Archive for December, 2008

Well, we’re past that time again where everyone has made their choices for their medical benefits (if you’re a January 1 renewal) if you’re lucky enough to work for an employer who still provides benefits instead of leaving you floundering to find your own.  As a Employee Benefit Consultant, I was amazed this year how many employers wanted to talk about HDHP (High Deductible Health Plans) but very few made the choice to offer these.  Basically it comes down to the overall costs and regardless of what plan you choose, when a catastrophic illness happens, the carrier doesn’t save any money and that is why premium isn’t really impacted for these plans and therefore they are rarely more cost effective to offer.  Dual options, triple options, buy-up plans and catastrophic plans are thrown around the conference room table but every dollar basically comes down to the health and well-being of a company’s employees and the overall cost of their care.

Why haven’t HSA’s and HRA’s really caught on?  Typically with HDHP’s, employees are on the hook for the first $2,000 or $3,000 individually and then the plan kicks in and starts paying.  Many people are pretty savvy about treatments options due to the Internet but when you’re in the middle of running your child to the ER, do you really stop to think about how much it will cost?  That’s what carriers are hoping.  Initially, HDHP’s were put in place to help change consumerism.  By making the employee pay for service at the time of service, the plan was to make you stop and think about your pocket-book before seeking care and therefore help eliminate non-urgent services and make the employee ask more questions, etc.  We haven’t seen the big savings that President Bush anticipated with this concept.   I believe health care services is the only item we Americans “buy” before asking the price in most cases.  Would you take home a car, drive it around and wait for the bill to come in the mail before finding out what it costs?

In an annual survey done by the Henry J. Kaiser Family Foundation, it was determined that the annual premium a health insurer charges an employer for a health plan covering a family of four averaged to $12,700 in 2008. Workers contributed nearly $3,400, or 12% more than they did in 2007.  The annual premiums for family coverage significaly eclipsed the gross earnings for a full-time, minimum-wage worker ($10,712).  How can paying more money up front at the time of service help this family?  Workers are now paying approximately $1,600 more in premiums annually for family coverage than they did in 1999.

The United States of America is the number 1 (one) “spender” of healthcare dollars and we seem to be fine with that. We want choice and we want top dollar care and yes, we want it for less money out of our pockets.  U.S. health care spending is expected to increase over the next decade reaching $4.3 TRILLION in 2017 or 20% of the GDP.   Experts agree that our healthcare system is riddled with inefficiency, excessive administrative expenses, inflated prices, poor management and inappropriate care, waste and fraud.  These problems significantly increase the cost of medical care and health insurance for employers and workers and affect the financial securities of families.  With that said, we all still need affordable health insurance coverage.

According to the Kaiser Family Foundation and Health Research and Educational Trust, premiums for employer-sponsored health insurance in the United States have been rising four times faster on average than workers’ earnings since 1999.  The average employee contribution to company provided health insurance has increased more than 120 percent since 2000.  The average out-of-pocket costs for deductibles, co-payments for medications, and co-insurance for physician and hospital visits rose 115% during the same period. 

It appears that we not only have a problem with nearly 46 million Americans uninsured but we also have insured families filing bankruptcy and losing their homes because of their out-of-pocket expenses are more than they can handle.   How can we change this?  Truly shop around and determine the best route to take when an emergency happens rather than waiting for it to occur.  Set aside “emergency” (or as my mother used to call it, “mad”) money for this occasions.  Ask many questions or your primary care provider.  Call their office before just automatically setting an appointment and ask a few questions.  More family doctors are willing to call in a prescription than you might think.  Ask for samples ask he/she is pulling out the script pad and ask if there is a generic or an alternative to the “brand new” drug now being advertised on TV today.  Enroll in your employer sponsored wellness program, this will benefit you first and foremost. 

We all can make a difference by just taking a few more steps.

Jacquey Tabcum, Vice-President
Trilogy Benefits, Inc.

Chair, Ethics & Bylaws Committee
Western Regional Association of Health Underwriters

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  1. Contact your financial institute immediately.
  2. File a police report.
  3. Report suspicious contacts to the Federal Trade Commission or the Internet Fraud Complaint Center.
  4. Contact each of the following credit bureaus and place a fraud alert statement on your credit information

Federal Trade Commission (FTC) (877) 382-4357 www.ftc.gov

Consumer Fraud – www.usdoj.gov

Internet Fraud Complaint Center (IFCC) www.ifccfbi.gov

Social Security Administration (800) 269-0271 www.ssa.gov

Identity Theft Resource Center (858) 693-7935 www.idtheftcenter.org

Privacy Rights Clearing House (619) 298-3396 www.privacyrights.org

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Why fish?

By Megan Rauscher


NEW YORK (Reuters Health) – For adults with diabetes, eating fish twice a week may help prevent kidney disease — one of the most serious complications of diabetes, according to British researchers.


Dr. Amanda Adler from Addenbrooke’s Hospital, in Cambridge and associates studied the diets of more than 22,000 middle-aged and older men and women, 517 of whom had diabetes, primarily type 2 disease.


They found that people with diabetes who reported eating fish more than once per week were considerably less likely to have protein in the urine – an early sign of kidney disease.


The condition, known medically as macroalbuminuria, “can herald worse kidney damage and increase the risk even for heart attacks,” Adler told Reuters Health.


A little more than 8 percent of those with diabetes had macroalbuminuria versus less than 1 percent of those without diabetes.  And 18 percent of diabetics who did not eat fish regularly (less than once per week) had macroalbuminuria compared with just 4 percent of diabetics who ate fish more than once per week.


“This suggests, then, that eating fish may prevent this early sign of kidney problems, which patients with diabetes are more likely to develop,” Adler said.


The study appears in the November issue of American Journal of Kidney Diseases, the official journal of the National Kidney Foundation.


Lead investigator Chee-Tin Christine Lee told Reuters Health: “It is possible that fish oil improves blood lipid profiles and decreases the risk of kidney disease.  It could be other components of fish, such as protein or micronutrients, are protective against diabetic kidney disease. However, it is also possible that people who eat fish frequently have other lifestyle factors, which we could not account for.”


The study could not answer whether one kind of fish was better than another. “Future studies may be able to test this question,” Adler said.


Source: American Journal of Kidney Diseases, November 2008

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