Archive for December, 2009

Health Care Reform

Colorado is ranked 8th in the states for overall good health.  So, why is it that we are 7th for highest health insurance premiums?   The reason is complex.

Inpatient care is high in Colorado due to technology and capital construction.  How do we control that?  Based on care given, do we want to?

In rural areas, most testing is done in the hospital and will drive up rates.  There is little competition and free-standing clinics are not available in many rural communities.  A simple vaginal child-birth delivery is as much as 11% higher in northern Colorado than in metro Denver where hospitals must compete for patients.

Colorado has the 15th highest percentage of uninsureds, according to the Kaiser Family Foundation.  This adds an average of $1,570 a year to each employer-sponsored family insurance plan.  If we consider there could be as many as 857,000 Coloradans without insurance, this figure is astronomical.

Medicaid reimbursements do not cover the average healthcare costs in Colorado.  Therefore, hospitals will pass the difference back to insurers.  As the government continues to trim Medicaid and Medicare reimbursements, this only drives our health insurance premiums up.

Insurance regulations drive costs.  House Bill 1355 approved by Colorado legislators and Governor Ritter approved a bill barring carriers to give premium discounts to small business with healthy workers.  The thought was to keep everyone on an even playing field.  Two-thirds of group businesses received these premium discounts. 

Another state mandate is all group business must include maternity benefits.  Several years ago, this was not the case.

Now, we have an approved mandate that requires carriers to cover educational services associated with autism.  This mandate is expected to cost 3% more on your insurance premiums.

We all have heard of or have special needs we would like covered.  However, do we understand the cost factor attached to each mandate proposed and made into law? 

So, more government involvement is not a solution to health care reform.  A 2,000 page document has some provisions in it that are not going to be in our best interest.  This is our government and we owe it to ourselves to question our government.  These are men and women we voted into office.  From what I have seen and heard, they are not giving very good answers other than we’ll make a change, and it is better than doing nothing.  That is not necessarily true.

We all agree costs have gone sky high.  Reform is needed.  But the legislators are not discussing reform.  They are focused on health insurance premiums.  Breaking down the health care components and having a very informative discussion with insurance carriers, hospitals, doctors is the first step to a solution. 

We should have all 857,000 Coloradans in the “mix”.  If everyone were required to have health insurance, there should be no more pre-existing rules.  The hospitals could not “write off” those who did not have health benefits because it would not be an issue any longer.  How to mandate the requirement that everyone have healthcare benefits is another topic entirely.

Trilogy Benefits consults with employer groups to meet your objectives in offering quality health plans that are the most cost effective for you, their clients.  It does not cost you any more to work with a broker who knows the insurance laws, carriers, plans, and rates.  The brokerage fee is included in your rates already. 

Use a professional.  Consult with a dedicated group benefit specialist today.  Trilogy Benefits would like to apply for that position.

Jacquie Healy, CEO/President

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