Does Vanguard offer MSAs?
Do any brokers such as Merrill Lynch offer MSAs?
Are you aware of banks that offer MSAs?

The reason I ask about "MSA" information above is that existing IRA or ARCHER MSA trustees or custodians are automatically approved for Health Savings Accounts.

Have any of you had contact with insurance companies offering HSAs?

Thanks,

Unkie

"Chip G" <NOSPAMchipg_98[at]ATyahoo.TODELETE.com> wrote in message
news:AhkLb.295$8H.3488[at]attbi_s03...
- quote -

There are thousands of online sources. Do a search for the admiral. You'll
find all you need.

Brent D. Gardner, ChFC
Chartered Financial Consultant
http://members.cox.net/brentdgardner1378/

"Be ever questioning. Ignorance is not bliss. It is oblivion. You don't go
to heaven if you die dumb. Become better informed. Learn from other's
mistakes. You could not live long enough to make them all yourself." - Hyman
George Rickover (1900-86), Admiral, US Navy, advocated development of
nuclear subs & ships

The Chartered Life Underwriter (CLU) and Chartered Financial Consultant
(ChFC), designations owned and exclusively offered by The American College,
signify the highest standards of academic study and professional excellence
in the financial services industry.

"Brent D. Gardner, ChFC" <bgardner20[at]cox.net> wrote in message
news:0yfLb.9069$zf.975[at]okepread05...
- quote -

Any idea where I can find a referencable quote for the statement above? I
especially love the "You don't go to heaven if you die dumb" part and would
like to use it but need a documented source for my purpose.

Thanks!
Chip

This thread has drifted away from issues relating to general financial
planning.

Please either direct future posts to the appropriate medical
newsgroups or bring the thrust of the posts back to the financial
planning arena. Thank you.


-HW "Skip" Weldon
Columbia, SC

"Brent D. Gardner, ChFC" <bgardner20[at]cox.net> wrote in message
news:0yfLb.9069$zf.975[at]okepread05...
- quote -

I guess I'm again confused. This sounds exactly like the health insurance I
currently have. I don't see anything has changed. If you live in rural
America, there is no such thing as an HMO. The only limitation in providers
is the geographic area in which you live. These policies are still here,
alive, premiums being paid. The premiums are not flat, rather they are
escalating.

Elizabeth Richardson

Caroline wrote:
- quote -

Road trip to Salem, anyone?

Caroline, Brent...you're both sticklers for data...could you
substantiate the claims that mental illness is "often affected greatly
by lifestyle choices," that "the number of people who are truly mentally
ill is very small," that treatment of mental illness "doesn't work," and
that therefore it shouldn't be treated "the same way any disease would
be treated" (i.e., mental illnesses are not bona fide diseases)?

Also, if you're able to find such data, could you then reconcile your
apparent position that these treatments shouldn't be paid for, with the
fact that a lot of money is spent treating countless "unusual" diseases,
and for other expensive treatments that are largely ineffective (such as
certain cancer treatments, late-life procedures, and virtually all
experimental procedures before they are perfected)?

I see this thread as an example of a cultural bias against recognizing
mental illness as an ailment of the nervous system, rather than a
behavioral problem fully in the control of the afflicted. Remember,
people used to be burned at the stake for dementia, and now we prescribe
Aricept. You don't want an insurance system that covers that? Why would
you think that YOUR brain, by far the most complex organ in the body,
would be less susceptible to malfunction in the future than your other
organs? Until its operation is better understood, won't you want the
best available treatments?

My point is, we need to count on a system of insurance that pays for
treatment of mental illness, the same way it needs to pay for Spina
Bifida, the same way it needs to pay for interferon. Segregating out
treatment/coverage for mental illness would be a sad step backwards.
Many of you reading this post (or your families) are going to be hit by
it, if you haven't already. If you think it's unusual to have a "real"
illness, you might be basing the observation on media hype about
Ritalin-disciplined kids or Prozac as "mother's little helper." And if
you think treatments are ineffective I suspect you haven't seen what
happens when a manic depressive doesn't receive Lithium. (a relatively
uncommon mental illness...1%+ of the US population, according to NIMH -
that's only, what, something north of 2.8 million people?)

-Tad

"Brent D. Gardner, ChFC" <bgardner20[at]cox.net> wrote
- quote -

I think it's quite likely true they don't get the best care for the money they
pay.

I have witnessed it myself.

