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S&S Benefits.....Opinion, Hearsay & News Review

S&S Benefits Consulting, Inc.  219 Darien , Dundee , IL 60118   Phone: 847-428-5353, Fax:847-428-9876

Email : jseiler@ssbenefits.net                                               http://www.ssbenefits.net/   July 2009 Issue


According to a study of chronically ill Medicare beneficiaries in the two last years of their life published by The Journal of Health Affairs, there was no link between the quality of care and the cost of care from 2,172 unidentified hospitals. The patients all had one of three common conditions: heart attack, pneumonia or congestive heart failure. The spending average of the bottom 20% of the hospitals for end of life care was $16,059 and was $34,742 for the top 20% of the highest spending hospitals.

The National Business Group on Health surveyed 1500 employees working at large companies: 27% decided against seeking health services to avoid making co-payments or paying coinsurance. 20% said they skipped taking Rx medication. 52% said they are making a healthier lifestyle more of a priority and 72% said they have become more aware of the total cost of health care in the last year.

The time that physicians, nurses and other staff spend interacting with insurers costs an average of $68,274 per physician per year according to a story published in Health Affairs. The average time spent was 4.3 hours per week, so that makes the average cost of the time just over $305 per hour per physician. Just wait until they have to deal with government plans and regulators.

Towers Perrin and Watson Wyatt are merging into Towers Watson in an equity transaction worth approximately $3.5 billion.

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The Congressional Budget Office released a health reform study in December 2008 that clearly shows that insurance companies spend 51% less on administration than government does on its health care programs. The study used CMS data and shows that private insurance will spend $879 billion, of which 87.3% is paid to providers. The 12.3% spent on administration includes government mandated taxes and assessments. If you take away the taxes the figure would reduce to less than 10%. The government uses government agencies to administer its internal programs of Medicaid, CHIP, VA, etc.-except Medicare. These internal programs will spend $691 billion with $180 billion (26%) going to administrative costs. Another item pointed out in the same study was that while private insurance companies pay for advertising and premium collection, the government cost of collecting Medicare premiums through the IRS was not calculated (which would make government expenses even higher). So the next time you see a politician saying that the government will save money by involving itself with health care administration and making it more streamlined, you can now just stand up and call that person a liar.

Illinois just gave a nice new tax to fully insured employers. For policies renewed on or after June 1, 2009, insurance contracts must cover unmarried adult children as dependents until age 26, regardless of student status. Military personnel are also eligible to be added if they are unmarried and under the age of 30.

A survey by Partnership for Workplace Mental Health of 143 employers says that 74% of those employers are not dropping mental health benefits due to the Mental Health Parity Law that takes effect January 2010.

House Democrats have released their draft of health reform legislation that includes a public plan option and an 8% payroll tax on those employers who donít offer health insurance. Aside from disruption of a system that covers 160 million people who receive benefits through their employers, the use of a public plan option is just the beginning of rationing as a means of controlling costs. Unwittingly, the President said so himself in his ABC network kiss up festival. The news stories never focus on the fact that all but 15% of the current population has health coverage and many of those that donít have coverage, have chosen that option for themselves or are people who are in the USA illegally. The misguided Democrats also believe that their focus on preventive benefits and wellness delivered through primary care physicians will save money that is not being saved in todayís private plans. They completely ignore the fact that most private insurance has covered those benefits for years. Yep, primary care and wellness sure saved HMOs a lot of money. So much so, that most of them are now out of business. To top things off, the current Baucus plan would tax health care benefits received by workers, but exempt union employees from the tax!

HAVE A SAFE AND HAPPY INDEPENDENCE DAY!! ENJOY IT WHILE YOU STILL CAN!