Stanley Feld M.D.,FACP,MACE
I received several comments in recent weeks highlighting the hardships employers face trying to provide healthcare insurance to their employees. Employers, and individuals who want to buy individual insurance have been deceived by the healthcare insurance industry. Many associations subcontract healthcare insurance companies to provide healthcare insurance for the association membership. However, the healthcare insurance is expensive and deceptively limited. People think they are covered until they get sick and discover they are not.
The healthcare insurance industry and congress have blocked the ideal medical savings account concept for years. Why has congress been so stubborn? MSAs were introduced by the Golden Rule insurance company at least a decade ago. Congress has been influenced by healthcare insurance industry lobbying to block the concept of individuals owning their healthcare dollar and also receive a pretax dollar tax exemption for buying their own healthcare insurance policy. I also do not believe that many of the members of congress want to understand the power and intelligence of the consumer.
In my naïve younger days, I simply could not understand why congress would be opposed to such a logical plan. It would eliminate 150 billion dollars of administrative waste in the healthcare system. My problem was I was not aware of the excessive influence the healthcare insurance industries lobbying groups have on congress.
Lobbying groups in general wield more influence than the will of the people in the daily activities of government simply because they have more money and are more focused than the individual. Previously, I spent a lot of time on TXU’s desired to pollute Texas even further with “Dirty Coal Plants”
and the subsequent acquisition of TXU by KKR with KKR’s promise to discontinue the pursuit of dirty coal plant permits.
This past week it was published that TXU and KKR spent $17 million dollars just to get its merger passed and work its way toward building dirty coal plants in Texas. Imagine how much the healthcare insurance industry pays lobbyists.
It is a true goliath against a weak and divided foe, namely patients (the consumer). Consumers do not get activated unless they are affected. Only then to they want to do something to solve the problem. The problem is only 20% of consumers are sick at any one time. We do not anticipate that we could be affected any day now.
It took the healthcare insurance industry four years and many millions of dollars to have firms like Cooper Lybrand and Price Waterhouse develop schemes that would counter the potential effectiveness of the Ideal Medical Savings Account. They developed the concept of the Health Savings Account. The HSA kept the premium dollar in the control of the healthcare insurance companies. The healthcare dollar does not belong to the patient. The healthcare insurance industry robbed patients, physicians and hospitals of incentives to be innovative in order to repair the healthcare system by being competitive.
United Healthcare bought the Golden Rule Insurance Company. It immediately destroyed Golden Rule’s medical saving account product. UnitedHealthcare has converted Golden Rule’s MSA to an HSA. I cannot understand why the health policy experts who advocated MSAs are satisfied for the now. Their argument is this is compromise. It is a step in the right direction.
To paraphrase the great German philosopher Fredrick Hegel “An ineffective step in the right direction is worse than no step at all. If the ineffective step fails then you will never created the correct concept.”
I will add, especially if the step in the right direction is a purposeful step in the wrong direction. HSAs are destined to fail, in my view, because they do not put the consumer in charge of his healthcare dollar.