Archive for April, 2009

The cost of health insurance continues to climb unabated. As the number of uninsured in America swells to 45 million people, many look to our political leaders for answers and relief.

Presidential campaign rhetoric about how to control skyrocketing health care costs provides only short-term solutions focused on the sticker price. But the administration should address long-term solutions to the spiraling crisis.

In 2002, the United States spent $1.6 trillion, or nearly 15 percent of GDP, on health expenditures. Medicare, the government’s single payer model for seniors, spent $267
billion.

Analysts project national health care expenditures to reach $3.1 trillion by 2012 nearly twice the amount spent in 2002.
The dramatic numbers have a tendency to overstate the obvious for many, the cost of insurance can be as much, if not more,
than rent or a mortgage. Until the administration places its focus on the rising cost of health care, those costs will continue to escalate far exceeding the rates of earnings. Whether you subscribe to a higher monthly premium charged by an HMO or a payroll tax collected by Uncle Sam, someone has to pay
the bill. Shifting the burden from our premium bill to our tax bill is not an acceptable solution.

There are basic initiatives that policymakers need to address in an effort to streamline the delivery system and minimize
the soaring cost of health care.

First, encourage investments in technology improvements across all levels of the health care delivery system, including insurers, hospitals and physicians. For a $1.6 trillion industry in the 21st century, the technology employed is comparable to
driving a Model T on a highway full of modern cars.

Consider the banking industry. A simple piece of plastic, from any bank, allows you to purchase anything from antiques on eBay to milk at the local grocery store. In health care, the piece of plastic serving as an ID card serves little purpose other than
to inform the physician where to send the bill. Physicians and their staffs then spend an inordinate amount of time completing
the proper paperwork to get paid.

Inefficiencies are expensive. Administrative expenses are the fastest-rising component of health expenditures. In 2002, public and private insurance spent $105 billion on administrative expenses, almost 13 percent more than in 2001. Support for developing common standards and technology improvements is necessary to eliminate the costly inefficiencies that
contribute to rising health costs.

Next, support the release of cost and quality information. Most of us know where we can find the best deal on a car, mortgage or even shoes. But how many people can afford to buy something without ever knowing the price?

Do you know the average cost of a physician office visit? We have grown accustomed to the minimal office co-payment as
the benchmark for the cost of delivering care. Yet who would seriously consider a $10 co-payment a sufficient amount for
physician treatment?

As consumers, we are asked to bear a greater share of health care costs. In return, we should demand more information
about price and quality. Disclosure of such information has the potential to have a profound effect on consumer behavior and the cost and quality of health care. Such transparency should reform inequities and deficiencies in the cost of
health services.

There is no single magic bullet to solving the issues facing the American health care system. Our system is an immense and
complex web of interdependencies. Expanded public financing and subsidies will provide only short-term relief unless the
drivers of health care expenditures are resolved. Solely addressing the problem by throwing more money at it, public or private, while ignoring the elephant in the living room serves little to alleviate the large financial burden the health care system has become.

We must accept the fact that health care in the United States is expensive and get to work on long-term solutions that will effectively control costs. We have the ability to control health care costs in this country; what we lack are the commitment and
stamina to get it done.

JOHN R. CANTILLO is vice president of underwriting at VISTA.
An industry expert with more than 10 years of experience in
health insurance, he received his MBA from the University of Florida. Cantillo is a member of the Health Underwriting
Study Group, a national think tank and information source for health insurance executives. Reach him at http://www.vistahealthplan.com

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As a business owner, you’ve come to expect big increases in your employee health insurance premiums of late. Employer-sponsored health insurance premiums increased an average of 11.2 percent in 2004, and this was the fourth consecutive year of double-digit growth, according to the recent Annual Employer
Health Benefits Survey released by the Kaiser Family Foundation.
That’s about five times the rate of inflation nationally, and probably significantly higher than the price increases your company has imposed on its products and services in the same time frame.

