OP-ED

Op-Ed: Defending Regi

Matt you can’t have it both ways.

First you attack a well-known Harvard professor, Regina Herzlinger, for accepting an invitation to become a director at a company that only later was publicly accused of accounting problems. Then you denigrate her when she goes public with her attempts to get the board to move more aggressively to tackle those problems and ruffles the feathers of several board members who retaliate. You then insinuate that she profited while shareholders suffered and yet you dismiss it as sour grapes when she resigns before her term ends (costing her a significant sum of money in the process).

And while we’re at it, how can a site with the name “The Health Care Blog” routinely ignore the ideas of one of the most creative thinkers in health policy? This field is so completely dominated by unoriginal thinking; I don’t know why you don’t welcome with open arms someone who is not just parroting the latest fad.

And speaking of character, we have just been through a period when an embarrassingly large number of leading health policy analysts sold their souls, their self-respect, their reputations and whatever is left of their intellectual honesty to the highest bidders in what we loosely call “health care reform.” In the midst of all that, I would think that someone also has shown the unimpeachable rectitude and character Professor Herzlinger has is deserving of a THCB award.

John C. Goodman, PhD, is president and CEO of the National Center for Policy Analysis.  He is also the Kellye Wright Fellow in health care. The mission of the Wright Fellowship is to promote a more patient-centered, consumer-driven health care system. Dr. Goodman’s Health Policy Blog is considered among the top conservative health care blogs on the internet where pro-free enterprise, private sector solutions to health care problems are discussed by top health policy experts from all sides of the political spectrum.

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bev M.D.ExhaustedMDMargalit Gur-ArieMGPeter Recent comment authors
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ExhaustedMD
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ExhaustedMD

to bevMD: People need to have some form of Medical Savings Accounts and catastrophic insurance coverage so they take the responsibility for paying for their own health care needs, and, unfortunately, we continue to need to rely on Medical Assistance for those who are TRULY impovershed and do not have the ability to have such accounts. I have no respect for what health care insurance has done to the profession, and the sooner it becomes a non profit business, the sooner it may actually provide coverage and allow people to get care. But, with the Nate’s in the world being… Read more »

Margalit Gur-Arie
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“The only people that take COBRA are those with large claims that can’t get cheaper insurance elsewhere.” Not true. I know quite a few responsible folks who stay on COBRA and are as healthy as they come. Why do you make generalizations? I found 123 plans from multiple payors (all the big guys plus some locals), available in my area: 2 with zero deductible, 8 with 500 deductible, everything else was 1000 and up There were no plans for 250, 750 or 200 43 plans were 5000 and above. Also when you click on these contraptions, some, but not all,… Read more »

Nate
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Nate

“but you are not funding their HSA any more, so in effect you got rid of the biggest expense.” LOL Margalit how many times do you have to be wrong before you give it up? Groups don’t pay COBRA premium the individual does. If someone only has $5000 or less in claims do you really think they are going to pay $3000-$5000 in COBRA premium? The only people that take COBRA are those with large claims that can’t get cheaper insurance elsewhere. The couple thousand in contributions is meaningless. As many times as you have been factually wrong today why… Read more »

Margalit Gur-Arie
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If you fire someone they do stay on your COBRA, which means you have to keep paying the insurer, but you are not funding their HSA any more, so in effect you got rid of the biggest expense.
When I did my little experiment with that fictitious family in Missouri, there were only 2 zero deductible plans and 8 with $500 deductible, out of 123 plans. I would say that it is pretty hard to find a low deductible plan nowadays, so they must be pretty good for business.

Nate
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Nate

“Are insurers loosing money on HDI plans? Are they making a horrific business error in pushing more and more high deductible plans with higher and higher actual deductibles?” Not sure what you mean by pushing, a number of carriers are not only not pushing them but taking them off the market. Aetna eliminated most of their 100% plans, Humana severly underpriced theirs and was giving out 40% increases to healthy groups. Small carriers like Alden and some others are “pushing” HDHPs. Your big carriers like Anthem would probably prefer they go away. I don’t think Anthem and some of the… Read more »

Margalit Gur-Arie
Guest

Nate, let me ask you a very simple question. Are insurers loosing money on HDI plans? Are they making a horrific business error in pushing more and more high deductible plans with higher and higher actual deductibles? As to your TPA services, the employees in your plans do not really have high deductibles. They have one plan from the big insurer and another for small things from their employer. How does a private person buying in the individual market get the same benefits? Not to mention that their rates are higher than even a small employer to start with. I… Read more »

bev M.D.
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bev M.D.

