[Vision2020] More Proof Preventative Health Care Saves

Wed Jan 18 15:25:29 PST 2012

I can't speak to your personal finances, or your HSA.  I can only speak for mine.  

I would imagine that you know the same offices that are inclined to charge a "tremendously higher rate" do so because of their fear of not getting paid.  Having an insurance company on the back end with a promise to pay (through coverage) lowers their risk, and therefore lowers the price charged.  

If you can provide payment at the time of service, and remove their fear of getting stiffed for the bill, then you can typically get the same rate they would charge if they would have billed the insurance company.    To get this information, you just have to go one level above the smiling faces behind the front desk who enforce 'policy' without checking with their superiors.

(And no, for anyone that decides to jump on the keyboard with an "ah-ha  à universal insurance must therefore mean cheaper rates since you've lowered the risk!".... nope... it means more people getting unnecessary procedures/tests simply because they don't have to bear the cost directly... which then drives it up for everyone).

Jay

From: keely emerinemix [mailto:kjajmix1 at msn.com] 
Sent: Wednesday, January 18, 2012 3:04 PM
To: Jay Borden; donovanjarnold2005 at yahoo.com; vision2020 at moscow.com
Subject: RE: [Vision2020] More Proof Preventative Health Care Saves

My tax-deductible HSA of $500 a month still doesn't cover my medications or anything else that exceeds the $6,000 annual family limit we have.  I wish it did.  As it is, it's just a nice way to augment my basically catastrophic insurance.  And I imagine you're aware that procedures not paid by insurance and not ordered by a doctor are charged at a tremendously higher rate than those covered by insurance.

HSA's are great, but they're still largely available only to those who can afford to make those extra payments.  I can; if it were all about me, I suppose I'd be happy.  It isn't, though, and I'm not.  

Keely
www.keely-prevailingwinds.com

________________________________

Subject: RE: [Vision2020] More Proof Preventative Health Care Saves
Date: Wed, 18 Jan 2012 15:00:26 -0800
From: jborden at datawedge.com
To: donovanjarnold2005 at yahoo.com; kjajmix1 at msn.com; vision2020 at moscow.com

Not true.

If your test is NOT "ordered" by a doctor, it can be still paid for via HSA... of which the contributions ARE tax deductible.

Jay

From: Donovan Arnold [mailto:donovanjarnold2005 at yahoo.com] 
Sent: Wednesday, January 18, 2012 2:28 PM
To: Jay Borden; keely emerinemix; vision2020 at moscow.com
Subject: Re: [Vision2020] More Proof Preventative Health Care Saves

Jay,

Just so you know. If a test is NOT ordered by a doctor it is not tax deductible, and doesn't go against your insurance deductible. Considering that they are usually expensive, I would get an order. Most doctors are willing if there is any sort of legitimate concern. 

Donovan Arnold

From: Jay Borden <jborden at datawedge.com>
To: keely emerinemix <kjajmix1 at msn.com>; donovanjarnold2005 at yahoo.com; vision2020 at moscow.com 
Sent: Wednesday, January 18, 2012 2:47 PM
Subject: RE: [Vision2020] More Proof Preventative Health Care Saves

I have had my fair share of doctors and hospitals... with myself, my wife, and my 9-year old son (who looooooves to ride his dirt bike).

Diagnostic tests are ADVISED by doctors, it's the public that blindly follows their advice and assumes that it's an ORDER.  Short of your being unable to voice your own opinion (or have someone with legal authority to do so) a doctor can't ORDER you to do anything.

Yes, you can, in fact, order your own MRI.  (Feel free to do it yourself... that's what we did with my wife's shoulder injury last year... we got all the images from the MRI burned to a CD that we were able to take with us until we found a specialist we liked).   The FACT is, society is dealing with doctors who THINK they have the authority to "ORDER" something, or that tests can't get done unless they accompany a doctor's ORDER ... but when you cut through the crap, you are left with a series of businesses that trades consultations and services for currency.  

Doctors sometimes (well, often) HATE being questioned.  I've walked out of a doctor's office more than once, unsatisfied with either the answer (or lack of their willingness to explain), and found another doctor.  (From my personal experience... Texas was the worst in this regard).

Yes, I have, in fact, had the experience of a doctor "ordering" an MRI (on my knee)... and I have, in fact, asked the doctor if it was truly necessary, and what the likelihood that a simple X-Ray would be able to pinpoint the problem.    (I opted for the X-ray, I got lucky, and the problem was found...).

Yes, I do, in fact, have a "high-deductible" on my insurance policy.  I choose to pay for my own medical, dental, prescriptions, etc... and I choose to use insurance as a safety net, not a blanket.  I take advantage of my HSA, and I make sure that I have sufficient capital stashed to pull the trigger on my high-deductible (should I or our family need it)... as a result I choose to scrutinize the costs and procedures with everything below that line and pay for it out of my own pocket. 

I make sure I am prepared...  I make sure my family is taken care of... yet when I look around society I see an increasing number of 'grasshoppers' and a decreasing number of 'ants'...  and more grasshoppers pushing agendas and legislation punishing the ants for being well-prepared and informed.