- quote -

I cannot think of a medical malpractice suit where the plaintiff was not
insured.

I think insurance companies looking to reimburse costs lost on a plaintiff drive
the fray of lawsuits as much as the actual person physically harmed by the
alleged medical malpractice.

- quote -

The above is an argument that favors having uninsured people on one's client
list.

It doesn't support your point.

But I agree this accounting is largely chicanery and capricious from one
provider to the next.

- quote -

What I have read recently is that people are so fed up with health care costs
that they are ready to break the law.

E.g. several states and communities are planning on re-importing U.S.
manufactured drugs via Canada. The drugs are much cheaper because the Canadian
government refuses to pay the U.S. manufacturers more than a certain amount. Yet
the U.S. drug manufacturers accept the low price.

E.g. health care providers who are out of network and who are supposed to
collect an insurance company- required co-pay from a patient are often not doing
so. Why? Because what they get from the insurance company ensures plenty of
profit.

These examples are both from recent NY Times articles.

- quote -

Lot of folks disagree with you. No matter what you say. ;-)

I blame them but also agree other factors you describe are at fault, too.

Everyone's greedy, particularly at the higher ends of the income spectrum.
Insurance co. executives are no more removed from this than a $250,000 a year
surgeon, $120,000 a year psychiatrist or $150,000 a year lawyer.

As I expect will become usual, this will likely by my last post responding to
your remarks on this subject.

"Brent D. Gardner, ChFC" <bgardner20[at]cox.net> wrote
snip
- quote -

I don't think the requirements for covering mental/MNDA health care are nearly
as sweeping as you suggest.

There seems to be a movement, particularly and not surprisingly by mental
health care practicioners, to treat mental illness of any color the same way any
disease would be treated. This for-profit lobby reasons that, 'Damn right
physical health insurers should pay our patients' (psychotherapy;
anti-depressant drug; etc.) bills. Even if we can't prove that our treatments
work.'

- quote -


- quote -

snip
- quote -

Some of the blame does belong with insurance companies. Insurers should be
arguing tooth and nail for mental health care providers to prove that their
treatments work. Insurers should inform prospective clients of resources that
discuss the efficacy of different treatments and how partaking in them can
affect their premiums for the long term. I realize the law undoubtedly has some
restrictions on insurers pressuring clients to take one route or another when it
comes to their health care; yet the simple fact is insurers are allowed to
pressure clients in many ways.

Lastly, I think the reason insurers don't complain more about mental health care
is because, bottom line, it's more revenue for them.

"Michael T Wing CPA" <mtwingcpa[at]yahoo.com> wrote
- quote -

Okay. This reinforces exactly some words of wisdom a relative of mine was giving
me on the subject recently.

- quote -

Okay, I understand.

I agree it makes complete sense for the consumer to have ready access to
different billing rates at hospitals, so the consumer can shop around and let
the markets work.

I have never heard of anyone doing this but hope more people are.

- quote -

Cool.

I wonder what sort of law might back you up in obtaining the necessary
information from the health care provider(s).

For the last couple years I'd say, the New York Times has been routinely running
front-page online headlines a couple times a month on one or another health care
issue, which almost always boils down to how screwed up the system is,
economics-wise, and how the ordinary consumer is getting stepped on.

Your story and like stories deserve some serious professional investigating and
reporting. Maybe I'll email the Times and propose it. They seem to have a
somewhat regular stable of reporters working on this subject.

"Michael T Wing CPA" <mtwingcpa[at]yahoo.com> wrote in message
news:btk4va$7lk8d$1[at]ID-42614.news.uni-berlin.de...
- quote -


Can you say "De-mutualization?"

"We need access to capital so we can grow!" says Ma Mutual.

Horse Puckey! Big mutuals have a printing press in their basements, and they
mint US currency. They don't need capital, they WANT capital. Moreover, they
want stock and stock options for the big kahunas. I've never quite
understood the Mutual Holding Company concept. The Mutual owns 51% of a
non-public stock company. Who owns the smaller half? Who would want to?

Well, since one can't buy a participating policy from them anymore, ANYBODY,
if they live long enough, will end up with control. Why? When those
participating policy holders are gone, there won't be any 51% left. It'll
all be in the back pockets of some MBAs who spent their lifetime trying to
bilk policy owner money out from under them. Legalized larceny is what it
is.

