On Mon, Aug 17, 2009 at 5:45 PM, Andrew Crystall<dawnfal...@upliftwar.com> wrote:
> And in most cases, the likelyhood of you developing those conditions > is dependent on pre-existing conditions! I have not seen any evidence that suggests this. There are a large number of conditions that can result in a large increase in cost of health care, and many of them are not correlated. Having a heart condition is not likely to lead to prostate cancer, for example. > So it magically constantly decreases costs? No, read it again - the > trend is that it will be 3-5% cheaper than a "PPO" plan. Interesting that you would say that I should read it again. I have read the entire article carefully before I posted it. For example, I read these passages, twice now: | Beyond the first year cost savings with CDH designs, is there | is a continuing favorable effect on cost over a multiple year | timeframe? Traditional actuarial models assume that cost savings from | plan design changes are persistent over time (i.e., the differential | cost of a given benefit remains lower by a similar amount), but the | utilization difference for changes in cost sharing is not assumed to | compound or result in lower trends over time. It has been suggested | that the favorable utilization changes associated with CDH designs | may also create reduced demand for health care services over a | multi-year period and further reduce the ongoing trend when compared | with traditional plan trends. This reduced trend may not be unique | to CDH designs and may be a component of all higher cost-share | designs. However, unlike the first-year result, reduced multi-year | trends have not been established previously as a core actuarial | principle that is applied consistently to all plan designs. .... | Results for continuing cost-savings experience with CDH designs are | often difficult to interpret, but the studies do seem to indicate that | there may be a favorable effect on ongoing cost trends as well. Some | studies have combined multiple years of results together and indicated | that the overall trend over a two-year period has been less than the | corresponding traditional product trend over the same time period. The | Cigna study specifically identified the trend for the second year of CDH | plan experience and compared it to the corresponding traditional plan | trend. It found that the second-year trend in the CDH plan was nearly | 5 percent lower than the traditional plan trend. The Uniprise study | measured trend savings over a four-year period and suggests that the | trend for the CDH plan is about 3 percent lower per year on average over | the four-year period. | If this favorable trend effect can be further established as significant | (e.g., 3 percent to 4 percent or more per year) and persistent over | a multiyear period, this would be a strong argument for the further | adoption of these plans. There are few other alternatives available | to employers that demonstrate this degree of ongoing savings and trend | reduction. It is possible that the favorable trend effects currently | being observed are merely due to residual riskselection effects or other | factors that may cause this apparent trend to erode or disappear over | time as larger data sets become available. It is also possible that | this apparent trend-dampening feature of higher cost-sharing plans is a | consistent element of all plans (similar to the first-year effect which | has been well-measured), but one that has not been measured historically | because the differences in cost-sharing levels for traditional plans is | relatively small. Also, you seem to have ignored the substantial first-year savings: | the total savings generated could be as much as 12 percent to 20 percent | in the first year. >>Actually, a health insurance market without government interference >>would be a lot more consumer-driven than the current system, which >>is why I mentioned it. In nearly all cases, if there is to be a > > Howso? Competition for consumer business. > You've just empowered the insurance companies to do a lot more > cherrypicking of good customers and to jack rates up for everyone > else. No, I have not "empowered" anyone. I do not control other people. Other people are free to do as they wish without my interference in their lives. _______________________________________________ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