Um, Exhausted, what kind of payment system would you like to see? I’m not sure I recall you actually commenting on that part of things. I am asking seriously. You gotta get paid somehow.
As for Nate, I refrain from comment except to say thanks for answering my question. I understood the answer, thanks.

Nate
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Nate

Exhausted you don’t seem to know the difference between an opinion and lies. You also don’t have the slightest idea what I do for a living, it might help to know that before you comment on it.
Please do explain how I; “You may scam some health care providers” this is sensless drabble, sorry attempt to insult someone when you don’t know what your talking about. Seeing as I sell providers nothing in what matter are they scammed? Seems you yourself are; ” nasty, projective, minimizing, and deflecting comments!”

ExhaustedMD
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ExhaustedMD

You know what, Nate, your 6/19 8:35 comment does not invalidate all your prior nasty, projective, minimizing, and deflecting comments! You run a bully pit, have absolutely zero tolerance for a differing opinion that sells your profit driven motives short, and you are like Maggie M in the end, full of sound and fury, signifying nothing. Throw out lots of numbers, confuse with the shell game antics, and then cry foul when someone catches on to the shenanigans! Make a point, use responsible facts, and if your agenda is honest and fair, objective and unbiased readers will see such agenda.… Read more »

Nate
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Nate

For starters SmartSense $5000 isn’t an HSA. If you had ran a Lumenos quote the OOP would have been $10,000. In NV your $500 Ded Smartsense has a premium of $752. OOP is $6000 but co-pays don’t apply to OOP so they go on forever. $5000 Lumenous HSA has premium of $337 with OOP of $10,000 but Rx and office visits are paid at 100% after deductible. HSA products also usually have much better preventive benefits and wellness services. That is a savings of $4980 more then enough to pay the additional OOP cost of $4000 and it is also… Read more »

Margalit Gur-Arie
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Nate, I went to eInsurance website and entered a fictitious family of 4 here in Missouri, and picked Anthem and two identical policies in everything other than deductible. SmartSense 500 – Premium $598.22 $500×2=$1000 deductible 30% coinsurance $35 Office visit OOP $8000 SmartChoice 5000 – Premium $299.89 $5000×2=$10000 deductible 30% coinsurance $35 Office visit OOP $17000 If I pick SmartSense I pay $7178.64 per year and may end up paying $1000 more and $8000-$1000=$7000 more if things get dicey. If I pick SmartChoice I pay $3598.68 per year, which is a savings of about $3500 compared to the previous choice.… Read more »

Nate
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Nate

I’m so misunderstood. I am the nicest person in the world to honest people. I spend hours every week educating and assisting people for free. But when someone is going to lie and make things up for political gain they need taken down. I’m not going to equate healthcare reform to genocide but propoganda when left unchecked leads to very bad things. If people would be honest they wouldn’t be liars, their decision not mine. I own firms referred to as TPAs, Third Party Administrators. We process claims and handle the day to day administration of health plans. We are… Read more »

bev M.D.
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bev M.D.

I hate to agree with Nate because he has reverted to his name-calling ways, but based on at least one anecdotal experience he is generally correct. I am friends with the COO of a mid sized law firm who recently converted his firm and employees to a HDHP and the terms/benefits were generally as Nate indicates. Nate, explain one thing to me if you can do so without maligning my ignorance – what do you mean by “they hired us to process claims back down to the $0 deductible?” Can you explain that in layman’s terms? (ps I don’t use… Read more »

Nate
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Nate

so everyone can see how full of it you are margalit lets review an actual example of how it works in reality, outside your made up world of propoganda. Small group in Ohio, had a $0 deductible in $250 out. 100% co-insurance in network and 60% out. $10 co-pays. The carrier they are with has 6 tier rates. If they ought this $0 deductible plan from the carrier in 2008 the cost was; 878.59 1757.18 1130.27 1522.77 2008.86 2401.36 Instead they bought a $5000 deductible HDHP with premium; 279.93 554.86 356.04 479.67 634.16 757.46 In 2008 they saved $250,629.52 in… Read more »

Nate
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Nate

“You also know that the difference between the HDI premium and the 0 deductible premium with the same coinsurance and copay is usually way less than the deductible amount.” 100% complete lie! I see dozens of these and never once in my life have I ever seen a $0 deductible plan where the group couldn’t buy up to a higher deductible, fund 100% of the deductible and save money. You have no clue what you talk about margalit. My entire business model is taking people from low deductible plans to high deductible plans because they can fund the difference and… Read more »