There are some philosophical reasons why mutual companies make sense for
permanent life insurance. Sy Sternberg, CEO of New York Life calls it the
"stewardship" principal, and I think many companies have lost that part of
their compass. A contract that can last upwards of 100+ years needs to be
managed for the benefit of the policy holder, and I'm not sure that a public
company can do that. There is a reason why Met, Pru, Hancock, MassMutual,
Guardian, Northwestern Mutual, etc. got to be so big, while stock companies
were usually a distant second in size. Mutuals, historically, delivered the
best long term values for the policy owner. Alas, those days are perhaps
gone. Some mutuals left, but not many. I sell for several of the remaining
ones.

Our local Blues are trying to sell themselves to Anthem, which is in Indiana
or Illinois...I can't remember. They are losing policy holders faster than
one can count, and are sucking wind (have been for a while, but that's
because they "bought" so much group business for so long). Our governour
used to be the insurance commissioner, and she quashed it. I'm pretty sure
that the exit strategies for top execs is why they are looking to merge.
Golden parachute, where art thou?

Brent D. Gardner, ChFC
Chartered Financial Consultant
http://members.cox.net/brentdgardner1378/

"Be ever questioning. Ignorance is not bliss. It is oblivion. You don't go
to heaven if you die dumb. Become better informed. Learn from other's
mistakes. You could not live long enough to make them all yourself." - Hyman
George Rickover (1900-86), Admiral, US Navy, advocated development of
nuclear subs & ships

The Chartered Life Underwriter (CLU) and Chartered Financial Consultant
(ChFC), designations owned and exclusively offered by The American College,
signify the highest standards of academic study and professional excellence
in the financial services industry.

Brent D. Gardner, ChFC <bgardner20[at]cox.net> wrote:

- quote -

Yep, that's exactly the deal. Except the particular policy in
question is new within the past few months. It features higher
payment amounts than I've seen on similar policies in the recent
past, and is intended to provide reasonably "full" coverage (not
merely a supplement to other policies). My "guess" is that its
scheduled coverage amounts represent about 60% - 80% of what you
might expect to be billed. But, the latter point (how much I
would be billed) is what I'm trying to ascertain. <g
- quote -

How about this: One of the Blue Cross affiliates in my area that
has always been organized as a "not-for-profit" is trying to
reorganize as a public investor owned company. It is painfully
clear that the only reason for doing this is so that the officers
(several already making over $500,000) can offer themselves stock
options.

Who is to blame for THAT ??? <g
MTW

"Michael T Wing CPA" <mtwingcpa[at]yahoo.com> wrote in message
news:btjtqq$88uf4$1[at]ID-42614.news.uni-berlin.de...
- quote -

Michael,

What you describe sounds a lot like the old Menu contracts from the good ol'
days. Before the dawn of "comprehensive" coverage (what I call "blank check"
policies), health insurance was in the form of a menu.

For example, if you had procedure X, the contract might specify $1,000
benefit, after deductible of $200. If the provider charged $1,200, you paid
your deductible and everyone was square. If the provider thought he was
worth more, you and the provider had to negotiate, or you could move on.

- quote -


Why did we change?

First, the tax code. When the board of directors for GM goes to the
president in the 1950s and says "We'd like to give you a raise" - the CEO
says "Nothin' doin'! I can't spend it anyway! Give me perqs and freebies."
The marginal tax bracket was 90%, so a cash raise wasn't worth much. So,
instead of trying to control the cost of insurance, the competition was to
deliver the BIGGEST benefit, no matter the cost. The big corporation was
paying for it, so people soon forgot how much the stuff costs, and they got
used to the blank check benefit plans.

Second, de-regulation of licensed professionals. The term "ambulance
chasers" isn't an exaggeration, if one looks back a few years. If memory
serves, the year was 1974 when lawyers could start advertising. Now we have
"ambulance chasers" on TV, with informercials all night, full page ads in
the phone book, and billboards across the street from hospitals "Hurt? Call
us! We'll get you a LOT of money!" Solicitation of litigation is the
national passtime for many lawyers.

Third, no limits on liability. Our legal system is effectively a legal
lottery. If you have a good target, you don't even need to suffer a loss, in
order to get a settlement. You just have to file. We need tort reform.
Frankly, I'd like to see "loser pays." Punitive damanges are a joke. Who pay
s those damages when they "punish" a corporation? The stock holders! Who do
they pass the cost on to? The consumers! So, who is getting punished with
these so-called 'punitive' damanges? EVERYBODY! Hence, the litigation lotto!

