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Jewish World Review Jan. 12, 2007 / 22 Teves, 5767 Consumer-directed health plans taking off and get a boost from Congress — HMO's are losing favor By Drs. Michael A. Glueck & Robert J. Cihak http://www.JewishWorldReview.com | As the New Year 2007 begins there is some good health news for consumers who want a say and choice in their own health care. HMO's are dying a slow painful death (their just due) while consumer-directed health plans and health saving accounts (HAS' s) are becoming healthier and flourishing. According to a recent Mercer survey of 3,000 U.S. employers, consumer-directed health plans tripled in 2006. Compared with a managed-care plan such as an HMO, they reduce the annual cost per employee by a bout $1,000. While small businesses were first to take an interest, larger businesses are beginning to take notice also. The Houston Independent School District has offered two consumer-directed options for the past three years, with excellent results. The annual health benefit cost per employee rose by only $270 rather than the expected $1,500, from $5,500 to $5,770 (Brett Brune, Houston Chronicle 12/18/06). A provision rushed through Congress just before adjournment makes the funding of health savings accounts much more practical. Employers will be allowed to roll over balances from a Health Reimbursement Account (HRA) and/or Flexible Spending Account (FSA) into the H S A of employees who are switching. The allowable HSA contribution has been raised and will be indexed to inflation. Previously, it was limited to the amount of the deductible, but in 2007 can be up to $2,850 for singles or $5,650 for a family. See www.ustreas.gov/press/releases/hp209.htm. Democrats generally opposed the provision, which was pushed through by outgoing House Ways and Means Committee Chairman Bill Thomas (R-CA). When economist John Goodman, founder of the National Center on Policy Analysis began pushing for the idea of tax-favored medical savings accounts 16 years ago, only about five Congressmen would listen to him. Goodman thought that nothing but market forces could tame rising medical costs. A recent Rand Corp. study showed employers report saving 10 percent on health benefits costs, and plan participants appeared to trim spending between 2 percent and 15 percent. Some worry that people are skimping on necessary as well as unnecessary care. But Goodman says: "Someone is going to have to choose between health care and other uses of money. If you want someone else to make those choices for you, you can join an HMO. But if you want to make those choices for yourself, these accounts give you the financial ability to make them" (Christopher Lee, Washington Post 12/28/06). While HSAs are growing, customers are bailing out of HMOs in record numbers. Patients complain about restricted choice. And the promised cost savings have not occurred. The average HMO premium cost per person paid out by major companies is projected to jump to $8,151 in 2007, a 64 percent increase from $4,979 in 2002 (Bruce Japsen, Chicago Tribune, posted by sunherald.com 11/22/06). A previous Association of American Physicians (AAPS) News of the Day release in March, 2006, noted there had been a seven-fold increase in individuals covered by HSA-type insurance between November 2004 and December 2005 (Data from the American Health Insurance Providers for a U.S. Treasury Department fact sheet). As these writers have often railed against managed care since the 80's we do take some satisfaction in seeing its proper demise. As we said then, "There is no way a healthcare corporation can provide more care, better care, at a lower cost while the patient wants all the latest expensive technology (but prefers not to pay for) while the corporation and stockholders want a greater return on their investment." This was not economic rocket science then nor is now. HMOs and managed care were doomed to fail. When "for-profit" corporations offer potentially unlimited services for a flat fee (plus the usual co-pays) they reach a point where the only way they can make money is to withhold care. Managed care, in these writers' opinion, was and is a cruel experiment on America's patients which provided Wall Street opportunists and non-medically-trained corporate presidents and officers with immoral obscene profits while the sick, elderly, disabled and mentally ill suffered. Ironically corporate run managed care has been around just long enough for its lethal genes to rise up and destroy itself. We should never again allow such a deadly experiment with patients as guinea pigs. Editor's Note: Michael Arnold Glueck III, M.D., wrote this week's commentary Every weekday JewishWorldReview.com publishes what many in in the media and Washington consider "must-reading". Sign up for the daily JWR update. It's free. Just click here. Michael Arnold Glueck, M.D., is a multiple award winning writer who comments on medical-legal issues. Robert J. Cihak, M.D., is a Discovery Institute Senior Fellow and a past president of the Association of American Physicians and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists. Comment by clicking here. Archives © 2006,

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