Jay

From: keely emerinemix [mailto:kjajmix1 at msn.com] 
Sent: Wednesday, January 18, 2012 12:46 PM
To: Jay Borden; donovanjarnold2005 at yahoo.com; vision2020 at moscow.com
Subject: RE: [Vision2020] More Proof Preventative Health Care Saves

I think, Jay, we have all seen a multitude of examples of "people making BAD decisions" in the healthcare climate we endure these days in the U.S.  Most of the time, those decisions are made by insurers, whose approach to market-driven, business-model healthcare counts every single cost except for the very real personal costs inflicted on sick people.

I don't see the truth in your example that using "other people's money" in healthcare distribution is like you and me going to a restaurant and my ordering not the lobster I would've if I'd known you were paying and, lacking that knowledge, ordering only the soup-and-sandwich combo.  Bad manners in social interactions are not the same thing as denying people access to preventative care that not only spends healthcare dollars wisely in prevention and early diagnosis, with better treatment outcomes, as well as empowers people to manage their own personal health.  You seem to believe that the indignation I might feel that someone "orders up" if I'm paying is at all analogous to having access to and making use of comprehensive preventative, diagnostic, and treatment options that by every standard improves the life -- and life expectancy -- of the patient.  It isn't.

I cannot imagine a scenario under which people "pig out" by availing themselves of "other people's money" -- which, given the tax-supported nature of government involvement in healthcare is actually THEIR own money -- to pay for their scooping up each and every test possible.  You're aware, I know, that most diagnostic tests are ordered by doctors themselves, not by patients.  In other words, while I might call and schedule my own mammogram (at my doctor's recommendation), I can't just wake up one morning and decide that an MRI would be a fun way to pass the day.  No, those tests are ordered by physicians.  I suspect you haven't had the experience of having your doctor suggest that you have an MRI to pinpoint the source of your pain, or a complete blood panel to rule out leukemia, only to have to tell her/him that you can't afford it -- either because you're uninsured, or because you carry a $10,000 family deductible and can't come up with your share of the cost.  Further, it's hard for me to imagine that you actually envision a world in which "too much" medical care is a bad thing, unless, of course, you're in the camp that believes that Grandma really ought to have to have her case reviewed by managers disinclined to spend money on an 80-year-old.  If you're at all "pro-life," you're not.  But you tell me.

Finally, I think that you and I would measure the moral strength of a country in different ways.  You seem to think that the market-driven, frankly discriminatory stinginess now evident in the way this nation deals with healthcare is not only a good business model, but an honorable way to have its citizens deal with each other -- and not as equals or as co-citizens, but in a hierarchical model that ensures that those in power, those who are not doctors, those who control the pursestrings and thus make life-and-death decisions that result in death, not life, are entitled to inflict a business model on people who are only "customers," disposable and easily forgotten.  I disagree.  The measure of this nation's moral character is when the gap between the have's and the have-not's, while evident in other areas, should never result in the acceptability of early death and prolonged suffering because it makes business sense to people whose healthcare needs are immune to the "silent hand of the market."  That, I'd never apologize for.  I'm just amazed that you and others would defend it.

Keely
www.keely-prevailingwinds.com

Date: Wed, 18 Jan 2012 11:35:41 -0800
From: jborden at datawedge.com
To: donovanjarnold2005 at yahoo.com; vision2020 at moscow.com
Subject: Re: [Vision2020] More Proof Preventative Health Care Saves

It sounds great... the math might be right, but I believe the human nature component is wrong... human nature changes when dealing with "other people's money".  

("Oh, if I had known you were paying for dinner, I would have ordered something more expensive...")

Putting the word "preventative" in the name doesn't change the way humans would react to and use it.  

If we had universal health care, it means that individuals would never see the benefit of money saved... they would simply be given a "blank check" in terms of their health care and how they care for themselves... and therefore dismiss risks with personal choices for their health.  

I can tell you first-hand my experiences on how human behavior changes as soon as fiscal responsibility to pay is shifted to the individual as opposed to a faceless 3rd party.

It's sounds heartless to say (and even harder to defend)... but in order to have people making GOOD decisions, you have to have examples of people making BAD DECISIONS.

Jay

From: vision2020-bounces at moscow.com [mailto:vision2020-bounces at moscow.com] On Behalf Of Donovan Arnold
Sent: Wednesday, January 18, 2012 10:56 AM
To: vision2020 at moscow.com
Subject: [Vision2020] More Proof Preventative Health Care Saves

Numbers show high cost of skipping your meds

Numbers show how skipping your meds can have serious health impact, financial consequences

http://finance.yahoo.com/news/numbers-show-high-cost-skipping-214621515.html <http://finance.yahoo.com/news/numbers-show-high-cost-skipping-214621515.html> 

"-Every dollar spent on medication decreases total health costs to patients, insurers and government health programs by about $10.10 for people with high blood pressure, by $8.40 for congestive heart failure patients, by $6.70 for diabetics and by about $3.10 for patients with cholesterol disorders."

And what idiots would pass up $3.10 to $10.10 return on each $1 invested? The same idiots that pass up universal preventive health care. The same idiots that believe it is better to pay $10.10 of taxpayer dollars in medical treatment tomorrow than to a give the person the opportunity of insurance to spend $1 on medication today. But when your interests lie with the person who gets the $10.10, only then it becomes clear why denying them the insurance to get the medication is the preferred action. 

Donovan Arnold                  

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