Fourth, mandatory coverages for lifestyle choices. For example, MNDA
coverages (that's Mental, Nervous, Drugs and Alcohol). Two of those are
lifestlye choices, and the other two are part of the new psychology where
every symptom has a disease (and are often affected greatly by lifestyle
choices). The number of people who are truly mentally ill is very small, but
the number getting treatment is fantastic, and growing. Insurance companies
have analyzed claims, and guess what? Lifestyle choices are RARELY cured by
treatment. Treatment is more often that not, a MYTH, but the various states
and federal government have seen fit to mandate coverage. MNDA coverages
accout for fully 40% of health insurance costs. Think about that for a
moment. FORTY PERCENT! Would you like to see a 40% premium decrease? How
about giving us the choice to opt out of lifestyle choice coverages and
government mandates? I'd sign up yesterday.

Fifth, lawyers working both sides of every litigation equation. Sometimes,
we need to be human and act like people with each other. For example, the
VA, or Veteran's Administration. Their hospitals are notorious for being a
place to avoid. There is one exception -- the one in Lexington, KY. They
implemented a program about a decade ago to curb litigation. How does it
work? NOBODY, EVER gets punished for making an error, AS LONG AS they report
it AS SOON AS they find out they did it. If you screw up, and hide it,
you're gone. Nobody gets penalized for pointing out something somoene else
missed. A team approach is used. There's a sign at the door that says "Human
Error Is Inevitable" with the rest of the policy spelled out. If they screw
up, then own up. For example, even if someone dies and the survivors have no
clue anything is amiss, they go out of their way to make their mistake
known, and to suggest legal counsel to potential plaintiffs. The most
imporant thing -- They APOLOGIZE for mistakes, PUBLICLY. The result? They
have the lowest occurence of claims of any VA, and are the envy of non-VA
hospitals everywhere. Their average liability claim is a fraction of what
other hospitals endure. Their insurance costs are down, as a result. Why
hasn't this idea spread? Remember, lawyers on BOTH sides. Those that defend
the hospital don't want their cash cow killed, either.

And politicans want to blame insurance companies. Ha, ha, veddy funny! Gimme
a break.

Brent D. Gardner, ChFC
Chartered Financial Consultant
http://members.cox.net/brentdgardner1378/

"Be ever questioning. Ignorance is not bliss. It is oblivion. You don't go
to heaven if you die dumb. Become better informed. Learn from other's
mistakes. You could not live long enough to make them all yourself." - Hyman
George Rickover (1900-86), Admiral, US Navy, advocated development of
nuclear subs & ships

The Chartered Life Underwriter (CLU) and Chartered Financial Consultant
(ChFC), designations owned and exclusively offered by The American College,
signify the highest standards of academic study and professional excellence
in the financial services industry.

"Caroline" <caroline10027remove[at]earthlink.net> wrote in message
news:z05Lb.44522$Pg1.36181[at]newsread1.news.pas.earthlink.net...
- quote -

This has been common practice for more than a generation. A hospital knows
how much they need to bring in to pay the bills, provide care, etc. They
know how many, on average, are going to have coverage. The rest? Rack up a
major bill. Why? Several reasons (this is courtesy of my many interviews
with bean counters and admin people at health care providers):

1. People with no coverage are more than likely to seek legal remedy for
failure to diagnose and failure to treat, citing the fact that they don't
have coverage as the reason they didn't get the "best" care available. These
suits are EASY to win, but expensive to defend, so they settle out of court.
Its even cheaper to run every test known to man, just to fend of a few suits
per week.

2. Unpaid bills get written off, thereby potentially reducing taxes. Lots of
funny accounting can be done. If an ininsured person can't pay a big bill,
it doesn't matter whether the bill is $50,000, or $500,000, so they have no
incentive to keep the toll low, but potentially a tax incentive to bill out
the wazoo. I have clients who own and operate medical billing practices for
providers, and they tell me stories about how even small clinics are doing
this.

- quote -

Providers agree to charge reasonable rates in order to join networks, such
as those for a PPO plan. In this way, insurers keep the cost of claims under
control. Patients are going to go where they get the lowest out of pocket
cost, for the most part, and POS, PPO and HMO plans do a good job of
eliminating providers who won't play ball.

