Just before the Fourth of July, the Wisconsin State Senate approved a budget provision - called "Healthy Wisconsin: Your Choice, Your Plan" - that would guarantee all Wisconsinites good health insurance, lower employers' health costs and cut property taxes by over $500 million.
The numbers work, despite critics' best efforts to twist the facts.
The independent Lewin Group, a highly regarded team of experts who have evaluated dozens of health care initiatives around the country, found that "Healthy Wisconsin" would:
- Reduce the number of uninsured in Wisconsin from 476,000 to 15,000 (meaning we'd have the lowest percent of uninsured in the country by far).
- Reduce costs of currently insuring private firms by over $600 million.
- Reduce costs of government by over $1 billion.
The Senate's “Healthy Wisconsin” plan builds upon Gov. Jim Doyle's excellent "BadgerCare Plus" proposal, which would expand Medicaid to low-income childless adults and expand BadgerCare itself to additional lower-income families. It leaves Medicare untouched.
But for the vast majority of us in the "middle" - for those not poor enough to qualify for Medicaid or BadgerCare, but not yet old enough to join Medicare - Healthy Wisconsin would bring about the major changes we urgently need, while preserving the current health care system where it's working well.
The critics complain that Healthy Wisconsin is too bold, or hasn't been thought through enough, and so forth. What Wisconsin needs, they say, is … inaction. Despite over 475,000 uninsured and health care costs rising at two to four times the rate of inflation, some critics claim we really don't have a health care crisis after all. And if we do have a crisis, they say, the solution is to wait … and debate … and wait … and debate … and wait and debate some more.
They have problems with Healthy Wisconsin, yet they have no coherent plan of their own to ensure all Wisconsinites good health care coverage or lower costs. All they've got is complaints - complaints about the status quo and complaints about Healthy Wisconsin - plus a smattering of ideas that (while sometimes worthy) don't come anywhere close to a solution.
We've waited long enough. Healthy Wisconsin is a bold and good measure. The State Senate deserves credit for adopting it. It's now time for the Legislature as a whole to enact it into law.
The case for Healthy Wisconsin is overpowering.
For virtually all of the 3.8 million Wisconsinites who, according to the Lewin Group, would not qualify for BadgerCare Plus because of our incomes and who don't yet qualify for Medicare because we're under 65, the Healthy Wisconsin plan would guarantee health insurance, good benefits, and freedom to choose our doctors
Wisconsinites would have health insurance whether or not we had a pre-existing medical condition like asthma or diabetes or hypertension. Today, these health care problems, which are typically beyond our control, deprive many of insurance coverage.
We'd have insurance regardless of marital or family status.
We'd also have health insurance even if we lost our jobs, or could only find part-time employment, or low-wage work.
And we'd remain insured, as long as we stayed in Wisconsin, until age 65.
As a result, some of the most perverse incentives in the current system would disappear. Today, couples have an incentive not to get married, or even to get a divorce, in order to lower their incomes enough to qualify for BadgerCare health care benefits. Parents often feel compelled to leave their newborn (or older) children to take a job just for the health insurance. Under Healthy Wisconsin, no one would feel pressure to refrain from marriage or get a divorce, or reject a job or a pay raise, just to stay on BadgerCare. And no one would have to give up caring for his or her children at home simply in order to have good health insurance. The current system's perverse incentives would be replaced by healthy, pro-family values.
And it is indeed good health insurance.
Under Healthy Wisconsin, our health care benefits would be almost identical to what state legislators now receive. The plan provides coverage for medical services, hospital care, and prescription drugs. It covers mental health services, and alcohol and other drug abuse services. All of us would have the same types of coverage, and the same level of coverage, that the State of Wisconsin already provides (using our tax dollars) to our state legislators, the governor, state judges and all the professors in the UW system.
Cost-sharing under the Healthy Wisconsin plan - in other words, what we'd have to pay out-of-pocket before insurance benefits kick in - would be very reasonable. To begin with, there would be no cost-sharing at all - no deductible, and no co-pays - for kids, or for preventive care, or for people with chronic illnesses who successfully participate in a chronic care management program. (The only exception would co-pays for prescription drugs.)
Otherwise, a modest $300 deductible ($600 for families) would be paid each year. After that, each visit to a doctor or other health care provider would cost only $20. There's also a small $5 per prescription co-pay for generic drugs, or $15 for brand-name drugs on a formulary developed by medical experts, or $40 for brand-name drugs off the formulary.
Cost sharing stops long before it threatens to eat up our savings. Once annual total costs reach $2,000 per adult (or $3,000 per family), cost sharing stops entirely, and insurance pays 100%. No longer will families go bankrupt, or deplete their college funds or retirement assets, in order to pay catastrophic medical bills.
It would be one of the best insurance packages in the country. And any employer that wanted to offer an even better insurance coverage would be free to provide supplemental benefits.
Wisconsinites care not only about health care security, but also want to be in control of their health care. Healthy Wisconsin puts you in the driver's seat. That's why it's called, "Your Choice, Your Plan."
First of all, the proposal would let us choose from among different, competing health care networks. A health care network is a coordinated group of health care providers (comprised of primary care doctors, medical specialists, physician assistants, nurses, clinics, hospitals) who agree, in exchange for a fixed payment per month, to provide enrollees with all the benefits spelled out above. Under Healthy Wisconsin, you could choose to enroll in any health care that submits a bid.
Networks would compete - not in turning people away (they couldn't), but to see who could provide the most efficient, highest-quality care at the lowest price. If you chose to enroll in the lowest-cost network - or even one that's close to the lowest in cost - you wouldn't pay any extra premium to join. But if you wanted instead to enroll in a higher-cost network, you'd be free to do so, provided you agreed to pay the extra premium equal to the increased cost.
Luckily in Wisconsin, we already have several health care networks in operation: DeanCare, Physicians Plus, the two Group Health Cooperatives and Security Health Plan are among the networks not available. As Healthy Wisconsin gets ready to take effect, we'relikely to see more networks form.
Some Wisconsinites, however, will not want to enroll in a health care network. Healthy Wisconsin thus provides yet another option, the so-called fee-for-service option. Under this option, you would have direct access (without needing to select an intermediary organization that's put together a health care network) to every doctor or hospital that accepts the rates set by the program's board of trustees. Enrollees in the fee-for-service option would get the exact same benefits. In addition, they'd be required to select a primary care provider, who'd coordinate their medical care. Enrollees who select the "fee-for-service option would pay no extra premium if this option turns out to be the lowest-cost choice or close to the lowest in cost. Only if the fee-for-service option turns out to be higher cost would enrollees be required to pay an extra premium - but even here, the extra premium is capped at no more than $100 per month ($200 per month per family).
It's no surprise that a program that guarantees health insurance to virtually all Wisconsinites will dramatically lower the number and percentage of uninsured.
