The truth in humor

I have a great network of friends and colleagues, and they keep me amused with a steady stream of anecdotes and jokes delivered directly to my inbox. One recent arrival made me chuckle, then made me think:

Two patients limp into two different American Medical clinics with the same complaint. Both have trouble walking and appear to require a hip replacement.

The first patient sees the family doctor after waiting a week for an appointment, then waits eighteen weeks to see a specialist, then gets an x-ray, which isn't reviewed for another month and finally has his surgery scheduled for 6 months from then. The second patient is examined within the hour, is x-rayed the same day and has a time booked for surgery the following week.

Why the different treatment for the two patients?

The first is a Senior Citizen.
The second is a Golden Retriever.

While the story is meant to be humorous, it's illustrative of an important principle of consumer-directed health care. Why does the golden retriever get the special treatment? Not because he's a dog, or because vets care more about their patients than human doctors do. Rather, it's because veterinary care represents a model of truly consumer-directed care. If a patient takes his/her golden retriever to the vet and the vet leaves them waiting in the lobby for 45 minutes, you can bet that pet owner is going to be looking for a new vet! There are no "HMOs" or "Hospital Networks" or "Preferred Providers" when it comes to veterinary care. Services are generally paid for directly, without adjudication or reconcilliation. Providers compete for business, making them more aware of the need to keep costs in line and service levels higher.

Granted—there is a huge difference between health care for animals and health care for humans. The stakes are higher for human patients than they are for our animal companions, no matter how much we treasure them. However, this little joke did make me think.

At last a fuss about discriminating tax treatment of health coverage

The best outcome from President Bush's State of the Union speech last Tuesday night would be that more people think about having coverage and care about what it cost. There hasn't been a real consumer market for coverage options, since employers receive a tax deduction for the premiums they pay for their employees and dependents. Meanwhile, individuals and families that buy private health insurance outside of an employement situation don't have any tax advantages, like employers do, to buy coverage.

Just having this discussion at the water cooler, where workers congregate, or hearing it on the evening news has put this topic of appropriate level of health insurance coverage on the radar screen of many Americans. It's about time that those who are covered truly understand the costs associated with their coverage, and those not yet covered take the time to review the affordable options that exist in the emerging market.

160 million, or so, Americans have employer sponsored coverage. It is believed that 80% of them fall under the proposed tax deduction cap and the remaining 20% would be required to pay taxes on their more expensive coverage. The irony is that many of those who have the more expensive coverage, who would be subject to increased tax liability, are lower paid workers who may not be able to afford it. All the more reason to shop for the most appropriate coverage that fits the coverage needs of the individual, rather than the Also, the carriers offering insurance products will inevitably find ways to compete with consumer friendly products and policies to underwrite those applying for insurance.

We need all the incentives we can get to create a real market for health insurance and stop hiding the costs of premiums and treatment costs to consumers.

"Tectonic Shift" Anticipated

From today's "Managing Your Healthcare" newsletter by Don Mazzella, a very interesting article on some anticipated proposals in the upcoming State of the Union address. Huge news for individuals who purchase healthcare "off the shelf"! — Mary Hobson

Tectonic Shift In Healthcare Payment Landscape Being Proposed By President Bush

President Bush will propose a tax deduction of $7,500 for individuals and $15,000 for families regardless of whether they buy their own health insurance or receive medical coverage at work, according to published sources.

The proposal, to be announced Tuesday in his State of the Union address, has a two-fold purpose: reducing the cost of healthcare insurance for most Americans and providing an incentive for the uninsured to buy a policy.

While administration officials say the changes will not affect total tax dollar collections, the published reports are unclear as to whether the traditional exemption for employers who pay for healthcare will continue. At present, employers can deduct the cost of healthcare insurance for employees dollar-for-dollar.

Employees with policies costing above the $7,500 and $15,000 limits would pay taxes on the excess. Individuals and families who purchase healthcare insurance directly would, for the first time, have some tax relief.

Interview with bWell CEO Phil Micali

Published in "New York Business Group on Health Newsletter"
Volume 29, Issue 2, Fall 2006

Meet a Member—bWell International, Inc.

New York Business Group on Health recently spoke with Philip Micali, founder and CEO of bWell International, Inc.

Given the changing healthcare market place, how does your company help in easing the transition?
bWell was founded to help consumers gain more confidence about their health coverage and lifestyle decisions. Fundamentally, bWell links and forecasts consumer health assets with personal wealth assets over time (multiple years.) The company’s vendor-neutral interactive and personalized consumer learning tools enable individuals to gain more confidence about making health/insurance coverage decisions and lifestyle decisions.

Can you discuss specifically how health benefits are becoming more focused on the consumer?
Health benefits are becoming much more flexible and focused on wellness. Benefit plans are also more complex and difficult to understand because it is not enough to evaluate a health benefit plan in one-year increments. In addition, financial incentives are being paid to consumers who participate in healthy behaviors. This is a major departure from the defined benefit world of health benefits where a $10 copay was the only “skin in the game” that consumers had.

Also, health coaching has become the holy grail to changing consumer behavior in a way that can be sustained over time. Think about it: Did you learn algebra overnight? Did your fitness training take some time to sink in?

Can you describe how your company helps increase the quality and/or reduce the costs of providing healthcare?
bWell’s consumer learning tools improve quality and appropriateness by providing vendor-neutral education before the health plans come in and ‘sell’. I am a firm believer that consumer understanding and education must precede the ‘sale’ by the health plan to buy their coverage, even when there is only one health plan option. The integration of a thorough health and well being assessment (aka “health risk assessment”) within our learning tools enhances quality by making individuals aware of their personal health assets and how to manage them over time as aging occurs.

bWell drives cost savings as a result of its emphasis on vendor neutral understanding and education around the cost of ownership of various health plan options, along with the understanding of personal health and well-being assets. The consequences of implementing our products are direct claims cost savings, as well as higher productivity in the workforce -- the result of consumer awareness of the targeted areas of their health that require attention. As more people are aware and feel comfortable with Consumer Driven Health Plan options, including Health Savings Account models, employers can expect a halving of the recent historical double digit percentage medical claims trend. This represents substantial cost savings for all size employers.

What should a company look for when choosing a consumer education and learning tool firm?
Companies should look for health plan vendor neutrality and integration of health asset algorithms with wealth asset forecasting tools. In addition, incorporating plan suitability based upon consumer readiness for change is very important. We are talking about overcoming some emotional barriers to change. A firm should understand how an education service/tool synchronizes benefit plan branding with corporate values and brand. This serves to maximize the potential that messages are heard and acted upon.

How does NYBGH membership benefit your company?
bWell has been a member of NYBGH since its inception in 2004. I am personally very active in the Health Benefits Advisory Group. I find the participation and content of the NYBGH to be very stimulating and the ideal forum for a healthy debate about the proposed solutions to our ailing healthcare system.

Welcome!

Welcome to bWell International's new blog, "Your Health is Your Wealth." We hope, through this forum, to bring a new voice to the discussion surrounding the dynamic Consumer Directed Health Care industry.

Over the next year, we will be inviting guest bloggers from throughout the industry to post here, in addition to bWell International's executive team. Watch this blog for important industry news, events, and commentary. And join in the discussion -- we look forward to hearing your voice!

Happy New Year,
Mary Hobson, bWell International Chief Marketing Officer