To say healthcare is changing would be an understatement. Depending on your preferences, you might call it good, bad, or varying doses of each.
One of the more interesting changes to me has been the insurance options. In 1988, 73% of covered workers used a conventional medical insurance plan. Another 16% and 11% respectively used an HMO or a PPO. By the time we arrive at 2005, only 3% of workers were still using conventional medical insurance plans while 21% used HMOs, 61% used PPOs, and 15% used POSs.
As the new high deductible, low premium, HSA-linked insurance plans became available in the last seven years, they quickly gained market share. In 2012, 19% of workers used them while less than 1% used a conventional medical insurance plan, 16% used HMOs, 56% used PPOs, and 9% used POSs.
The new high deductible, low premium, HSA-linked insurance plans have increased in popularity every year since their advent in 2006. Part of the reason is the new plan puts the consumer more in charge of the money. Instead of watching premium dollars disappear, the consumer watches fewer dollars go to premiums while tax-free dollars begin to amass in an HSA. That process alone empowers the consumer to shop more rigorously for all healthcare products and services. This is a positive change in healthcare that growing numbers of consumers are embracing.
On the other hand, not all healthcare changes are being embraced as warmly. For example, since the October 1 rollout of state-based insurance exchanges as dictated by the Affordable Care Act, consumers, insurance companies, and the states are finding numerous glitches in the system. Drew Armstrong and Alex Nussbaum describe the disaster (“If You Think Enrolling Is Hard . . . ” Bloomberg Businessweek 9/30/13–10/6/13, p. 36):
“Each night, healthcare.gov sends files on new enrollments to insurers. Some files are being transferred with missing data. In other cases, the information being transmitted is wrong; the file says a customer signed up for a plan that doesn’t exist in the customer’s area, for example. Some files are so corrupted that insurers can’t open them. The Department of Health and Human Services declined to comment.”
So how’s that working for you? I think I will decline to comment.