What is surprising to some is that Healthy Wisconsin will also greatly lower the cost of health care - for Wisconsin as a whole, for families, for most private employers and for government employers.
In doing so, Healthy Wisconsin makes it possible to enact one of the largest property tax cuts in our state's history - over half a billion dollars in a single year!
The Lewin Group, an independent team of expert economists and health care analysts based in the Washington, DC, area, has estimated that at the same time that “Healthy Wisconsin” dramatically shrinks the number of uninsured, it will also lower overall health spending by over $750 million, save families $432 million, save currently insuring employers $686 million, save government employers $1,360 million, and thus permit property taxes to be cut statewide from over $8 billion to under $7.5 billion.
Following are the key numbers from the Lewin analysis (using 2007 as the base year):
- Uninsured population drops. The number of uninsured would be reduced from 476,000 to 15,000--from 9% to well under 1% of Wisconsin's population.
- Total spending declines. Total health care costs would decline by $751 million, with a large increase in spending for the uninsured more than offset by reductions in administrative & other costs. Over ten years, compared to the status quo, "Healthy Wisconsin is estimated to save $13.8 billion."
- Families save money. Wisconsin's families as a whole would save $432 million, because the new assessment paid by employees and others is more than offset by reductions in current premium payments, reductions out-of-pocket payments, and reductions property taxes. Families with annual incomes under $75,000 - which constitute 77 percent of all families in Wisconsin- would see reductions in health spending (depending on income category) ranging from $1,328 per family to $262 per family.
- Private insuring employers save. Private employers that currently provide insurance would save $686 million. Not surprisingly, non-insuring private firms would experience an increase in costs. But even employers that now insure fewer than 75 percent of their workers would see, as a group, a modest $50 million reduction in their costs. And those employers that currently insure 75 percent or more of their workers would see, as a group, a very large, $631 million reduction in costs.
Compared to the $9,191 billion that currently insuring private employers (of all types) are now spending on employee health care, the amount that Healthy Wisconsin actually requires them to pay - that is, the $7,769 million assessment - would actually result in an enormous $1,442 million savings. And when the $169 in property tax cuts is added to this, the savings for currently insuring employers mount to $1,588 million. But Lewin's methodology requires them to assume that certain voluntary spending to provide supplemental health care coverage - both contractual commitments that employers have voluntarily entered into, as well as voluntary spending that is not required by contract but that Lewin assumes employers will commit to in order to maintain their competitive position - will cut into this $1,588 in savings, ultimately reducing currently insuring employers' net savings to the $686 million figure initially mentioned.
In its analysis, Lewin frequently applies a concept called "wage effects," which assumes that (1) employees bear in the form of lower wages any extra health care costs their employers incur, while (2) employees also receive in the form of higher wages - less applicable payroll taxes - any reduction in health care costs that their employers experience. After applying this "wage effects” methodology to both insuring and non-insuring private employers,
Lewin concluded that the Healthy Wisconsin plan would actually save currently non-insuring private employers $24 million! This is because non-insuring employers are assumed to pass on to their employees, in the form of lower wages, the entirety of their new health care assessment, but will get to keep for themselves a $24 million slice of the overall property tax cut that “Healthy Wisconsin” generates. Meanwhile, currently insuring private employers would continue to experience savings: $73 million for those firms that insure fewer than 75 percent of their workers (a higher figure than before "wage effects"), and $354 million (a lower figure than before "wage effects") for firms that insure 75 percent or more of their workers. All in all, after "wage effects," Lewin estimates that private employers as a whole will save $378 million.
Government employers would save more than any group. Even after local and state governments guarantee their employees receive the same total benefit package by supplementing the Healthy Benefits benefit itself with "wrap-around" coverage, Lewin estimates that government employers would save $1,360 million.
The Healthy Wisconsin plan requires that 50 percent of this savings - total of $680 million - must be passed on to households and businesses in the form of a property tax cut.
Such a property tax would significantly reduce the overall property tax levy in Wisconsin. According to the Wisconsin Legislative Fiscal Bureau (LFB), the 2005 property tax levy (for 2006) totaled $7.7 billion.
Recently, property tax levies have been rising somewhat more than 5 percent per year. Thus, it is reasonable to assume that the 2006 levy (for 2007) would be somewhat over $8.1 billion. If this statewide levy were reduced by $680 million, the 2007 levy would decline from $8.1 billion to $7.4 billion.
Healthy Wisconsin would clearly be very good for Wisconsin.
It would dramatically reduces the number of uninsured, putting Wisconsin in the lead as the state with the lowest percent of uninsured by far.
It would ensure that virtually every Wisconsinite has good health insurance - regardless of medical condition, family status, or employment status.
It would provide nearly 4 million people - those who don't quality for Medicaid or BadgerCare, and who aren't yet eligible for Medicare - with the same, excellent benefit package that taxpayers now provide to state legislators, the governor, and the courts.
It would also guarantee that we are in control. Under Healthy Wisconsin, we choose the health care network we like best (or the non-network "fee-for-service" option), and we choose which doctors we want to see and which hospitals we want to use. Healthy Wisconsin also guarantees that we get to keep our health care choices, even if our health worsens, our family status alters, or we lose a job or switch employers or venture out to start up our own businesses.
Finally, by putting consumers in control of the choice of health care plans; by giving consumers a strong economic incentive to choose a less costly plan and to seek out preventive and primary care; and by providing "health care networks" and providers a powerful incentive to focus on prevention and primary care, operate efficiently, lower costs, and improve quality; Healthy Wisconsin properly aligns - at long last - the incentives in our health care system.
Today, the incentives are all messed up. Consumers today have little reason to seek out low-cost, high-quality care (since high-cost, low-quality care costs them the same). Meanwhile, providers have no incentive to offer low-cost/high-quality care (since they actually make less money by preventing illness, doing primary care, and seeing healthy patients infrequently than they can make by bypassing prevention and seeing sick patients as frequently as possible). Little wonder that, with today's incentives so misaligned, the system's costs are out of control.
Healthy Wisconsin gets the incentives right, and also reduces administrative costs because of its simple design and avoidance of wasteful functions. That's the reason why the Lewin Group found that, "Healthy Wisconsin" will have such enormous positive impacts on the people, families, employers - and taxpayers - of Wisconsin.
Healthy Wisconsin will save money for families as a whole, and for the average family.
It will save money for employers as well - especially for private employers that provide good insurance and for government employers.
And, to top things off, Healthy Wisconsin will result in the largest property tax cut in recent history - more than half a billion dollars - that working families, middle class homeowners and businesses can use to improve their living standard and invest in Wisconsin's future.
David Riemer is the director of the Wisconsin Health Project.
