POLICY/HEALTH PLANS: More evidence that HDHPs work, by Eric Novack

Eric Novack has something to say about HDHP/HSAs, even more to say about who’s getting rich as a result, and little to mention about self-selection. But then I’m just a cynic.

>A simply fascinating report has come from Aetna recently. This from the company that has been about the worst in the Phoenix area for reimbursing physicians at well-below Medicare rates for services. Let me just copy some of the main findings (highlights mine).

Full replacement plans see the most significant savings from Aetna HealthFund. Health Reimbursement Arrangement (HRA) plans effective in January of 2003 experienced an average medical cost trend of 1 percent over three years, meaning that medical costs for these plans increased only 3 percent between 2002 and 2005.Employers who offered Aetna HealthFund as an option are seeing savings across all products offered. Those who offered an HRA option plan effective in January of 2003 experienced an average medical cost trend of 6.7 percent over a three-year period. Both Aetna HealthFund HRA and Health Savings Account (HSA) members with chronic conditions maintained or improved the level of care they received prior to joining the plan, including a 6 percent higher usage of inhaled steroids among asthmatics when compared to a similar population. Preventive care was also maintained or improved. For example, first-year HSA members received cervical cancer screenings at a 13.8 percent higher rate than PPO members. Generic drug utilization for HRA members was 4.5 percent higher than PPO members.

The essence is this: companies that only offered HSA/HRA saw health cost increases averaging only 1% per year over 3 years. Those that had an HSA as an option saw increases averaging only 2.3% per year over 3 years. All this while utilization of preventative services appears to have stayed the same or gone up. Now this is only a snapshot of proprietary data. But maintaining below inflation rates of health spending increases for more than one year deserves the attention of everyone genuinely interested in keeping the healthcare from going over the cliff (or further down the hillside, depending upon where you believe we are).

The really big question is this: Are the cost savings to Aetna being passed on to the consumer? In other words, are premiums getting that much more affordable compared to standard PPO, HMO plans? I do not know for sure, but I am suspicious that these savings are translating into much higher profits, at least for now—meaning that costs to the public are continuing to go up unabated. I shall try to contact Aetna and get the answer and update you.But for the anti-HSA crowd… this certainly does not help the arguments that are so vehemently against HDHP/CDHP.

UPDATE: A shot across the bow for the Medicare-for-all crowd.

From the story:

Medicaid officials comb applications to find Medicare recipients who work in such jobs, focusing on large employers most likely to offer health insurance. If the employee premiums are less than Medicaid's costs for the same family, the state contacts the family and offers to reimburse their portion of the premiums. Under the program, Medicaid pays only the employee portion of the premium, not the employer's. Typically, employees pay about a quarter of the total insurance premium, with the employer paying the rest, according to the Kaiser survey. Washington spends an average of $173 a month per person on Medicaid. But it pays only about $76 a month in premiums to put a person on an employer's plan, plus another $16 a month for any services not covered by some employer's plans, such as vision and dental.

It is still very flawed, since it relies on the employer tax exclusion for health benefits—but it is saving the state (and really, you, the taxpayer, money). But, where is the Dad in the story… or is that not politically correct?