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

At the beginning of the month the Illinois Supreme Court struck down limits on jury awards in medical malpractice cases. The court said the limits ($500,000 per case for doctors and $1 million for hospitals) were unconstitutional.

The CMS Office of the Actuary has released the National Health Expenditure Accounts (NHEA) for 2008. Health care spending growth slowed to 4.4% in 2008, a 40 year low.  Spending growth was 7.9% in 2005, 6.6% in 2006 and 6% in 2007. However, the health care portion of GDP grew from 15.9% in 2007 to 16.2% in 2008. The figures represent all health care spending, including administrative expenses and workers compensation as well as hospital, physician and prescription drug costs. It also included public health initiatives, investments in structures, equipment and noncommercial research.

Just when we thought it was over, Obama, Pelosi and Reid have come back with a vengeance. After basically finding their version of health reform DOA for the House and Senate bills, Obama cobbled together the worst from both worlds and put his stamp on it as HIS health care reform initiative. He called for a bipartisan health care summit at which time both Democrats and Republicans could put forth their best ideas. Not exactly.

During what was supposed to be an exchange of ideas, each Democrat who spoke seemed to open with some vague sob story that may or may not have been real. They spoke for 135 minutes. Obama spoke for 122 minutes and made sure he talked down each point a Republican offered. The Republicans spoke for 111 minutes. At the end, Obama and Pelosi basically announced that they were not going to take any of the Republican ideas into consideration and that they would move forward without them. The next step is to attempt to pass the bill through the Reconciliation process. That process was correctly fought against by the Democrats against the Republicans during the Bush years as being unconstitutional. However, they are throwing all their Constitutional arguments away and attempting to use the reconciliation process to force health reform against a public that overwhelmingly does not want their version.

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A Towers Watson Survey of large companies says that 83% of companies have already revamped or expect to revamp their health care strategy within the next two years. Sixty-seven percent of employers identify employees’ poor health habits as a top challenge to maintaining affordable benefit coverage. While 58% of those employers surveyed indicate that changing employee behavior is made difficult by lack of employee engagement, most employers seem to recognize that federal limits on incentives make it difficult to encourage employees to change.

While there are no doubt problems with the health care system that need to be addressed, the ridiculous process of opening every argument in favor of change with a sob story is getting old. We would love to have the opportunity to question each of the stories instead of taking them all at face value. Having been in this business for many years, we are all aware of stories that just don’t ring true. While we don’t doubt there are people who have been hurt by the system, that is true of almost any system, be it traffic laws or health care.

However, we never hear the stories about people who had hundreds of thousands of dollars worth of care and were rendered well by the system because they had made the responsible choice to purchase health insurance. What if every Republican during the “summit” had opened with a success story? We have one here at S&S. Years ago a couple decided they needed health insurance when they quit their jobs and started their new business. They wanted something inexpensive since they were starting a business and couldn’t afford a “Cadillac plan.” They agreed to buy a high deductible plan in November of that year, since they were both young and healthy. Three months later, the wife was diagnosed with breast cancer. After a double mastectomy and chemo and radiation treatments, the wife was cured and their business survived. Did the insurance company check to make sure there was no pre-existing condition as was stated on the application? Yes. Was treatment withheld? No. Did the insurance company pay the claims? Yes. Is the client happy they made the responsible decision to purchase coverage? Yes. But you won’t hear that story on the evening news or in some political speech. End of story. We are sure you have others.