21 Comments
Thanks to David Riemer and the other groups that spent months coalescing around a system that is highly workable. While some would prefer a Medicare-for-all solution, Healthy Wisconsin is very close to that and allows people to choose between a health care network -- which has advantages and disadvantages -- and a fee-for-service network that also has advantages and disadvantages. It offers people the choice so many opponents have argued for.
Yes, it is bold and it should be. The Republicans opposing it would have preferred simply allowing high-deductible plans that (a) protect their insurance industry contributors, (b) transfer the risk from employer to employee, and (c) will ultimately cause great havoc in our state economy as it puts emphasis on saving dollars rather than receiving appropriate health care.
To the Republicans I'd say this: When you convert your family health care to a health savings account, come back and let's talk about it then.
Importantly, this program will reduce costs for most employers and bring jobs to Wisconsin -- over 13,000 according to a Families USA study. And many of those will be in the higher paying healthcare industry.
Except for the companies who provide zero or inadequate health care, this is a no-brainer for Wisconsin businesses. I doubt that we'll get the business associations like WMC on board, because they sell healthcare to their members.
But it is time for the business leaders themselves to lead.
With all due respect, the numbers look good unless you are self-employed. Under the Healthy Wisconsin plan, the self-employed would be taxed the same 10% as employers. Ten percent of my taxable earnings is more than the cost of my current individual PPO health insurance policy. Add another 10% tax to current state, federal and self-employment taxes and the burden becomes staggering for many sole proprietors. For the self-employed who rent, a property tax credit has no value since landlords generally pass along only tax increases. The self-employed may be just a few thousand tax payers, but Healthy Wisconsin needs to take another look at its impact on us and find a better solution.
It is one thing to require all residents to purchase health insurance as the state of Massachusetts has. It is quite another to collect a tax based on income, only to then send the money to health care networks and / or health insurance companies. If, like Massachusetts, the money to finance health care were sent direct to health insurance companies or health care networks this plan would have merit. I see no need to send $15 billion to the state first. Part of the $15 bilion health care tax will be spent by the new state health care bureacracy. For what? Private sector insurers will continue to provide the coverage. The plan to watch is Massachusetts "Commonwealth Connector".
I know I've commented several times. But the proponents keep trotting out someone for this plan every other day. So here goes-
1. If this plan is so great why are public school teachers exempt? We currently spend about $20,000 per year per teacher for health care benefits- way above private sector spending. Mr. Riemer may argue that they are not exempt, but in fact if teachers are required to participate in unHealthy Wisconsin, the taxpayers will have to make-up the difference (in additional health care benefits) between the $20,000 per year benefit they currently get and what we mere taxpayers are expected to pay for and get under the proposed plan. Why are teachers exempt- because they have paid-off the dems/socialists with campaign contributions. If only the rest of us could get such a deal!
2. No matter what this group states will be the cost of the plan, the real numbers will be significantly higher. What government entitlement has been efficient and fiscally conservative? Also, does anybody trust this consulting firm's findings? How many times has the government or some special interest group paid for a consultant to come-up with findings that they desire?
3. The proponents claim the one-year residency requirement will stop migration into the state for use of the program by unhealthy persons seeking free or virtually free health care. However, the one-year residency requirement may be unconstitutional (consider our current left-wing Supreme Court), resulting in persons moving into the state gaining unHealthy Wisconsin benefits upon meeting residency requirements (10 days). This is similar to when Wisconsin was a welfare magnet in the 1980's.
4. The plan includes illegal immigrants. Sure they can currently go to an emergency room to get health care, but the unHealthy Wisconsin plan will be a magnet for illegals and will cost significantly more than only emergency room care. Why would we want to encourage illegal immigration by providing government benefits? Assuming illegals earn $25,000 per year, they would be paying in about $3,750 a year- way under the cost of providing the benefit, especially if it covers a family. This makes no economic sense, but the dems/socialists are being compassionate with our money.
5. This tax is another burden on the middle class that currently has health care and requires them to not only pay for their own health care but also for everyone else. Small business owners pay 15.3% for Soc. Sec, plus this 10%, plus 7% state income tax, plus say 28% federal income tax, plus high property taxes in Wisconsin, plus 5.6% sales tax- What is left?
6. Only about 8% of Wisconsinites are uninsured. Some because they choose not spend money on health care insurance. Just by bringing public school teacher health benefits to reality and using that money to fill the 8% gap, we could solve a large part of the health care needs of the uninsured.
7. Due the aging of the US population, our overall population growth, rising incomes in other countries, and the very limited growth in the number of new US physicians, we have a shortage of docs in some areas. This problem will only get worse. By controlling prices at the state level, the quality of health care in Wisconsin will decrease as better-quality physicians wanting to earn what the real market will bear, will go to other states.
I would love to see an answer to Mr. Johnson's concerns. I have never read or heard anybody who is touting this plan fully address these questions. Mr. Reimer where are you?
John, perhaps others have seen "Bob Johnson's" other remarks and have written him off for what he is; a freeloader. He is a small employer who employs students and trusts that if they need care they simply go to the emergency room. After all, our own President Bush says that's all you need to do. So I can understand that his gaming the system would be upset by an honest fix.
But in answer to the issues:
1) Teachers are not exempt. Nor are politicians. Bob doesn't get it.
2) Disregarding the Lewin study for a moment, even Families USA claims that the plan would generate more than $1 billion in new business activity and create nearly 13,000 new jobs. David Newby, president of Wisconsin State AFL-CIO, believes that the Families USA study's job creation estimates are derived entirely from the implementation of Doyle's BadgerCare expansion and the new jobs created in the healthcare field. Newby predicts that far more jobs would be created by the reduction in healthcare costs for firms that pay good wages and expect to provide good benefits. Dropping health care expenses from typically 15-25% of wages to 10.5% will allow employers to add more people and pay higher wages, and lean toward more full time jobs and fewer part time jobs. (Except for "Johnson's" company.) See http://familiesusa.org/assets/pdfs/healthy-wisconsin.pdf
3) Now he is grabbing at straws and even resorts to calling Bush's new Supreme Court Left Wing. But suppose people do move to Wisconsin and wait their year? Can you imagine the growth in the housing market and the state's economy? And can you imagine the effects of corporations "migrating to Wisconsin." These scare tactics are pure BS.
4) "Johnson" absolutely refuses to accept what the illegal immigrants are costing us now, when THEY show up at the emergency room (along with his employees). Under Healthy Wisconsin they would now be paying a part of their wages and so would their employers, so we'd see more "illegals" contributing to the health care system than are today. Besides, the immigration system should be solved in ways other than depriving them of health care. We ARE still a humane society, aren't we?
5) It is absolutely hogwash that the lower-wage earners are going to get a free ride on this. They already have free BadgerCare and Medicaid, both paid by the taxpayers. Why do they need Healthy Wisconsin? This will improve the lives of the students Johnson hires, incidentally, and he doesn't like that. Neither do the righteous self-employed who have off-loaded their medical responsibilities to their wives' employers.