The reasons for these increases are not mysterious. The largest share of the ongoing increases track to increased utilization of advanced medical technologies new diagnostic and preventive screenings, and other high-tech therapies and medical hardware the majority of which are delivered at hospital on an inpatient or outpatient basis.

Prescription drugs also continue to play a major role in the rising cost of health care, owing to the higher prices of new formulations, the wider application of combination therapies and greater consumer demand for, and need of, medications in all areas of prevention and treatment. About the only area that has seen relative stability is physician costs.

Such increases, when they are part of the costs of running your business, are naturally cause for concern. It only makes sense that employers who want to continue offering their employees access to quality health care become more knowledgeable about how well their money is being spent by the health care carrier they choose.

For example, did you know that virtually all carriers in Florida spend roughly the same percentage of your premium dollars
on medical claims which works out to a medical loss ratio of 76 percent to 80 percent? They also spend about the same percentage, 10 percent to 12 percent, on administering your plan (processing claims, providing customer service functions,
covering fixed costs).

And most of the carriers factor in a 2 percent profit margin. The balance of your premium dollars go to the commissions,
which carriers pay to the independent health insurance brokers who act as consultants.

Brokers are, of course, a critical element in matching clients with carriers. Most small business employers don’t have the
time or staff to determine the best package of benefits for their group, shop the market for bids and compare product offerings carefully.

They depend on their broker to explore the different options, give them objective recommendations on the best choices and complete their applications. And brokers’ services may often continue after enrollment.

It’s extremely valuable for employers to better understand where their premium dollars go. Don’t hesitate to ask questions to fully recognize why one health plan may be preferred over another.

Employers can exercise some control over their costs by finding a health benefits company that provides the best value for their company’s premium dollars. The way in which you shop a health plan can impact the price.

It’s the same as if your travel agent had a great deal for you air, car, hotel and meals included. You tell your agent to book
it. Coincidently, your neighbors just booked that same trip for $1,000 less through their travel agent.

One agent shopped for the best price, the other agent arranged the trip through his or her vendor of choice. Whether it’s a family vacation, buying a car or choosing a health benefits plan, how you shop can impact your cost.

So why are health care premiums different?
Take a closer look.

Peter Joseph is senior vice president for commercial sales for VISTA, a health benefits company headquartered in South Florida with more than 330,000 members. VISTA, through its affiliated companies, Vista Healthpla Inc., Vista Healthplan of South Florida Inc. and Vista Insurance Plan Inc. offers a choice of health benefit plans, including health maintenance organization (HMO), preferred provider organization (PPO) and point-of-service (POS). Reach Joseph at 954-858-3000 or through VISTA’s website, http://www.vistahealthplan.com.

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Long term care insurance is best when you know you will need medical service for more than a few days or weeks. Long term care insurance offers protection for individuals against unforeseen or catastrophic long term illnesses, and provides them with the assistance that they would require. It can be of great help to older people, as they are not in a position to look after themselves. Thus, long term care insurance provides coverage to them and also offers financial security.

Long term care insurance policies can protect against overwhelming healthcare costs and pay for the expenses that the client incurs from his illness.

Long-term care insurance is not for everyone. A long-term care policy makes sense as an affordable and worthwhile form of insurance, but buying long-term coverage should not cause financial hardship or force you to forego other financial needs. You should do a full financial analysis to decide whether long-term care insurance is appropriate or not.

The need for long-term care rises with age, when people need more assistance with the activities of daily living. People suffering from acute illnesses may need nursing-home care for a matter of months or even years.

If you cannot afford to pay the premiums then they are paid by Medicaid programs administered by the state government. And as the policyholder grows older, the premiums for long-term care policies increase to cover this risk. When buying long-term care coverage, the consumer should anticipate such situations and see that it will not strain a fixed income and result in cancellation just prior to the time when coverage is needed.

Long Term Care Insurance provides detailed information on Long Term Care Insurance, Long Term Care Health Insurance, Long Term Care Insurance Quotes, Long Term Care Insurance Rates and more. Long Term Care Insurance is affiliated with Child Health Plans.

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