IN THIS ISSUE:
? You’re Never Too Young to be an Old FOGI
? Insurance-Induced Demand Results in Physician Shortage
? So More Physicians Stop Taking Insurance
? HSAs – Catalyst for Major Shake-up in Health Insurance
? HSAs – Health Care of the Future or Tax Shelter for the Rich?
? HSAs – Long Lasting Implications on Health Care
You’re Never Too Young to be an Old FOGI
With a new — and very exciting — year dawning, this is the perfect time to become a Friend of the Galen Institute. This year we’ll be working on the continuing roll out of HSAs and HRAs, the implementation of the initial Medicare Rx provisions, federal proposals for refundable tax credits, fighting proposals for single payer programs at the state level, and a host of notions from electoral candidates all across the land. It will be a very busy year and we could use your help. Please visit our web site to see how: http://www.galen.org/join.asp.
Insurance-Induced Demand Results in Physician Shortage
The “Milwaukee Journal Sentinel” is raising alarms about a growing physician shortage. An article by Joe Manning cites Dr. Bud Chumbley, the president of Medical Associates Health Centers, who says physicians are “maxed out” in terms of providing patient care. The docs in his six clinics are “trying to educate patients to eliminate the ‘worried well.'” He adds, “Everyone talks about the cost of health care going up. But people want more and more and more and more. They want as much health care as their employers will pay for.” And Richard Cooper, a professor at the Medical College of Wisconsin, says managed care’s ability to limit doctor’s office visits has worn off, “and patients with insurance have gotten used to visiting their doctors whenever they want.” He says Americans are “outraged when they cannot have immediate access to the health care they feel they are entitled to.” To meet this growing demand, the Council on Graduate Medical Education is recommending that medical schools increase enrollment by 15% over the next ten years, according to Dr. Carl Getto, chairman of the council. But, he adds, that may not be enough – “We (physicians) need to tell them, ‘You don’t need to have this done. You don’t need to be here.'”
So More Physicians Stop Taking Insurance
The “Fort Worth Star-Telegram” takes a different slant on the same issue. Maria Perotin identifies “a small but growing legion of doctors across the country who are breaking away from conventional medical practices and redefining their businesses – often in an effort to remove managed health care from the process.” She cites Gary Claxton of the Kaiser Family Foundation as saying this trend may be enhanced by the growth in consumer driven health plans. He says, “You may see more doctors who are thinking, ‘More and more of these patients are coming to me directly. So why should I be part of the fee schedule of this insurance company?'” The article cites a number of doctors who are setting up “retainer medicine” practices or operating on a cash-only basis. Some are even returning to the days of house calls and not even maintaining office hours. One is Dr. William Jones who says he can earn as much income while seeing half as many patients as he used to because he has eliminated “two of four staff jobs that handled insurance-related duties.” He adds that patients “want face time with their doctor. They don’t want to be rushed through like a piece of bologna on a conveyor belt.” Dr. Michael Fleming, the president of the American Academy of Family Physicians, says all this activity is a “symptom of a much greater problem, and that is physician frustration with the reimbursement plans.” But Donna Kinney of the Texas Medical Association says it is much more than inadequate payment. Physicians want to simplify their practices and contain spiraling costs. “There are now small hordes of clerks working in every physician’s office, and those clerks aren’t doing anything that contributes anything at all to patient care … ” She also predicts that consumer-driven health care will enhance this direction.
HSAs -Catalyst for Major Shake-up in Health Insurance
The Sunday “Oregonian” ran a major article by Julie Tripp about HSAs on January 4. She writes that the “new tax-blessed health savings accounts? could become the catalyst for a major shakeup in U.S. health insurance in the next several years. More immediately, HSAs could help some Americans get a grip on out-of-control medical costs.” She cites independent insurance agent John Mahar as saying, “Once people understand how it works, it’ll skyrocket.” The article cautions consumers who think their employers will take care of everything. Jennifer Barrows of Lifewise Health Plan of Oregon says the average deductible is rising anyway and more employers are looking for alternatives. Mr. Mahar adds that smaller businesses especially have been raising deductibles to $500 and $1,000 and dropping coverage altogether in some cases. The articles goes on to say, “Surveys show that consumers with medical savings accounts tap medical services 35% less than consumers in managed care plans with low co-payments.” [I am not aware of these surveys. Can anyone cite them? — GS] It also cites Ms. Barrows as reporting that, “for traditional coverage with a $250 deductible, the monthly premium is $234 for individuals and $678 for families. For HSA coverage with a $2,500 deductible, the premium drops to $99 for individuals. Families would pay $287 monthly, with $4,000 deductible.”
HSAs – Health Care of the Future or Tax Shelter for the Rich?
The Charleston (West Virginia) “Daily Mail” also featured HSAs in an article by Karin Fischer. She quotes Rep. Shelley Moore Capito (R-WV) extensively as saying, “This can possibly be the health care of the future. If I have an HSA, I might make decisions to make my money go further, like going to the doctor versus the emergency room.” The article continues, “Small business owners are expected to find the accounts especially attractive.” NFIB’s Jessie Brairton says, “A lot of small businesses can’t afford to offer coverage. This is a great option.” But Sen. Jay Rockefeller (D-WV) isn’t so sanguine. “Health savings accounts are basically tax shelters for the wealthy that will pull the healthiest people out of the employer-based health care system,” he says. “They drive employer costs up and that means some employers will be forced to stop providing health insurance to their workers.”
SOURCE: I could not find this article on the website, but Karin Fischer may be contacted directly at: firstname.lastname@example.org
HSAs – Long Lasting Implications on Health Care
The other Charleston (South Carolina) “Post and Courier” discusses HSAs, too, in an article by Jonathan Maze with the regrettable headline, “New Type of Insurance Could be Popular Among the Young and the Healthy.” The rest of the article isn’t so tilted, quoting both Edwin Park of the Center on Budget and Policy Priorities (CBPP) and me about equally. Mr. Park says, “Both supporters and opponents agree that this could have very long lasting implications on health care.” The article describes the product and says that “a number of big insurers have said they plan to offer HSAs, including Blue Cross Blue Shield of South Carolina.” I’m quoted as saying, “The notion of a $1,000 deductible per person is no longer as exotic as it used to be. The market is ready for this.” But the article also says that “critics of the accounts believe this could leave traditional managed care plans with only the sickest patients?” [Aha! At last we learn what the critics mean by “traditional” – it is managed care. Who would have thought that CBPP was so gung-ho for HMOs?] The rest of the article is mostly a back and forth on the merits.
Please send all comments/questions directly to me at email@example.com.
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The views expressed in this newsletter are the opinions of the authors and do not necessarily reflect the views of the Galen Institute or its directors.The views expressed in this newsletter are the opinions of the authors and do not necessarily reflect the views of the Galen Institute or its directors.The views expressed in this newsletter are the opinions of the authors and do not necessarily reflect the views of the Galen Institute or its directors.