6) True that some Wisconsinites choose not to buy insurance. They'd prefer pocketing the savings and jumping in when they need it later, but that robs the system of fairness. HW will provide for the rest who are under-employed, or employed by Johnson.
7) Absolute bullsh*t. Even the AMA supports a Medicare-for-all system and HW isn't far from it. The only difference is that it allows privatized networks to compete with the fee-for-service doctors, so the right-wingers should be absolutely thrilled about it.
Few of us like to see 31% of our health care dollars going to an insurance bureacracy that pockets the money without ever providing patient care.
Having been in the medical industry for 35 years, but now retired, I believe that even the medical community should get behind HW for survival reasons. They should look at how the dominoes are going to fall over the next five years.
He who has the gold, rules. And in this case that's the corporations paying high healthcare costs. They are not going to stand for the continued rip-offs by the insurance industry and already are setting up their own medical co-ops. Thus medicine in five years -- if not administered by a single-payer system -- will be administered by CEOs and shareholders with only one goal: to cut out the fat not just consumed by the insurance industry but also that taken home by physicians and hospitals.
At least the Medicare fee schedule offers fair reimbursements (some are too low and some too high, but at least are fair and guaranteed), and a growing number of physicians are supporting a Medicare-for-all system (64% in some surveys).
Letting the CEOs and shareholders determine the level of care one gets would be disastrous.
Well, ok, let's see the details of the plan(s).
Also,
1.) Does a dual income family pay in twice as much as a single income family?
2.) I read that a working person would be paying about 4 1/2% a month out of thier pay check. If I make $100,000 a year I'll be paying in $4,500 a year. If a person is making $50,000 they'd be paying in $2,250 a year. Am I getting a plan with twice the benefits and coverage that the other person is getting? If not why am I paying twice as much more for the same plan?
3.) Same senario as above with a dual income family. If my spouse was making $100,000 a year we'd be paying in $9,000. How much better would our plan be that someone paying in $2,250?
4.) Currently I have a high deductible HSA plan and love it. With my wife and children we use it. Will one of these new Healthy WI plans be an HSA qualified plan? I'd like one as we plan to have that HSA account available when we hit 65 and use it for possible Medicare expenses.
5.) The article said about 15,000 people in WI will still be without health insurance. Why? In the spirit of Health WI they should be, don't you think?
6.) The Business Health Care Group in SE WI is reporting today in the MJS a 13.7% cost savings for those in the group. The reports goes on to say that the savings amounts to $24 millon dollars. Does anyone really think a government sponsered or run program can deliver results like this?
7.) Resent projections regarding the % business pay and the % out-of-pocket employee's will pay will most certainly rise. What make's the Healthy WI plan thinker's think they can do better to keep costs at or below inflation levels?
8.) If Healthy WI went into effect, do the thinker's of this plan think it will attract new business in WI? Have they concidered how many business might leave WI?
9.) With no competition around and state people running a plan like this what will Health WI do to motivate its staff to perform better than the DMV?
10.) If the Healthy WI plan is planning to cut income levels for doctors, hospitals and clinics state-wide to meet current or expected cost levels to run Healthy WI, do you think maybe doctors would leave WI and / or hopitals and clinics might close down some of thier facilities. How does this help us?
Following are the answers to Richard Champion's questions about the Healthy Wisconsin plan to provide health insurance coverage to all Wisconsinites, provide benefits as good as our legislators now have, ensure we got to choose (and keep) our doctors, and lower costs for families, employers, and taxpayers:
1.) Does a dual income family pay in twice as much as a single income family?
Answer: It depends on how much the members of the family earn. If two members of a family jointly earn $40,000, they pay exactly the same as a single-earner family with earnings of $40,000. If the two members of a family jointly earn $30,000, they pay half as much as a single-earner family with earnings of $60,000. It's not the number of earners that matters; it's the total earnings.
2.) I read that a working person would be paying about 4 1/2% a month out of thier pay check. If I make $100,000 a year I'll be paying in $4,500 a year. If a person is making $50,000 they'd be paying in $2,250 a year. Am I getting a plan with twice the benefits and coverage that the other person is getting? If not why am I paying twice as much more for the same plan?
Answer: First of all, the employee assessment is set by the Healthy Wisconsin bill at between 2-4% (not 4.5%). The Lewin Group, in its independent analysis, assumed 4%, but the Board of Trustees that oversees the program would make the final decision. Second, the assessment rate applies (a) only to workers below 65, and (b) only to Social Security wages, which is approximately the first $97,000. So a person earning $100,000 would have a maximum of 4% x $97,000 deducted from his or her paycheck.
The value of the benefits is not linked to the amount a person pays in. Rather, each enrollee receives the same basic benefit package—the same benefits that we taxpayers provide to State Legislators and the Governor. The benefit package is not altered because of a person's health status (sick or healthy), family status (single, separated, divorced, married), employment status (unemployed, part-time employed, or full-time employed), or income. Why? Because the whole idea is to make sure that every Wisconsinite has health insurance--allowing everyone to always be able to see the doctor to preserve their health and avoid financial catastrophe—regardless of their health situation, personal situation, or economic situation.
3.) Same senario as above with a dual income family. If my spouse was making $100,000 a year we'd be paying in $9,000. How much better would our plan be that someone paying in $2,250?
Answer: Same answer as above. The benefit is not linked to income. Which means you wouldn't lose your coverage if both you and your wife got laid off, or you developed a health problem that made you uninsurable.
4.) Currently I have a high deductible HSA plan and love it. With my wife and children we use it. Will one of these new Healthy WI plans be an HSA qualified plan? I'd like one as we plan to have that HSA account available when we hit 65 and use it for possible Medicare expenses.
Answer: No. The Healthy Wisconsin deductible of $300/adult is too low to be linked to an Health Savings Account.
5.) The article said about 15,000 people in WI will still be without health insurance. Why? In the spirit of Health WI they should be, don't you think?
Answer: Several reasons. First, Healthy Wisconsin has a 12-month residency test for people who aren't gainfully employed, children, or pregnant women. So, for example, an adult male who hasn't lived here yet for 12 months and doesn't have a job wouldn't be eligible. This is to discourage people simply crossing the border to take advantage of a good health insurance plan that they're not paying for in any fashion Second, some people have religious objections to insurance. We don't want to force people to participate in a program that violates their profoundly held religious beliefs. Third, some people are running from the law, or otherwise don't want to come forward and enroll in a program like this. Healthy Wisconsin will reduced the number of uninsured from 476,000 to 15,000—a huge reduction—but it's unrealistic to imagine that we can get 100% enrolled.
