128 of 136 people found the following review helpful
Very Surprising Information on Individual Plans
, September 13, 2005
I am a V.P. at a large Tennessee-based third party administrator and typically work with sizable employers (over 250 employees). My interest was in gathering more information about the individual plan market and how it works. As the title suggests, the book is loaded with surprising information about the individual plan market.
First, I have to admit that I knew very little about individual plans (other than what is available at numerous Internet quoting sites) and was shocked to see how inexpensive individual plans are in many very large states. For instance, the average price of an individual plan in California is less than $200 per month (individual plans are on a monthly contract, not annual like group). If you live in California, this is a book you should pick up to learn more about individual plan rates there. Plans here in Tennesse are a little more expensive and the author did a good job of explaining why plans cost less across numerous states. If you are in New Jersey or New York or Massachussetts, it is clear that you are screwed when it comes to trying to find affordable insurance for you and your family. That is because the carriers are not allowed to underwrite you and therefore have to take the crack users with the marothoners and triathletes -- great thinking, NY and NJ! The result? Carriers price individual plans to the moon.
Second, the HSA is an excellent tax savings vehicle as it is one of the few government approved accounts you can put your money in tax free, use it tax free (for medical expenses) and take it out tax free. We administrate HSAs for many groups here in Tennessee and in North Carolina -- so that was no surprise. What was surprising was the availability of individual HSAs and how inexpensive they are -- again, depending on where you live. If you are self-employed, you owe it to yourself to look at an individual HSA just given how cheap the rates are. I suggest you read this book cover-to-cover and then go shop around online for plans to get the best deal.
Third, the author highlights the plight of small businesses in America and suggests that small business owners get out of the group business and move to a reimbursement model for employees to get their own health plans. I was not aware that most US bankruptcies are caused by medical bills and not credit cards. Even more of a shocker, the majority (forget the percentage quoted) were actually on a group plan when they got sick and started encountering major medical bills. So much for the protections afforded by getting insurance from your employer via a group plan. Most of our clients are self-insured -- which means they pay for substantial amount of their health care costs themselves. They use us to manage their claims. In Professor Pilzer's world, small companies would not need group insurance and would just give employees allowance to go buy what they want. An interesting idea that a small business owner may want to consider (after getting their 3rd major rate increase in 3 years).
The negatives to the book are that there are so many examples and cross chapter references that you will find yourself skipping around the book pulling information from different sections on numerous occassions. There is also almost TOO MUCH data and examples listed in the book. I realize the author wanted to support his claims (and he did), but the number of Tips and Hints was a bit overwhelming. I am in the health care business and I found myself having to go back and review sections more than once to make sure I "got it" and the accompanying charts and tips that are found on what seemed like almost every page.
The final negative is a call to action to "contact your Congressman and get them to remove themselves from the government health insurance program". Yeah, right. Like they are going to give up benefits for life. Perhaps this is why so many politicians do not understand the United States health care system -- because they actually are insulated from it by taking office and getting on some incredibly rich benefit plan. Most of my clients cannot afford such a plan and are getting priced out of the market. This book offers a "cook book" of what employers can do about it. I am not sure that bombarding your Congressman is going to have much effect -- they are set for life and are not like the rest of us.
The negatives are largely outweighed by the positives in the book -- not the least of which is the sheer amount of information and data from real world policy purchasers -- not some think tank guessing about what individual health insurance actually costs. If you want the most in-depth look at the US health insurance market, look no further as I am not aware of any other book that covers the entire marketplace and provides the latest info on new Health Savings Accounts. If you are self-employed or own a small business, this book will likely be enormously useful to you. Good luck.