Month: August 2009

by Patrick Appel

South Park puts its un-aired pilot episode online.

by Patrick Appel

A reader writes:

I am an account manager at an insurance brokerage, dealing specifically with group (employer-based) benefits. In response to the Heath Savings Account/Flexible Spending Account reader– unused FSA funds are turned over to the employer.  Employers may do whatever they wish with it. Most of our clients turn it into the employer-paid portion of the insurance premium. Some forward-thinking companies are putting that money towards an employee-wellness program.  In my opinion, this is the smartest choice, as it is a value-added benefit for employees, positively affects the company's bottom line, and no matter what happens in Washington with healthcare, wellness is important.

This has been an interesting time in our office.  I am a Republican, who happily voted for Obama, and have an Obama magnet on my car.  I am constantly surrounded with comments on what "my President" did now to screw up our lives.  I have explained to my boss that we just have a different paradigm for viewing this issue.  He is looking health reform from a business perspective, in insurance.  Perfectly understandable, since that what he does for a living.  I am looking at it from human rights perspective.  My insurance job just pays my bills so I can do what I really love- run a non-profit that provides free arts education camps and workshops to children that have experienced either a natural or a socio-economic disaster.  I have the very interesting position of seeing both sides of the healthcare issue intimately.  I don't know that there is one right answer.  I do know that the issue is more complex than we often see.  A little bit of basic "walk a mile in another's shoes" could go a long way. 

by Patrick Appel

Josh Green profiles a friend in the zombie business:

by Robert Wright

Did Jesus really say "Love your enemies"?

by Patrick Appel

A reader writes:

I do risk management for a number of different industries, and what I do includes selling commercial insurance – including health benefits, and HSAs and HSRs. I have been hearing a lot of talk recently about HSA's being held up as an example of why reform is not needed as a way to control healthcare costs, especially from a local radio guy.  As an insurance professional, I'm here to tell you that believing this underscores a lack of understanding of basic insurance principles.

Its true, of course, that if you are a younger, healthy person that accessing a HRA is a great way to save money.  You are, in essence, betting (literally) that nothing catastrophically bad will to your health in the coming year.  If nothing does, you save a bunch of money.  And even assuming that you will eventually have something bad happen, the money you will save in previous years where you've been just fine still means you're way ahead of the game.  So it really works to drive down costs – for a single person, for a limited amount of time.

But health insurance isn't a fancy bureaucratic way of billing you for your medical procedures; it's a way of spreading risk so that those who have bad losses have those costs subsidized by the vast majority who don't.  If a significant percentage of our country's healthy population all decided to commit to HSAs, one of two things would happen: One is that they could succeed in some way in keeping their costs separate from the unhealthy.  Were that to happen, the costs of providing coverage to those who needed it would rise astronomically; no one who needed costly care would actually be able to afford the premiums needed to cover that care.  The second, more likely possibility, is that the healthy HSA folks would not be able to separate their costs from the rest, and so to compensate the premiums of what is now a low cost HSA system would balloon to compensate.

You may think you can dodge the costs in an insurance system, and you might be able to for a few years.  But unless you drop dead at an early age, eventually you will pay back what you’ve saved, because that’s the way insurance works.

Believing otherwise is akin to believing in the tooth fairy.

 
A civet is eating coffee during the production of Civet coffee, the world's most expensive coffee in Bondowoso on August 11, 2009 in East Java, near Surabaya, Indonesia. The coffee, also known as Kopi Luwak, is produced by the civet (a small squirrel-like arboreal mammal) which eats the coffee berries or red coffee cherries, the beans inside which pass through its digestive tract, expelling them undigested as faeces. The faeces are then cleaned, dried and lightly roasted to make the coffee. Coffee from Indonesian civets is considered to have the best aroma, and it is the unique enzymes in the civet's stomach which give coffee its bitter taste. It retails for USD100 to USD600 per pound but only around 1000 pounds make it to market each year and supply is very limited. A small coffee house (Heritage Tea Rooms) near Townsville sells the coffee for AUD50 per cup, alongside limited international stores such as Selfridges in London. By Ulet Ifansasti/Getty.

by Chris Bodenner

"We're not worried about the detainees getting out; we're worried about sleeper cells getting in [Fort Leavenworth]," – one of my elementary school teachers who still works on base.

by Patrick Appel

Two Senators battle on Twitter.

by Patrick Appel

A reader writes:

In my last job I had an an HSA plan and I loved it.

We are a family of three, my wife and I were then in our late thirties, healthy and with a new son.  My paycheck deduction for health care was going to be ~$400/mo no matter if I went with an HMO, PPO or an HSA plan.  However under the HSA, the $400 was put into an account under my control.  The insurance company got the employer contributed portion.  My account was more or less like an IRA.  Money could accumulate year after year and after I turned 65, if there was money left in the account I could take it out.  Otherwise, my wife and I were issued debit cards from that account which we could use to pay for any medical item, like doctors visits or Tylenol at Walgreens.  No messy reimbursement forms.

The deductible under that plan was about $5000/year.  But that did not mean that I was paying the first $5000 of our medical care.  Just like any other non-HSA plan, the rates were negotiated, doctors visits had small co-pays, prescriptions were $10, etc.  But, if there ever were to be a situation where the deductible would come into play, I would already be contributing $4800/year (12 * $400) from my paycheck.  If not, that money did not disappear at the end of the year like in an FSA.  By the end of year two, allowing for normal expenses, I could have $8000 in the account, etc.  And I could spend this money on any medical expense I wanted, including glasses, Lasik, etc.

With my current employer, I am back to a "normal" plan, with a $3500 deductible, my paycheck deduction goes to the insurance company regardless of what happens, and I need to put on my 'clairvoyance' hat every January to guess how much to put into the frustrating FSA plan, knowing that if I guess wrong, at the end of the year, any remaining money in the FSA plan goes 'poof.'  During the year, it is usually a frustrating experience whenever I submit reimbursement claims to the FSA plan.

Here's a question for your readers, where does the unused FSA money go and on whose bottom line does it appear?