6.) The Business Health Care Group in SE WI is reporting today in the MJS a 13.7% cost savings for those in the group. The reports goes on to say that the savings amounts to $24 millon dollars. Does anyone really think a government sponsered or run program can deliver results like this?
Answer: The State of Wisconsin Employee Health Plan, particularly as it operates in Dane County where it has significant market share, has outperformed most private sector firms in holding down the growth in health care costs. It is a tired cliché to claim that government can never do better than the private sector. In some areas—like buying health insurance IF the right buying method is used—government can indeed do better and, indeed, has consistently done better, than the private sector. (In other areas, of course, doesn't do as good a job.) The Business Health Care Group in SE WI is to be congratulated, but on the whole the growth in private sector health insurance costs is estimated to be 10-12% in 2007.
7.) Resent projections regarding the % business pay and the % out-of-pocket employee's will pay will most certainly rise. What make's the Healthy WI plan thinker's think they can do better to keep costs at or below inflation levels?
Answer: If we do nothing, the cost of health care will rise. If we do nothing, employees' out-of-pocket costs will rise. If we do nothing, employers costs will rise. So the question is: Can a well-crafted system that gives everybody choice, forces health care networks to compete, offers enrollees an incentive to spend less if they enroll in efficient plans, offers insurers and providers an incentive to create efficient plans, and simplifies insurance administration keep the growth of health care costs below the growth levels that would otherwise occur? Those who developed Healthy Wisconsin concluded that such a highly incentive-driven system, coupled with a good fee-for-service alternative, would significantly reduce the growth of health care costs. The Lewin Group, an independent team of health economists and other experts, agreed. Lewin concluded that, although adding coverage for nearly 500,000 uninsured would raise costs by about $1 billion, the Healthy Wisconsin model would produce far greater cost savings (i.e., savings greater than $1 billon) due to emphasis on competition and primary care, more effective bulk purchasing of prescription drugs, and major reductions in provider and insurer administrative costs.
8.) If Healthy WI went into effect, do the thinker's of this plan think it will attract new business in WI? Have they concidered how many business might leave WI?
Answer: Yes. Healthy Wisconsin will have minimal negative effects on business location, while it will help retain and attract firms to Wisconsin.
To begin with, many of the firms that would pay more—service companies with small workforces and that now pay nothing or little towards their employees' health insurance—would not be able to leave Wisconsin. If you're in the business of running a restaurant in Milwaukee or a motel in the Dells or a dry cleaning establishment in Green Bay, you can't simply pull up roots and operate the same business in Chicago or Minneapolis. Furthermore, many non-insuring firms are competing against other non-insuring firms (Fast Food Restaurant # 1 vs. #2 vs. #3). To the extent they ALL must now pay a fair assessment to finance health insurance, they face no new competitive disadvantage because the playing field is still level.
On the other side of the equation, there are thousands of mobile companies around the U.S. that are now paying far more in health care costs that Healthy Wisconsin would impose. They have an incentive to shift production INTO Wisconsin. And, of course, firms already located here that are paying health care costs that exceed the assessment rate would have a strong incentive to stay here…and expand here.
9.) With no competition around and state people running a plan like this what will Health WI do to motivate its staff to perform better than the DMV?
Answer: This question assumes the cliché that government is always non-responsive and inefficient. Sorry, it just isn't true. One could equally ask the question: What will Healthy WI do to motivate its staff to perform as superbly as such government agencies as the Milwaukee Fire Department.
Yes, it's correct that it's a challenge to operate organizations that don't compete—whether government agencies, public/private partnerships like Healthy Wisconsin, or private monopolies like the gas company—in an efficient manner that responds promptly and courteously to customers. Some fail (like FEMA in dealing with Hurricane Katrina, or as you say the Wisconsin DMV does…although whenever I've taken my car in to the DMV inspection facility, the service has been quick and friendly). Others succeed (like the Milwaukee Fire Department). The Board of Trustees that oversees Healthy will have to work hard to make sure that the staff that it controls do a good job. It will be a challenge, but experience tells us it's quite possible.
10.) If the Healthy WI plan is planning to cut income levels for doctors, hospitals and clinics state-wide to meet current or expected cost levels to run Healthy WI, do you think maybe doctors would leave WI and / or hopitals and clinics might close down some of thier facilities. How does this help us?
Answer: The assumption is incorrect. Healthy Wisconsin is NOT planning to cut income levels for doctors, hospitals, or other providers. Its efficiencies will largely result, according to the Lewin Group, form non-provider administrative savings. Indeed, the fact that the number of uninsured will drop dramatically probably means that revenue for doctors and hospitals will increase during the first year (an increase offset, as noted above, by administrative savings elsewhere in the system).
Since the assumption you make is incorrect, the problem you identify (doctors leaving Wisconsin and hospitals closing) won't happen. In fact, Wisconsin is likely to be a magnet FOR doctors. Most doctors hate the current insurance system, with its uninsured and underinsured patients and all the uncertainty and hassles of getting paid. Many will find the Healthy Wisconsin environment very appealing. Healthy Wisconsin will also keep hospitals open, since hospitals that now treat large numbers of uninsured (like Mt. Sinai in Milwaukee, and many rural hospitals) will no longer face that problem.
Jack,
Calling your opponents names is not a good argument- grow up!
Each of the students working for me are covered by their parent's insurance, and happily so. I pay plenty in taxes, possibly more than you, and I pay my employees well. So please keep you nose out of my business and spend more time worrying about the color of the paint on your neighbor's house, or maybe about your carbon footprint out there in Colgate.
1. If public school teachers were covered they get an add-on to bring their benefits back to their currently obnoxiously high level. So no, they are not going to just take the plan as is.
Please see the attached: http://www.weac.org/Capitol/2006-07/june07/healthywisconsin.htm
WEAC says unHealthy Wisconsin will not void existing contracts and is a base for unions in negotiating benefits. So we serf/taxpayers will be stuck with and paying for unHealthy Wisconsin, and also pay for a better plan for teachers.
2. You can cite as many studies by lefty entities that this will be a great deal but I'll go with the history of nearly every government spending plan- they always cost more than expected and are typically poorly managed- ie, social security, medicare...
3. Jack, get a clue. I'm talking about the state supreme court! This is a state issue and would adjudicated by the state supreme court (look it up on your interweb). So Jack you're saying that drawing a bunch of low-income people into the state that will pay in less than they will take out for the unHealthy Wisconsin program, and who knows what other government hand-outs, will be a good thing for the economy? Enough said!
4. To say we are going to save money with this plan and then give away additional benefits over what are currently being given to illegal aliens is absurd. And please quit using other people's money to satisfy you need to be "humane". You can easily donate all your assets to whatever cause you like and take a vow of poverty if you so choose. But quit taking my hard-earned money under the force of law to satisfy your need to be compassionate. I'll choose my own charities, thank you.
