Saturday, November 21, 2009

With HSAs, Mammogram Frequency Is A Non-Issue?

The NY Times blog has an article "The Uproar Over Mammography," which links to a WSJ op-ed "A Breast Cancer Preview: The mammogram decision is a sign of cost control to come."

In a world of consumer-driven health care that includes Health Savings Accounts (HSAs), wouldn't this "uproar" be a complete non-issue? In that world, patients spending their own money could make decisions on their own, in consultation with their physician, about the timing and frequency of their mammograms.

Think about oil changes for your car. If the manufacturer recommends oil changes every 5,000 miles, but you decide on a different frequency - say every 3,000 miles or every 10,000 - that's not a problem. Now if your car insurance covered routine oil changes, and then the government introduced "government car insurance reform" with a "public option," then the frequency of oil changes would become an issue and could lead to an "uproar."

But in a world of consumer-driven health or auto care where consumers pay for routine maintenance or health exams, there's no "uproar," since consumers make decisions on the frequency of their oil changes or mammograms, and are directly responsible for the cost.

However, there's just one small problem - Senator Harry Reid wants to "kill consumer-driven health care" with the Senate's health-care "reform" bill (which would assault HSAs), read the WSJ editorial "The End of HSAs."

18 Comments:

At 11/21/2009 12:47 PM, Anonymous Anonymous said...

Democrat Party loves the Parental Relationship.
Accept, Cope and Obey.

 
At 11/21/2009 5:42 PM, Blogger OA said...

There's a huge mis-match between what people want and what's being interpreted in Washington.

So people want more jobs, and that's interpreted to mean people want the Administration to report what jobs it creates. Sorry, we could care less about what you can claim, we want jobs in TOTAL to increase. Saved or created is your made up standard to make yourself look good.

And when people say they want to keep their health plans, that's interpreted to mean they want their plan only if it's upgraded to meet some politician's view of what it should have. And increased cost is fine because it's a "better" plan.

My HSA is the best plan I've ever had. For the cost of a regular plan, I build up any savings in an account I own and control, rather than the insurers applying that money toward someone else's healthcare. Boggles my mind that people can, with a straight face, claim they're helping me by making me pay more for something else.

 
At 11/21/2009 6:16 PM, Anonymous Dr. T said...

I don't know why people are outraged by new recommendations for decreasing the frequency of mammograms. Mammograms are x-rays, and frequent x-rays can be harmful. Instead, people should be outraged at how mammography was over-hyped and overused in previous decades. Excessive mammography caused many unneeded biopsies and a few misdiagnoses.

 
At 11/21/2009 6:50 PM, Anonymous American Delight said...

Car insurance doesn't pay for maintenance & prevention, it pays after accidents. Why should health insurance cover routine, predictable doctor visits and health screenings?

If health insurance resembled the car insurance model which is (slightly) less regulated, then we wouldn't have to have these emotional debates about mamography.

You'd just pay for whatever tests you want whenever you want them!

 
At 11/21/2009 8:46 PM, Anonymous Benny "Tell It LIke It Is Man" Cole said...

Neihter party has really come up with a way to lower health care costs.
In fact, if procedures and tests can be dropped, such as mammograms, than they should be. If insurance companies are forced to pay for such tests. all of our bills go up.
Indeed, within the current context, the much maligned "death panels" are actually a great idea. There is no point in keeping the terminally ill aged person alive another week--but insurance companies or Medicare will pay for it, so hospitals bill for it, and no one wants to be accused of "pulling the plug."
I wish there was a choice--a national health insurance company, in which lawsuits were compelled into binding arbitration, old people were termiated humanely and quickly, and many wasteful tests, such as overdoing mammogragmas and pap smear were dumped.
And no keeping Terry Schiavo alive for years on end. Now, that runs into big bucks, paid for by others in the insurance pool.
I wonder how the R-Party call for national health insurance companies plays out against the backdrop of state's rights? Is the R-Party just engaging in its usual knock-kneed sniveling naysaying mode, or is that a serious proposal?

 
At 11/21/2009 11:15 PM, Anonymous Anonymous said...

For everyone there is a way to prevent a Terry Shaivo from happening to you, have you filled out a medical power of attorney, and an advanced directive? The medical power of attorney defines who will make decisions on health care for you if you can't do so for yourself. The advanced directive spells out what should happen if you are regarded as having a disease that you are unlikely to recover from or are permanently unconsious what kind of care you want. If Terry had filled out such a form, then there would have been no issue for the form is binding against relatives in all 50 states. It was filling out such a form that lead to the death panel controversy, because the republicans appear to not want people to make decisions on their own. What the provision would have provided was to pay your doctor to discuss the issue with you. These forms are downloadable by state, and generally require two non related witnesses to your signing. If one believes that there is often overkill in medicine (an ironic term) then if they don't want it to happen to them they need to take these steps.
Also discuss these issues with those given the medical power of attorney as well. (Actually a family discussion makes a lot of sense here)

 
At 11/21/2009 11:46 PM, Blogger PeakTrader said...

