state deposits $2,750 per year into an account controlled by the employee, out of which he pays all his health bills. Indiana covers the premium for the plan. The intent is that participants will become more cost-conscious and careful about overpayment or overutilization.

Unused funds in the account—to date some $30 million or about $2,000 per employee and growing fast—are the worker's permanent property. For the very small number of employees (about 6% last year) who use their entire account balance, the state shares further health costs up to an out-of-pocket maximum of $8,000, after which the employee is completely protected.

The HSA option has proven highly popular. This year, over 70% of our 30,000 Indiana state workers chose it, by far the highest in public-sector America. Due to the rejection of these plans by government unions, the average use of HSAs in the public sector across the country is just 2%.

...State employees enrolled in the consumer-driven plan will save more than $8 million in 2010 compared to their coworkers in the old-fashioned preferred provider organization (PPO) alternative. In the second straight year in which we've been forced to skip salary increases, workers switching to the HSA are adding thousands of dollars to their take-home pay. (Even if an employee had health issues and incurred the maximum out-of-pocket expenses, he would still be hundreds of dollars ahead.) HSA customers seem highly satisfied; only 3% have opted to switch back to the PPO.

The state is saving, too. In a time of severe budgetary stress, Indiana will save at least $20 million in 2010 because of our high HSA enrollment. Mercer calculates the state's total costs are being reduced by 11% solely due to the HSA option.

...It turns out that, when someone is spending his own money alone for routine expenses, he is far more likely to ask the questions he would ask if purchasing any other good or service: "Is there a generic version of that drug?" "Didn't I take that same test just recently?" "Where can I get the colonoscopy at the best price?"

...The Indiana experience confirms what common sense already tells us: A system built on "cost-plus" reimbursement (i.e., the more a physician does, the more he or she gets paid) coupled with "free" to the purchaser consumption, is a machine perfectly designed to overconsume and overspend. It will never be controlled by top-down balloon-squeezing by insurance companies or the government. There will be no meaningful cost control until we are all cost controllers in our own right.

Americans can make sound, thrifty decisions about their own health. If national policy trusted and encouraged them to do so, our skyrocketing health-care costs would decelerate.
 
This sounds like a very good plan.

I have a child with a couple of disabilities (which are expensive) and after adding everything up, using nondiscounted rates, it would still save me a good bit of money. I should forward this to my HR department .

Good find.

But yeah, any plan which allows the market to do what it does while protecting people from catastrophic problems is something we should encourage.
 
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Well actually, a high deductible plan coupled with an HSA could not be a very good idea for someone with a chronic condition or that has a child with a chronic condition.

You will go through several grand a year out of pocket dealing with the medical costs associated with treating a chronic condition and thus never see the benefits of allowing an HSA to grow over time.

Health Savings Accounts are great for those that are in the upper middle class and above, and young people without serious health conditions. The reason being is that most likely, at most in that case you are paying for a physical every year out of pocket and the rest of it is growing. However, if you have a lot of routine medical expenses, its basically going to work like an FSA, but with a 2,000 dollar or more deductible on your insurance plan.
 
What is "the plan"? Beside the H.S.A., what does the insurance cover?

Isn't that exactly what has been said in Washington, repeatedly?- That the overly generous insurance plans lead to unnecessary usage of H.C. and that is why they would like to apply a tax to such plans. Also, they have emphasized the need to transition Docs to salary rather than fee for service. All of this has been much discussed.
Americans can make sound, thrifty decisions about their own health. If national policy trusted and encouraged them to do so, our skyrocketing health-care costs would decelerate.
How many Americans still have generous comprehensive insurance plans?
Seems to me that if you are paying 23 cents on every health care dollar, you have the incentive to be thrifty.
 

I've been screaming this in the wilderness for years. Nobody listens.
 
SouthernDemocrat said:
"You will go through several grand a year out of pocket dealing with the medical costs associated with treating a chronic condition and thus never see the benefits of allowing an HSA to grow over time."

It is true that people with high spending will not see the benefit of return on their savings. However high deductible plans are still often better for high spending consumers since the out-of-pocket cap is usually lower than full coverage insurance. Someone who expects to spend $5k a year on routine (due to their condition) spending will still be better served by an HSA with a $5k deductible cap, since many similarly priced full coverage insurance policies have out-of-pocket caps of $10k or more. So if something unexpected happens outside of the $5k spending, it's covered by the high deductible plan attached to the HSA; while with the full coverage plan they'd be on the hook for up to $5k addition spending.

J
 
Well actually, a high deductible plan coupled with an HSA could not be a very good idea for someone with a chronic condition or that has a child with a chronic condition

hmm, well he's the one looking at the numbers. do you have a child with a particularly expensive special condition, as does megapropman?
 
The numbers work for me, but not all chronic conditions cost the same. My kid's is probably less expensive many other people's. Also, there is some cost savings because I have the same condition myself, but I have figured out how to fully function without any assistance or medication or any reduction in quality of life or health.

I am working on teaching these techniques to my boy, so I spend less than others might.

Really the only reason it would work for me is that the state contributes 2750. If that money came out of my pocket, I would be in a losing position. As it is described, that money from the state would be gone after 6.4 months anyway (according to my calculations). Still, it would be cheaper than my co-pays, deductibles, and current monthly insurance premium.

Also, I did not take into account things like sniffles, broken legs, and other normal family health problems. I was too lazy to go back through my accounting software to bring out all medical expenses and than estimate the full costs based on my insurance statements. So it might be a losing proposition overall. If I was actually considering that, I would have done the full accounting work for it and then turned my work over to my mom, who used to be the Finance VP of a rather large corp, for another look since she is a wizard with the numbers, so she can tell me what I did wrong and I can hopefully absorb some more of her knowledge.

Everyone's situation is different though. But given what I have calculated, it is a $700/yr difference based on a surface look.
 
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hmm, well he's the one looking at the numbers. do you have a child with a particularly expensive special condition, as does megapropman?

Yes 2 of our kids have special needs conditions that are chronic conditions and potentially very expensive to treat. My company's health plan is a traditional PPO and they offer a flexible spending account. So we put money in the FSA for every year. If they offered a High Deductible Account coupled with an HSA, we would probably go for that. However, we earn enough to adequately fund an HSA. You have to consider though that Median Household Income in the U.S. is 50k a year. That means that half the households out there live off of that or less. Thats simply not enough to fund an HSA along with a 401k and all the other expenses that everyone has. You can only stretch a dollar so far.
 
it is true that everyone's situation is different; which is why i think we need to expand choice rather than restricting it with these "exchanges"; let people purchase health insurance that meets their needs.

however, i think you are understimating people's abilities. If i made 50K a year, i could fully fund my IRA, all my other expenses, my sons ESA, and throw 5 grand a year into an HSA. I make a little under 40K now, and i do those things with the exception of the HSA.
 
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