5. Jack are you a not-so-secret shill for big business? So now you're complaining about self-employed people that get insurance through their wive's employers. At least these "wives" are producing enough benefits for their employers that they can pay for the "off-loading". UnHealthy Wisconsin is one big off-loading program with we serf/taxpayers paying the whole bill for another government give-away. Jack, you're coming across as being a very angry person. Anger doesn't sell.
6. You and your group never answer the question. Why not use the savings from the over-payment of benefits to teachers and help the truly uninsured?
7. Has the AMA come out for unHealthy Wisconsin? Just because they have accepted Medicare doesn't mean the like unHealthy Wiscosnin- quit twisting the facts.
8. 31% for administration? I believe that is incorrect. What is your source for this percentage?
As to who has the gold rules- very true. I can sue a business or find another job with better benefits. I can't sue the government for malfeasance and in Wisconsin we have only one state government. So I'll stick with the current system.
Finally, Jack, do you still own shares in a medical services company? Would you personally benefit from a government-run health care program here in Wisconsin? Being that you keep making off the wall suggestions as to what my interests are in this debate I thought I would ask. Or Jack are you having an LBJ retirement, sitting there in Colgate with long hippy hair, trying to make-up for your guilt for being a capitalist all those years and making money from this rotten capitalist system of ours?
Well, Bob, having called me a socialist and demanding transparency from me while hiding behind internet anonymity yourself, I don't much care what you think of me. But since you are hiding and I am transparent we really won't be able to compare our tax status, will we?
But just to set your mind at ease, since I sold my company they moved it to the east coast and no longer bill in Wisconsin. But I am sure that somewhere in my portfolio I have stock in insurance companies that would be hurt by Healthy Wisconsin. Such is life. Sorry to bust your bubble.
I'm not going to spend any more time on the teachers issue. Believe what you want, but they are not exempted. If they negotiate beyond that, so be it.
I am not a supporter of the current illegal immigration mess, and believe that it has to be fixed. Perhaps denying them healthcare, as you propose, will fix it overnight. Nice guy. Maybe you could do that to the teachers too.
I don't know where the AMA stands on Healthy Wisconsin, but they and the hospitals would be fools not to support it. If we give the system to the CEOs and shareholders to control the level of care we get, they'll wish they hopped on board sooner rather than later.
I can understand your bitterness. Most employers and employees will see reductions. Those not providing health care to their employees, and those on their wives' insurance, will see an increase. But don't get mad at me for it; get mad at the insurance industry that has raised premiums by 87% since 2000 and created this issue. I support the fix because it's the right thing to do for the people of the state. You don't because it's going to work to your disadvantage. Tell your legislator.
And so I don't ignore your question, here are (just three) sources for the 31% of wasted insurance bureaucracy money. There are hundreds more, but even if the number were half it would be bad.
http://www.pnhp.org/facts/single_payer_resources.php
http://www.citizen.org/publications/release.cfm?ID=7271
http://www.healthcare-now.org/shownews.php?nid=360&sid=&subid=
Clearly there are small businessmen that have been able to avoid health insurance and will have to pay up under Healthy Wisconsin, but not passing HW for the benefit of the majority of state residents is not the solution. I'd rather see small business tax breaks instead (but that's part of my big business favoritism coming out).
And please do not put words in my mouth. I did not say covering illegals under HW will reduce our costs. I said that because we are already absorbing costs when they show up at the emergency room, the net will be less than the alarmists claim, and the illegals will now be paying for at least some of their healthcare costs through the new taxes.
And you and others totally miss the value brought to the small businesses that do pay high insurance rates today, and the new small business that will result when this new healthcare program begins.
I passed Richard Champion's questions to a source close to the issue and have posted his response below. This debate will give the senate an opportunity to revisit the issue before it becomes a bill to be put before the legislature.
I favor providing a small business tax break to resolve the problem for the guys on their wives' policies. It is sane debate that will help the Senate improve the bill, and improve it we must because exorbitant health care costs are tearing down our nation's ability to compete. Getting the Republicans off of the insurance industry dole is going to be the toughest problem to solve, however.
(Actually, I favor zero taxes for small businesses anyway, but they haven't asked me for my opinion yet!)
-----------------------------------------------------------
Response from my friend:
All questions don't have answers. Most of us thought that dual earner families would be capped at 4% of the Social Security wage cap: $97,500. That may not be clear in the Budget Amendment. We have a meeting in ten days to review some of these issues. (Also, more likely that employers of higher paid employees will pick up part or all of employee's 4% share, don't you think?)
Why different payments for same level of benefits? It's a sliding scale, based on ability to pay. Our property taxes are based on the value of our property, but everyone is supposed to get the same level of fire and police protection and same access to public schools. Why should health care, a basic need for all, be any different?
Champion may think his HSA is great now, but what if he loses his job and can no longer afford to put money into that HSA? No savings for health care, just a huge deductible. Same if he or someone in his family develops a serious medical condition or injury: savings in HSA disappear quickly and they are left with huge deductible. HSA's are great as long as you have plenty of extra money to put into them and you don't get sick or have an accident. The 20's mentality: I'll live forever (and never be sick)!
Business Group savings: costs are still far above actuary's projection of 10.5% of SSI wages as the employer payment for Healthy Wisconsin. The State Employee Plan, which does not include a number of the cost-saving elements of Healthy Wis. has had far lower increases than private sector plan since it was implemented 4-5 years ago. Healthy Wis. relies on "managed competition" between "networks"--and competition with a state-wide fee for service plan--to control costs. Payments to doctors and hospitals in fee for service plan are required to be fair and at a level that ensures that we are able to keep the highest quality providers in Wisconsin--i.e., can't try to save money by paying providers less than they are worth or than they deserve!
All critics seem to ignore that enormous costs of administration are eliminated: by everyone having a standard set of comprehensive benefits, billing costs are reduced immensely. Underwriting costs are reduced immensely, as each network has to estimate costs for one group--not hundreds of individual groups or firms. And, except for insurance companies and HMO's that might attempt to construct a "network" through the current practice on expensive negotiations for discounts from hospitals and clinics, this expense would be eliminated entirely. What is a fairly conservative estimate, I think, from the Lewin Group, indicates that over $1B of the current $17B being spent on the Healthy Wis. population can be saved by eliminate[ing] these administrative (unnecessary bureaucratic) expenses.
Re why more efficient than DMV. We could argue that DMV is efficient, but instead, better simply to point out that currently existing private sector networks will be submitting bids, administration will be contracted out to lowest bidder, and that only policy will be determined in the public sector. "Disruption" to the current system of actually delivering real health care to people will hardly be disturbed--just made more efficient.
