03/2001: The Pulse
More MSA Experiments in Africa
First it was South Africa, and now Zimbabwe is moving ahead on the Medical Savings Account (MSA) front. A new company, Sovereign Health Zimbabwe, has been formed to provide coverage to companies with 10 or more employees. The company is backed by the Anglo American Corporation, primarily a mining company, TAHoldings, and Medscheme, described as the "largest medical aid company in southern Africa." The company will use risk-based rating and will cover only "events such as hospitalisation or chronic medication." "Members who preferred more augmented coverage had the option to subscribe to a medical savings account," according to the article. (Africa News, February 9, 2001)
Opposition to Defined Contribution
Bob Bulla, CEO of the Arizona Blues, gives an example of the reactionary position on defined contribution in an article in the Arizona Republic. Bulla disagrees that there are problems in the employer-based system, and argues that defined contribution plans "could destroy the whole concept of insurance pooling," because "healthy people might decide to use the money for a car payment instead of buying insurance." (Arizona Republic, February 8, 2001)
Blue News for Patient Bill of Rights
A recent Hewitt survey of 600 employers found 46 percent would be likely to stop providing benefits if the Patient Bill of Rights expands their legal liability. Even without that, 22 percent are considering a defined contribution strategy and more than half "are considering other consumer-driven options, such as self-directed plan designs and multi-tier networks." It also notes that 54 percent support legislation to "change the tax code to enable an individual tax credit for the purchase of health insurance, an increase of 14 percentage points since last year."
To receive a copy of the 91-page Hewitt survey, call the Hewitt publications department at 847/295-5000 and request "Health Care Expectations."
Survey on Managed Care: Who Knows?
Another survey indicates that, while people may think poorly of managed care in general, they tend to like their own coverage. The Harris Interactive survey found that 69 percent of respondents gave their own plan an "A" or "B" rating, and only 8 percent gave it a "D" or "F." Seventy-eight percent would recommend their plan to a healthy friend, and 68 percent would recommend it to a friend with a serious or chronic illness.
Harris chairman Humphrey Taylor attributes the generalized unhappiness with managed care to "media-driven," not "experience-driven," concerns. Of course, the ratio of happy to unhappy is almost exactly the same as the ratio of people who rarely use health care and those who are ill enough to use it a lot. It's easy to be happy with a health plan you never use when someone else is paying the bill.
The Harris poll results are available on the Internet at www.harrisinteractive.com/about/vert_healthcare.asp.
Greg Scandlen is Senior Fellow in Health Policy at the National Center for Policy Analysis, located in Dallas, Texas. To sign up for his free weekly e-newsletter, send an email to HealthPolicyWeekfirstname.lastname@example.org. Scandlen can be contacted at GMScan@aol.com.