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November 03, 2004



John, I witnessed this first hand when Jane and I had an MSA. Between the cost of the premium and the MSA contribution (which, by law, COULD NOT be 100% of the deductible!) it was still more expensive than a typical HMO at the time. Then there was the balance billing issue. I had a hospital-based outpatient test that cost $1,200, but the indemnity insurer only approved approximately $600 of it as UCR. Since I was basically identified by the hospital as a "cash patient," guess who had to write a check to the hospital for the balance? Now, network contracting could solve that problem, but one of the arguements for HSAs is the ability to go outside of a network. Reflecting back on the straight indemnity days, what occurs? High balance billing and six figure receivables.

You know me and my belief that it is important to get the patient back into the cost equasion of health care. I'm just not sure that this is going to work. Although most rates have not been published for 05 yet, from what I am seeing it appears that the risk-reward just isn't there. I would have to agree with you and Matthew.



It will not be a fringe product for long. It is a market reaction to a bubble that is going to burst. Part of the reaction is due to government's inability to make any significant corrections to where the system is headed. Employers cannot ignore the economic forces that face their company -- especially while government shows no signs of making any improvements.

I'm just saying...


And hey, didn't we have a major election last week. What does it mean John? Or aren't you ready to talk about it yet?

If not, I can appreciate it. I was in mourning for a full two weeks after my beloved Sox lost in '03. But I'm feeling much better now.

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