Effect on business: Very few businesses can provide good health insurance to their employees at 10.5% of SSI wages [without Healthy Wisconsin]. The averages from the private sector that we have gotten from our unions seem to suggest the average is currently around 20%. Estimates from Wisconsin Alliance of Cities and League of Wisconsin Municipalities suggest 25-30% in public sector (since most public employee unions have sacrificed wages for higher benefits). So the reality is that Healthy Wisconsin is the most powerful economic development program Wisconsin has ever had: it offers huge savings to firms that expect to pay family-supporting wages and provide good benefits, encouraging them to expand in Wisconsin or locate here. (Graphics Packaging in Wausau, with two plants in Wisconsin, Wausau and Menasha, has, as I remember, 36 plants in 10 states. According to their Regional Human Resource Director Mike Rayome, under Healthy Wisconsin the two plants here would have by far the lowest health care costs of all their plants in the US.)
Hope this helps,
David, please provide me/us with the details of the health plan. I'd like to see the coverage of benefits and the list of "Exclusions & Limitations".
Also, some WI individual major medical health insurance carriers mix of business is 80% HSA-qualified and 20% ppo type plans. HSA-qualified plans have become very, very popular with consumers over the past few years. Why doesn't Healthy WI offer a plan design as popular as this? Why are we being pushed into a plan we might not like? There are many that can afford a higher deducible and what to save tax-free money that's dedicated to health costs today and can be used with a Medicare plan. Why can't we have one or two HSA-qualified plans? A free market would let us!
Richard:
For the details of the plan, please go to: www.healthywisconsin.net
Click on: More Information. Then go to: The Legislation. The other "tabs" also provide helpful summaries.
Most of the proponents of Healthy Wisconsin question the value of high-deductible health plans, which are necessary in order to have an HSA. They feel that people shouldn't be required to spend over $1,000 before insurance pays a penny. The concern is that high deductibles will deter low-income people, as well as some middle-class people, from seeking out necessary care as well as unnecessary or overpriced care. And if people avoid care they need, some may die, get sicker than would otherwise happen, and end up costing us more.
These are serious concerns, which the proponents of high deductible health plans have generally brushed off instead of reponding to with evidence. If you can provide any truly independent analysis that shows that high deductible health plans don't deter necessary care--just unncessary care--please bring it forward.
But there is another, frankly political, concern. You ask: Why doesn't Healthy Wisconsin offer high-deductible health plans coupled with HSAs? Part of the answer is: They believe such a change will not only make Healthy Wisconsin worse, but will do nothing to cause the legislative opponents of Healthy Wisconsin to end their opposition, support the proposal, and enact it into law. The answer to your question is, in short, a question to you: Why should the advocates of Healthy Wisconsin compromise on a change they seriously question on the merits when their opponents won't simultaneously compromise by letting the plan become law?
It takes two to tango. It takes two sides to agree on a compromise. But so far, the opponents of Healthy Wisconsin seem bent on opposing the plan in any form
This is in response to Bob Johnson's original concerns. I thought I'd submitted this several days ago, but apparently not. So here goes again:
Glad to respond to Bob Johnson's concerns. (By the way--this is for John Pierquet--my last name is Riemer.)
1. Public school teachers are NOT exempt. That myth has been floating around for several weeks. There's no truth in it. Teachers are treated like everyone else. They're covered by the plan. They pay the same assessments. Their employers pay the same assessment. Like all other unionized employees (both public and private), there may be a temporary delay in their joining Healthy Wisconsin IF they have a collective bargaining agreement in effect on the day the plan commences and IF they choose not to modify it. But this is a temporary situation (it ends when the collective bargaining agreement ends, or is renegotiated), and in any case it doesn't apply uniquely to teachers but to all unions and businesses that have collective bargaining.
The provision that Bob Johnson is referring to is a technical provision, added at the suggestion of the independent Legislative Reference Bureau, that seeks to harmonize Healthy Wisconsin with the existing requirement of the Qualified Economic Offer (QEO) signed into law, I believe, by former Governor Thompson. All it says is that, when the QEO refers to "maintenance" of current health benefits, that term shall mean--once Healthy Wisconsin goes into effect--the sum of the Healthy Wisconsin benefits plus, if applicable, any supplemental benefit needed to achieve "maintenance" of current health benefits. This provision only exists because of the requirements of the current QEO law. It doesn't exempt teachers from anything.
2. The Lewin Group, which estimated that Healthy Wisconsin would save $751 million and $13.8 billion cumulatively over 10 years, is a highly-regarded independent team of health care economists and analysts. Against this group's sophisticated analysis of the data, Bob Johnson offers...his personal opinion. What can I say? Most reasonable people, I believe, will concur with the neutral experts over someone who has an ideological dislike for the plan and doesn't have the same kind of expertise.
For what it's worth, my personal opinion is that Lewin has underestimated the savings. Unlike Bob Johnson, perhaps, I believe that the competitive, market force pressures that Healthy Wisconsin will unleash--its powerful combination of cost-conscious consumer choice, competition among health care networks and providers, and incentives to the networks to become more efficient, lower costs, and improve quality in order to attract more enrollees and expand their revenue--will result in very large improvements in the overall efficiency of today's highly inefficient health care system.
But until the evidence shows that I'm right on this, I'm content to stick with Lewin's projections.
3. If the 12-month residency requirement is struck down as unconstitutional, the Legislature will need to address that issue. But to block a good, comprehensive health insurance reform plan--one that dramatically reduces the number of uninsured, lowers costs, and savings money for most families and businesses--based on speculation about what a court MAY rule on a residency requirement would be a mistake.
4. The federal government has done a terrible job of policing our borders and enforcing our immigration laws. There should be no question, however, that this is a federal responsibility. Bob Johnson now apparently wants to spend additional money, create additional bureaucracy, and hire additional "screeners" to exclude illegal immigrants--that the feds have allowed to enter the U.S.--from programs like Healthy Wisconsin. It seems to me that, at least when it comes to basic necessities like the education of children or the provision of health care, the federal government's failure to enforce our immigration laws shouldn't require us to put a costly burden on Wisconsin to create costly bureaucracies to screen out people whom the federal government has allowed into the country in the first place.
5. Like most critics of Healthy Wisconsin, Bob Johnson points out the $15.2 billion assessment but fails to mention that this REPLACES health insurance premiums and other health care costs that are GREATER than $15.2 billion. He thus fails to mention that the assessment is part of a program that costs employers LESS as whole...that SAVES them money.
Again, let me provide the numbers
Wisconsin's families as a whole would save $432 million
Private employers that currently provide insurance would save $686 million. Employers that now insure fewer than 75% of their workers would see a $50 million reduction in their costs. Employers that currently insure 75% or more of their workers would see a $631 million reduction in costs.
Compared to the $9,191 billion that currently insuring private employers (of all types) are now spending on employee health care, the amount that "Healthy Wisconsin" actually requires them to pay—that is, the $7,769 million assessment—would result in an enormous $1,442 million savings.
