From The Health Insurance Lady

Why HSA Plans are better than Co-pay Plans

As an insurance broker, and RHU, who has specialized in helping individuals and small businesses get the best health insurance value they can qualify for for the better part of 20 years, I can not only say but I can PROVE that there are NUMEROUS benefits to choosing a HDHP (high deductible heath plan) along with an HSA –OVER a co-pay plan– and  not just for the young, rich and healthy, but for EVERYONE!

So called “experts” who  say that “co-pay plans are better for some people” especially those who are sick or elderly are just plain WRONG. The reason they are wrong is that the object of health insurance, like any insurance is to protect your assets against a catastrophic loss. With a co-pay plan you have no such protection as  your co-pays go on and on the sicker you get. Ten $50 Rx co-pays per month adds up to $6000 per year - JUST for Rx co-pays alone!

 Furthermore, it pays to sit down with the client and itemize the client’s healthcare needs and costs. Having them count towards a deductible, if the insurance is priced well enough is going to be much less expensive than having the insurance company pay for part of the costs under a co-pay arrangement. The roll of a good agent should be to find that definitive plan with a reasonable deductible and an affordable premium.

What you get with a HDHP and an HSA is 100% STOP-LOSS Protection after you meet your deductible and or total out of pocket responsibility. There is NO SUCH THING as TOTAL OUT OF POCKET RESPONIBILITY or 100% protection AT ANY TIME with a co-pay plan. Instead with a co-pay plan your losses get bigger and bigger the sicker you get (or the more you need real protection).

American’s have been given poor advice in my opinion regarding how to select a health insurance plan and sadly many health insurance agents aren’t doing a very good job of helping them. Many are just order takers for $10 office visit co-pay plans. However, when you add the higher costs of the insurance and the unlimited out of pocket exposure potential and compare that to an alternative that offers STOP-LOSS protection; tax savings; lower premiums and much lower bottom line cost — even after adding in the Deductible or total ouot of pocket costs, a properly selected HSA qualifed high deductible health plan is the ONLY WAY TO GO — FOR EVERYONE!

What your medical doctor did NOT learn in medical school.

Medical doctors are not omnicient saints who know everything there is to know about medicine. Instead they ONLY know about drugs and surgery as they have been trained in allopathic medicine ONLY and are ONLY trained to treat ACUTE conditions. Examples of Acute conditions: a gun shot wound; an injury from an accident; a stroke; a poisening; vomiting blood.

Medical doctors are NOT the experts when it comes to anything that is CHRONIC or DEGENERATIVE! Examples of chronic and degenerative condtions: asthma, allergies, high blood pressure, high cholesterol, Cancer, Heart Disease, M.S. Lupus, Chrones Disease, I.B.S. Diabetes.

If you have 6 months or more to live, no matter what the condition, the experienced Naturopathic Doctor is the doctor to go see. Going to a medical doctor for any of the above will not help the patient get any closer to getting rid of the disease or getting his health back. All the medical doctor will do is mask the symptoms. For example, a surgeon might cut out a cancerous tumor but, whatever CAUSED the tumor to get there in the first place HAS NOT CHANGED. It is the NATUROPATHIC DOCTOR that UNDERSTANDS CAUSES of disease and how, by ELIMINATING causes, YOU ELIMINATE DISEASE.

Go to the Medical Doctor to stablize your condition. Go to the Naturopathic doctor for a program to eventually help you get your health back and get rid of the disease altogether. If Americans only knew this and followed it, it would go a long way towards ending our health care crisis and controlling costs and people would TRULY being to live long healthy lives like we used to in the early 1900s — before we had the plethora of chronic and degenerative diseases we do today.

The truth about mammograms: They do more harm than good!

Unlike many of my colleagues in the health insurance industry who are like sheep when it comes to following the propoganda we are all fed by the medical establishment, I have done my research. I also have common sense and after decades of observing cancer rates deteriorating, obviously continuing the same mathods which should be all it should take for women, by now, to realize that mammograms do more to cause cancer than they do to prevent it.

First of all, mammograms have 1000 times the amount of radiation than a chest x-ray. (http://www.healingdaily.com/conditions/mammograms.htm). Women in the United States need to start thinking for themselves and stop “obeying” their OB-GYNs that prescribe regular mammograms. Chances are your OB-GYN has not read all the medical journals and is much more interested in running their practice (and making $$ and perhaps getting kick-backs on each mammogram prescribed) than he or she is in trying to do the best he or she can with their patients.

