High-deductible health insurance

Dear Mr. Berko: What will it cost my healthy son and his wife if they don't buy a high-deductible health plan, which would be a waste of money? High-deductible plans are a joke. They're great for the insurers because patients pay for everything except catastrophic occurrences. A $4,000 annual premium with a $4,000 deductible for each would be worthless. They each would have to spend $8,000 before any coverage would kick in. High-deductible plans enrich the insurance industry while hurting the patient.

- BC, Punta Gorda, Fla.

Dear BC: Is this a question or a complaint?

This insurance stuff is terribly complicated, and your lad's numbers don't make sense to me. He must counsel with an insurance professional for the straight skinny. But the tables are turning to patients' advantage, and medical costs could fall significantly in the coming decade.

If your son and his wife were not to purchase health insurance, the penalty would be either 2 percent of their annual income above $20,300, which is about the cost of Obamacare's bronze plan, or $650 for the year, whichever is higher. The maximum penalty per family is $975. How ducky! Therefore, many families are buying high-deductible health care plans, or HDPs, which only cover catastrophic illnesses, for $50 to $70 a month. So $4,000 a year sounds out of line.

Because HDPs are enormously cheaper than the plans of yesteryear, 38 million Americans have signed up, and 86 percent of employers now offer HDPs, compared with 38 percent in 2012. HDPs are becoming increasingly popular, and this trend will continue as Obamacare's 40 percent tax on "Cadillac plans" takes effect. As millions of Americans move into HDPs, health care spending will change the way patients deal with doctors, hospitals, rehab centers, medical equipment supply companies, imaging centers, etc. And there will be significant changes in how the medical community relates to patients.

In a typical year, HDP consumers pay almost all of their health care expenses - the costs for X-rays, fixing a broken finger, stitching a cut, treating a concussion, bloodwork, physicians' exams et al. Because the consumers are spending their own money, they'll shop prices for CT scans, EKGs, day surgeries, heart stents, colonoscopies, etc. Previously, these services were paid by insurers, so patients didn't give a fig about costs, believing they were spending the insurance companies' money.

In a few years, doctors will have to earn patients' business based on their personalities, cost, service quality, office waiting time (it's about time) and outcomes. Hospitals will practice becoming consumer-friendly, and their faked-up billing systems may become transparent and provide legitimate, understandable billing data. This is what American businesses do daily to attract and keep customers. Last year, U.S. health care spending totaled $3.8 trillion, and about 14 percent, or $530 billion (Americans only spend more on food, shelter and transportation), was plucked from patients' pockets. That amount is expected to double in three years. Imagine the changes in our health care system when patients' out-of-pocket spending exceeds $1 trillion.

Fortunately, forward-thinking, innovative companies have recognized this trend and are making changes in health care delivery. Consider the many independent walk-in clinics opening in neighborhood strip shopping centers and the retail clinics in CVS and Walgreens stores. Then there are new firms, such as HealthSpot and Teladoc (TDOC-$21), providing telehealth services via mobile devices and the Internet. Your smartphone can record your vital signs, analyze urine and blood samples, check your insulin levels, send photos of a rash to your doc, and perform numerous health tasks that your doctor, in his past life, coded on his submission forms to insurers and Medicare. A company called TalkSession gives patients immediate access to mental health treatments via cellphone or landline phone. Another, Twine Health, places patients at the forefront of their collaborative care. Twine Health uses synchronized apps, allowing patients to seamlessly manage their care and build self-efficacy. The list is long and portends radical changes to our delivery system, so in the next decade, consumers may gain the power to lower health care costs.

Please address your financial questions to Malcolm Berko, P.O. Box 8303, Largo, FL 33775, or email him at mjberko@yahoo.com. To find out more about Malcolm Berko and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

© 2015 Creators.com

Published: Tue, Sep 15, 2015

Comments

  1. No comments
Sign in to post a comment »