Dr T, it depends on "personal and family history of breast cancer...and other factors." A one-size-fits-all policy set by the government is purely a financial decision.

 
At 11/22/2009 4:23 AM, Blogger juandos said...

"Excessive mammography caused many unneeded biopsies and a few misdiagnoses"...

Well Dr. T I for one don't disagree but PeakTrader makes quite the salient comment...

The only thing I get from your comment initially is that mamography technology apparently has a long way to go before it can sort the wheat from the chaff...

Am I wrong?

 
At 11/22/2009 6:18 AM, Anonymous R4i said...

In response to Dr. T, I'm quite sure that the amount of radiation incurred by someone during an X-Ray (or mammogram for that matter) is minute and would not have any ill side effects.

To offset one flight to Europe from the U.S., you'd need around 150 X-Rays.

So with this being a non-issue, perhaps we should look into whether decreasing the frequency of check-ups risks failing to spot disease.

If this is NOT the case, then power to cost saving. But if it is...

 
At 11/22/2009 7:36 AM, Blogger W.E. Heasley, CLU, LUTCF said...

“The Uproar” is clearly an early indicator that health care recipients are more than a little worried about Central Planning. That their freedom to choose under a free market will be negated in Reid-Pelosi Scheme to replace a Free Market.

Also “The Uproar” is an indicator that health care consumers really do understand that when Demand and Supply do not intersect at Price, and Price is artificially manipulated, the only other mechanism to handle Demand and Supply comes into play: rationing.

 
At 11/22/2009 8:28 AM, Anonymous Anonymous said...

But what is a market price but a form of rationing, when demand = supply it implies that at a lower price there would be more demand, so there is rationing by price. One needs to state it more clearly, non price based rationing, some other method being used to determine who gets what is rationed. The whole point of the market system is to ration supply based on price.

 
At 11/22/2009 8:53 AM, Blogger W.E. Heasley, CLU, LUTCF said...

Anonymous:

Ok. Lets be clearer about rationing mechanisms:



http://thelastembassy.blogspot.com/2009/11/socialized-medicine-scheme-and-central.html

http://thelastembassy.blogspot.com/2009/09/socialized-medicine-pricing-scheme.html

http://thelastembassy.blogspot.com/2009/08/socialized-medicine-decisions-on-cost.html

http://thelastembassy.blogspot.com/2009/08/socialized-medicine-price-distortions.html

 
At 11/22/2009 10:43 AM, Anonymous Anonymous said...

So then the argument becomes which method of rationing to use the market or others. That is a somewhat different argument, a perfectly valid one none the less, but it is less loaded than the pure rationing one in that it admits there will be rationing by some means market or other. This latter argument does not play on fear to the extent that the simpler one does.
Of course stating the argument this way does not get the play on the fear mongering media that the alternative does. Fear is a great way to get ears and eyeballs to listen to/watch the adds you sell.

 
At 11/22/2009 11:59 AM, Blogger W.E. Heasley, CLU, LUTCF said...

Anonymous:

Agree.

We are now clear on this subject?

 
At 11/22/2009 6:03 PM, Anonymous Anonymous said...

W. E. Agree I do think it helps to get the element of fear out of a discussion, it allows more rationality in the the discussion. AS I noted earlier of course the media needs the opposite for their own purposes.

 
At 11/23/2009 12:16 AM, Anonymous Anonymous said...

Taxpayers are not going to be happy when they realize that they are paying for the cost of their healthcare for the elderly, the poor, the children and all of those Americans who do not pay taxes. Taxpayers will have reduced quality of medical care for themselves and their family and higher costs to boot.

 
At 11/23/2009 7:40 AM, Anonymous geoih said...

Quote from Anonymous: "The whole point of the market system is to ration supply based on price."

No, the price is just a subjective measure of value based on a mutual agreement between the buyer and seller. A market set price allows you to prioritize your preferences based on your own subjective values and decide what you prefer most (e.g., a mammogram or food or shelter or a new dress, etc.). The only rationing occurs in your head as you decide which thing(s) you will spend your limited resourses on first.

 
At 12/18/2009 2:48 PM, Anonymous Anonymous said...

If you choose a less frequent schedule for oil changes- you risk having to replace your engine sooner. If you cannot afford, and therefore choose a less frequent schedule for a mammorgram or prostate cancer check-up- you risk dying from cancer. BIG difference!

 

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