Secondly, false positives lead to unnecessary biopsies. In a study of 60,000 women, 70% of tumors  found  were  not cancerous nor were many of them tumors. (http://www.newstarget.com/010886.html)

Why risk increasing your risk of cancer when there are non-toxic more effective alternatives such as Thermograms, although they are not as widely available. Here are where you can obtain one: http://www.herbtime.com/InformationPages/Thermography.htm

Also recently  besides thermograms, MRIs have been suggested as a safer alternative to mammograms. http://findarticles.com/p/articles/mi_m0675/is_5_21/ai_112982437

Avoid these genetically modified foods to protect your health

Twenty years taking health insurance applications and watching more and more clients health decline at younger and younger ages combined with some health issues of my own has taught me that the food we eat makes a TREMENDOUS difference in our ability to maintain a healthy immune system and prevent chronic and degnerative diseases.

Eating anything that is not completely natural can not be properly assimilated by our bodies and is toxic. This includes genetically engineered or genetically modified foods(GM).

Today according to the American Agricultural Economics Association in their fourth quarter newsletter “Choices”, in 2005, it was estimated then that 60-70% of foods found in grocery stores accross the United States contained genetically modified ingredients.

Originally the FDA in 1992 was going to require labeling if food was substantially altered but it was NOT required to mention that this had anything to do with genetically modified ingredients being added- only that the food characteristics had changed. Then in 2001 this so-called labeling requirement was made voluntary which it continues to be today in spite of confirmed studies that GM peas cause lung damage in mice - (http://www.newscientist.com/article.ns?id=dn8347)-
 the off spring of rats that were fed GM soy died. In 1996 long term safety tests conducted by the UK government found rats that were fed potatoes engineered to produce their own insecticide “developed precancerous growths in their digestive tracts” and suffered “inhibited development of their brains, livers, testicles and partial atrophy of the liver, enlarged pancreas and immune system damage”. It was also determined that the damage was due to the genetic engineering process.(http://www.seedsofdeception.com/DocumentFiles/119.pdf)

In fact there are 65 documented health risks(http://www.seedsofdeception.com/utility/showArticle/?objectID=1040) described in a book called GENETIC ROULLETTE by Jeffrey Smith.

Which are the foods that are genetically modified? Here isa very comprehensive list on the Truefood.org website: http://www.truefoodnow.org/shoppersguide/guide_printable.html

Why Rhode Island can’t attract new small businesses to the state

Elected officials, including Governor Carcieri (with all due respect) in the state of Rhode Island continue to remain in a HUGE state of denial when it comes to their perception of how desirable the state is to prospective businesses when considering states to relocate to. What they continue to ignore is that our state has one of the WORST health insurance markets in the country with among the highest insurance costs and the FEWEST CHOICES of plans of any other state!

Considering health insurance costs are the second highest expenditure an employer has next to payroll, it isn’t surprising other states are more appealing to small businesses! Why is this concept so difficult for our leaders to understand??

80% of states in the rest of the country have vastly more successful health insurance industries which makes many of them tremendously more desirable places to do business in. These states all have certain commonalities when it comes to state health insurance legislation that make their health insurance markets thrive that states in crisis, like ours, MA, NY, NJ, VT, and ME tend to continue to ignore or resist implementing in their state. Instead we in the northeast, think we know BETTER and continue to try to reinvent the wheel while only  making things worse. 

The sad thing is, the Rhode Island Association of the National Association of Health Underwriters in 2003 and 2004 arranged for national government relations experts from a leading national health insurer, Fortis, to sit down with Governor Carcieri and point out what changes to Rhode Island’s health insurance regulations would be necessary to bring carriers back to the state; increase competition; increase choices and drive costs down. As the ongoing legislative chair and past president of the chapter, I was at that meeting and ensuing meetings and helped coordinate them with Senator Marc Cote who was willing to sponsor the needed legislation.

After hearing detailed explanations and proof of other states that pulled themselves out of health insurance crises, similar to the one Rhode Island is in, due to poor state health insurance regulations, Governor Carcieri should have been willing to publicly support these changes and strongly urge the legislature follow through and pass them rather than taking a back seat and deferring to the then Senator Elizabeth Roberts who slowed everything down.