When the $169 million in required property tax cuts for business is added to this, the savings for currently insuring employers mount to $1,588 million.
Lewin's methodology requires them to assume that certain voluntary spending to provide supplemental health care coverage—both contractual commitments that employers have voluntarily entered into, as well as voluntary spending that is not required by contract but that Lewin assumes employers will commit to in order to maintain their competitive position—will cut into this $1,588 in savings, ultimately reducing currently insuring employers' net savings to the $686 million figure initially mentioned.
Finally, the "Healthy Wisconsin" plan requires that 50% of the amount that government (as employer) saves--a total of $680 million—must be passed on to households and businesses in the form of a property tax cut.
6. The number of uninsured in Wisconsin, according to Lewin, is 476,000. This is a "point in time" figure. Over the course of the year, the number who are uninsured at some time during the year is much higher.
This is a huge number of people. Bob Johnson seeks to belittle the number by saying it's "only about 8%". But Wisconsin's uninsured population includes more people than reside in any city in Wisconsin except for Milwaukee. It's more people than reside in any county in Wisconsin except for Milwaukee. It's almost as many people as are enrolled in the "family" part of Medicaid and BadgerCare.
And the number is getting bigger every year.
Yes, some choose to remain uninsured even though their health is good and they could afford insurance. But many cannot afford insurance, or can only afford it if they skimp on food, housing, and other necessities.
Moreover, those who choose to remain uninsured even though they can afford it are sticking their costs on the rest of us. They do get sick, and have accidents. They may be able to afford insurance, but they can't afford $500,000 bills. When they can't pay those bills, their doctors and hospitals pass on the costs to...the rest of us, in the form of higher insurance costs. So their decision to remain uninsured doesn't just affect them; it penalizes you and me. I say: No more free riding! Pay your share!
7. Healthy Wisconsin generally lets the market set prices for doctors and hospitals. The private health care networks that the plan calls for--and which I believe most participants will enroll in--are are not subject to any kind of price-setting for health care providers. They make their own arrangements as to which providers to include in the network and what to pay them.
The fee-for-service option does call for setting prices. But the law requires that prices be set so as to retain doctors. Why would anyone want to drive doctors away? We need them to care for us.
Jack Lohman's "friend" is warning me that if I loose my job I won't be able to afford my high deductible health plan. That's a reach! Beside's what does Jack's friend know about me anyhow?
My HSA-qualified plan's high deductible is only $2,500.00 after that the plan pays 100%. Prior to getting on this plan my families out-of-pocket costs for my wife and I and our children was approximately $4,500.00. So, Jack's friend, let's do the math here... $4.500.00 - $2,500.00 = wow, a savings $1,500.00 on my HSA plan. Not a bad deal hey!
Further, David Riemer's opening description of the plan talks about cost sharing stopping at $3,000.00 for families before the plan kicks in and pays 100%. Geez, let's do the math again. The HW plan maximun out-of-pocket is $3,000.00 - my max out-of-pocket of $2,500 = wow, that's a $500.00 savings for me and my family over the HW plan. It looks like we'd all be better off with a plan similar to mine. If David believes that paying out $3,000.00 won't cause family bankrupcies or deplete college funds or retirement assests in order to pay for catastrophic medical bills he should be estatic about a plan like mine.
Jack, why is your friend hiding? Your friends comments are diluted behind the mask of "my friend". Tell'em to strap a pair on and get into this discusion. It's also good to know though that you do have a friend.
HSAs are a joke. They're the Bush Administration's lame attempt to introduce consumerism into the health care equation. It's just a way for employers to put the whole burden on their employees and wash their hands of it all. There is no transparency in health care, and consumers can't shop around for the best deals. So, when a middle-class family member gets sick and requires an overnight stay in the hospital, the family is socked with an HSA deductible of thousands of dollars. There's no way the family can afford to save enough for that. That's why bankruptcies are skyrocketing.
It's time for a new system. This one is busted and only getting worse. The players in the system won't reform it, because it's not in their best interests. That's why the players are pumping so much money into lobbying to keep the status quo. It's time to finally do the right thing. The fact that America is the only civilized nation without a national health plan is a disgrace. Help us reform this sick system or get out of our way.
Richard Champion doesn't get it. What exactly was said is:
"Champion may think his HSA is great now, but what if he loses his job and can no longer afford to put money into that HSA? No savings for health care, just a huge deductible. Same if he or someone in his family develops a serious medical condition or injury: savings in HSA disappear quickly and they are left with huge deductible. HSA's are great as long as you have plenty of extra money to put into them and you don't get sick or have an accident. The 20's mentality: I'll live forever (and never be sick)!"
To that he effectively says: "I won't lose my job." Good for him. How about the others who are having HSAs forced down their throats?
HSAs have a limited appeal as an investment tool for the young and healthy; not as a health care plan. So, we disagree.
Here's why I have a major problem with this plan. I make a nice living - over $100k, but we'll use that number. Currently my employeer pays $2,500 per year for my HSA, I pay around $4k. My wife makes $40k, both my college age kids earn $10ish. Right now everyone is covered under my family plan that costs us $6,500 (combined, me + employeer). Under this new plan, 15% of our household earnings ($170k) = $25,500 for our medical costs. But wait - it's not done yet. I do 1099 consulting several days a week for the tune of another $40k per year, gonna have to pay another 15% on that one. So it's going to cost my family $31,500 for medical that we're currently paying $6,500.
AHhh - but I'm adding our cost + our employeers together, right? Not a fair assessment? BS - if you think that all the employeers across the state are going to eat the 11% costs, you're crazy. They have to factor that into their employees total benefit costs, so its going to reduce earned income, one way or the other.
But regardless - someone please explain to me how it makes sense that we pay $31,500 for coverage we have for $6,500 now? And for those who dare to argue "You make it, you can afford it" - I sincerely hope that one day you make a decent living and you can try it on for size, guarentee you'll change your tune.
David,
I took a look at the Healthy WI health care plan. Thanks for the site address. The plan shown is very lean, and very high level. There were no details concerning exact Coverage of Benefits nor the all important "Limitations & Exclusions section. This last section really spells out what the coverage will and won't pay for. There's also no mention of co-insurance, is it an 80/20, 70/30 or 60/40 plan? It did say it's 100% after the out-of-pocket reaches $3,000.00. But what's between the family $600.00 deductible max and the $3,000 maximum cap? Is someone paying 20% say on an 80/20 co-insurance formula to $3,000.00? Is the family deductible an aggrate deductible or does each family member need to meet a specfic portion of the deductible?
Furthermore, as I wrote before, my current HSA-qualified plan pays 100% after my family deductible of $2,500.00. Considering the $500.00 savings between the HW plan and my own, I believe I'd be better staying where I'm at. Wouldn't you agree?
Richard