Who is Responsible For Unsustainable Health Care Costs – Part I

Who is really responsible for the health care costs in this country? We have been conditioned to point the finger at Government, Private Insurance Carriers, or Medical Providers. We have heard the endless barrage of blame, the assault of accusation, and the fury of fault-finding between these parties for many months now. Each would have us believe that the others are solely responsible for the problems in our health care system. Without question, however, there is shared blame and joint accountability. In addition to the government, the large insurance carriers, and medical providers I would suggest three additional parties with culpability:1) health insurance brokers
2) employers and
3) you and I individually.There has been and will be plenty more said of the role that the first three parties have had in creating the current situation. My intent in this 3-part series is to expose the role of the latter three groups and suggest how these groups can actually become part of the solution.Health Insurance BrokersTo include brokers in this discussion may seem self-incriminating since that is my profession. However, I do so with a clear conscience because of the approach that my company takes when representing our clients. Just last week I was discussing trends of High Deductible Health Plans with one of our local insurance carrier reps. She told me that she had recently heard a broker tell her, “I will not sell that product to one of my clients.” The broker who made this comment was referring to a High Deductible Health Plan paired with an HSA and the comment was made in context of his commission. The carrier rep. was astounded that the broker would confess to not showing a certain plan to his clients because of the impact it would have on his commission.Utilization of a High Deductible Health Plan (HDHP) strategy will generate a substantial and immediate reduction in premiums – typically between 30 and 50%. You guessed it. The reduction in premiums means a corresponding reduction in commission for the broker. How many brokers are honest and ethical enough to suggest a strategy to their client that will result in a sizable pay cut for them? Unfortunately, that is the way the system is designed and it creates an inherent conflict of interest unless the brokerage firm is built on another model. A model that measures success based on savings achieved for their clients. Under this model, the broker will always look first to take advantage of the savings created by High Deductible Health plans when building a proposal rather than looking at them as a last resort or only if the client asks about these plans.The government has actually provided some very good options for employer-sponsored health care plans. Flexible Spending Accounts (FSA’s), Health Savings Accounts (HSA’s) and Health Reimbursement Arrangements (HRA’s) offer different ways to achieve premium savings and tax savings. If properly designed, these tax-favored plans can result in equal or better coverage for the employees at a lower cost to the employer. A properly designed plan that accomplishes these win/win outcomes must be done by a broker that specializes in the design and administration of these plans, not a broker that merely suggests them as an afterthought or upon request by the client.From the 2009 Kaiser/HRET Survey of Employer -Sponsored Health Benefits report, we gain insight into why employers have adopted HDHP’s and what the outcomes have been:
72% of firms offering a HDHP said the primary reason they began offering this option was to save on health care costs
49% of firms offering a HDHP reported that the most successful outcome has been the control of health care costs
An additional 27% reported that the most successful outcome has been the encouragement to employees to be better health care consumers (which, by the way, ultimately leads to lower health care costs)
82% of the employees enrolled in a HDHP reported being either very satisfied or somewhat satisfied with the plan while only 3% reported being very dissatisfied
Here are the surprising statistics:
Only 5% of the firms not currently offering a HDHP reported that they are “very likely” to offer a HDHP with an HRA in the next year
Only 6% of the firms not currently offering a HDHP reported that they are “very likely” to offer a HDHP with an HSA in the next year (The Kaiser Family Foundation and HRET, 2009, p. 166-167)Why are so few companies planning to start offering HDHP’s when the results have been so favorable for both employers and employees? Brokers have not done a good enough job of promoting these types of plans and educating their clients on the financial benefits of utilizing a HDHP. Whether due to lack of product knowledge or a desire to preserve their commission, there is fault with the brokerage industry for not being more aggressive with the positive health care reform that the government has already enacted. Brokers must be knowledgeable enough and ethical enough to recommend, design and implement these plans to benefit their clients. Employers need to find a broker who is knowledgeable and ethical enough to recommend, design and implement these plans for their company.ReferenceThe Kaiser Family Foundation and Health Research & Educational Trust (2009). Employer Health Benefits 2009 Annual Survey (Electronic Version). 166-167.

The Effectiveness of Distance Education Classes For Nursing Assistants

Distance education is a field of teaching that focuses on technology and instructional system design that aim to deliver education to students who are not physically on-site, in such programs teachers and students may communicate at times of their own choosing by exchanging printed or electronic media, or through technology that allows them to communicate in real time. Many courses of study have currently adapted some sort of use of non-traditional technology to assist students in their studies from non-campus based locations.Many professions in both the medical and nursing field are now beginning to catch up with other fields in developing on-line study and review program utilizing new distance education technology, with newer developing distance education, students may not be required to be present in a classroom. Older models of distance education utilized regular mail to send written material, videos, audiotapes, and CD-ROMs or other media storage format, such as SD cards given to the student and to turn in the exercises. Today’s distance education course makes use of E-mail, the Web, and video conferencing over broadband network connections for both wired physical locations and wireless mobile learning. Often the material is supplemented by television and radio programming.Distance education programs are sometimes called correspondence courses, however in most courses of study this term has been replaced by distance education and expanded to encompass more sophisticated virtual technologies and internet based delivery methods. Many educators ask if distant students learn as much as students receiving traditional face-to-face instruction. Research comparing distance education to traditional face-to-face instruction indicates that teaching and studying at a distance can be as effective as traditional instruction, when the method and technologies used are appropriate to the instructional tasks, there is student-to-student interaction, and when there is timely teacher-to- student feedback (see: Moore & Thompson, 1990; Verduin & Clark, 1991).Research indicates that the instructional format itself of interactive video and distance education vs. videotape vs. live traditional instructor has little effect on student achievement as long as the delivery technology is appropriate to the content being offered and all participants have access to the same technology. Other conclusions drawn from this line of research suggest that achievement on various tests administered by course instructors tends to be higher for distant as opposed to traditional students (Souder, 1993), yet no significant difference in positive attitudes toward course material is apparent between distant and traditional education (Martin & Rainey, 1993).Without exception, effective distance education programs begin with careful planning and a focused understanding of course requirements and student needs. Appropriate technology can only be selected once these elements are understood in detail. There is no mystery to the way effective distance education programs develop. They don’t happen spontaneously; they evolve through the hard work and dedicated efforts of many individuals and organizations. In fact, successful distance education programs rely on the consistent and integrated efforts of students, faculty, facilitators, support staff, and administrators. Many vocational healthcare fields are now beginning to explore the use of internet based distance education technology in basic level instruction and review programs. This is the case in a program that was developed by St. Augustine Nursing Assistant School to provide students with an introductory working knowledge to enter basic level healthcare occupations. However, students should consult with local governmental regulatory agencies and potential employers or future schools to assure scuh programs will meet their needs and ultimate goals. The quality of distance learning has greatly improved in the past few years, as both students and educators have become more comfortable with the technology and will without doubt play a major role in the education of many healhcare professionals in the future.