Despite the less than enthusiastic, rather non-existant public support for proven reforms, Governor Carcieri left the impression with Fortis’ Director of Government Relations, at the initial meeting, that he was appreciative of the advice and efforts and wanted to move forward with the reforms right away. This led to the needed legislation being created and a committment that two national carriers Time Insurance and John Alden Life Insurance Co would return to Rhode Island once the reforms - (establishing a high risk insurance pool in the individual market; fixing the managed care rules under the Health Care Accessibility and Quality Assurance Act that don’t differentiate between a managed care company and a non managed care company and require any health plan in the state of Rhode Island follow rules designed for managed care companies –which is the reason, Rhode Island no longer has any national non-managed care companies doing business in the state– and fix the filing regulations).

Anyone would think a state with a health insurance market in as dire straits as ours is in would be ready to do WHATEVER it took to make things better — even if it meant getting rid of reforms that were supposed to make things better that are actually  making things worse— but NO! Even when an opportunity presented itself on a silver platter to double the number of insurers in the state, by passing legislation which were certain to attract even more insurers to our state, there was opposition. Attorney General Lynch was flatly against changing the filing rules which was a deal breaker. Senator Cote, not wanting to face anymore opposition, withdrew the bills which were Rhode Island’s only realistic hope to recover from its health insurance crisis and bring carriers back to the state.

The next mistake Governor Carcieri made was to allow his new health insurance commissioner appointee, Chris Koller to seemingly make all the policy decisions concerning the health insurance industry in the state. When as a regulator, regulating is what he should strictly be doing. Additionally he could be learning a great deal from his colleagues in other states with successful insurance markets.  Rather than learning about what is proven in other states with a view to doing the same in Rhode Island,  our health insurance commissioner was given the freedom by the Governor to design a new health plan “The Pledge Plan”  that both United Healthcare and Rhode Island Blue Cross are required to offer. 

Being REQUIRED to offer a plan that, you as an insurance carrier did not create yourself,  is just ANOTHER example of Rhode Island leaders making the health insurance industry less desirable in a whole NEW WAY to potential health insurers who might possibly return. No other state does anything like this!

Especially for anyone over the age of 40 this health plan which is supposed to be so competitively priced is actually MORE expensive than plans that already existed with both carriers!

I wonder how much of Rhode Island tax payers money was wasted coming up with this new “reform” which I’m sorry to say, just like all the other “health care reforms” Rhode Island has come up with  on its own is not a panacea.

When will Rhode Island leaders admit that they have a TERRIBLE track record when it comes to health insurance reform (and so does Massachusetts by the way)? If Rhode Island leaders were smart they’d LISTEN, LEARN and DO what those states that actually have MANY insurers doing business in their states offering both individuals AND small businesses a plethora of truly affordable health plans.

It is easy to find out what states these are. All one needs to do is go to a national health insurance quoting site and inquire about rate and availablility of plans in different states… or contact an independent insurance agent in Rhode Island who can generate quotes  in different states from national carriers.

Until Rhode Island leaders have the sense to do what has already proved to work in most of the rest of the country instead of CONTINUALLY trying to be different AT THE EXPENSE OF RHODE ISLAND INDIVIDUALS AND SMALL BUSINESSES, we can realistically only expect the health insurance situation for the aforementioned to get worse.

Bad states to live in for health insurance availability and afforability

Bad states are: Rhode Island, New York, New Jersey, Maine, Vermont, Massachusetts.

Of these the only states that at least offer short-term medical insurance which can be used as an affordable alternative to cost prohibitive renewable plans are Rhode Island and Maine.

Those of us who want to see these states improve the health insurance choices and costs have to have our elected officials do these things: 1) Establish a high risk health insurance pool in the individual market so those highest consumers of medical care can obtain their coverage through the pool and those in fair to good health can get their plans from private insurers in the private market.

Not having a high risk health insurance pool for individuals is a deterrent to health insurers with individual plans. States without a high risk pool essentially have no individual market. Individuals and families can’t call an agent to help with with coverage because no carriers are willing to pay an agent to help individuals and families with coverage. They are left to fend for themselves. In RI, ME they can at least obtain short-term medical insurance through an agent but in the other states people must settle for the crumbs that the few carriers that do do business in their states are willing to provide and pay astronomical prices for coverage.