Until we have tort reform, bring competition back, and get the government
out of the doctors office, one can't blame insurance companies -- most of
them pay out 100% of what they bring in, net of operating costs, with their
only margins being on the premium float. This has been a reality for
decades, no matter what any politician or reporter says.

Brent D. Gardner, ChFC
Chartered Financial Consultant
http://members.cox.net/brentdgardner1378/

"Be ever questioning. Ignorance is not bliss. It is oblivion. You don't go
to heaven if you die dumb. Become better informed. Learn from other's
mistakes. You could not live long enough to make them all yourself." - Hyman
George Rickover (1900-86), Admiral, US Navy, advocated development of
nuclear subs & ships

The Chartered Life Underwriter (CLU) and Chartered Financial Consultant
(ChFC), designations owned and exclusively offered by The American College,
signify the highest standards of academic study and professional excellence
in the financial services industry.

Caroline <caroline10027remove[at]earthlink.net> wrote:

- quote -

Because I am evaluating alternate insurance policies, including
so-called "indemnity" plans that in affect would cause me to be
viewed as "uninsured" by the provider (since THEY are not a party
to the contract).

Here is the dilemma: My current policy has a very high deductible
and does NOT pay for preventative or diagnostic treatment. In
over 25 years of paying for policies of this type, I don't recall
that I've ever collected a dime's worth of benefits. I have,
however, benefited indirectly by being able to pay for services
AT THE POLICY'S CONTRACT RATE which, as you note, is likely less
than what I would pay if completely uninsured. In other words,
while paying the insurance premiums has never gotten me any
INSURANCE reimbursements, is has gotten me discounts on services.

Meanwhile, I am considering switching to an "indemnity" style
policy. This policy has no contract with the provider. Rather,
they simply pay me scheduled amounts based on the services I
actually receive. It is left up to me to negotiate the best deal
I can directly with the provider. This policy DOES pay for
preventative and diagnostic services.

So, would I be better off to stick with my existing policy where
I at least get a discount on services? Or go with the new policy
that WILL pay for preventative care, but leave me on my own to
negotiate the actual fee with providers? There is no way I can
make an informed decision on this issue without knowing more
about the medical group's billing practices.

I have explained the foregoing, many times, to the billing
department at the practice group. Oh, and before anyone concludes
that the new policy I'm considering must be some weird, off the
wall deal, guess who provides it? AARP.

MTW

"Michael T Wing CPA" <mtwingcpa[at]yahoo.com> wrote
- quote -

I'm not sure I follow: What reason did you give for wanting to see their billing
rates?

Of interest to you and others might be the following media item.

A few weeks ago the Albuquerque Journal reported on how the University of New
Mexico Hospital bills around a third more for its services when the patient is
uninsured.

The university hospital spokesman's explanation: "As a matter of business, you
are charging one rate and you are offering a discount to your big payers." (This
is a very suspect statement to me, but I'll leave this for another post.)

A coalition of Albuquerque community groups recently got together about this.
Somehow, they got the hospital to cease many of these practices. I get the
feeling the coalition did it simply by threatening bad public relations. (The
article wasn't clear on this point.)

Yet I understand it's pretty usual to charge the uninsured (a lot!) more for a
medical service.

- quote -

I look forward to reading why you were after this information.

I don't think very many insured people care about making a "rational economic
decision." They blindly trust the MDs to be prescribing the right procedures.

"Health economists have long asserted that when beneficiaries are insulated from
the costs, they tend to overuse medical services." -- "New Medicare Bill Bars
Extra Insurance for Drugs," New York Times, Dec. 6, 2003

- quote -

Funny. I've been proposing lately that there may be widespread price-fixing and
collusion between insurers and health care providers.

Caroline <caroline10027remove[at]earthlink.net> wrote:

- quote -

I certainly agree as to the benefit of more information being
available to patients and premium payers. However, with that in
mind, I have been trying in vain for the past few weeks to get my
doctor's practice group (affiliated with the county's largest
hospital) to disclose their billing rates for 5 randomly selected
CPT codes, both the rates that would be charged to my current
insurer and the rates that would be charged to me if I had no
insurance. Regrettably, they come up with one excuse after
another as to why I don't need to know that and/or they shouldn't
be required to provide it.

IMO, it is impossible for people to make rational economic
decisions when information is withheld or unavailable. And, I
dare say, if any other industry tried to take this stonewalling
approach, I would expect the FTC to be all over them like a bad
smell.

No wonder our medical system is so screwed up!

MTW

Caroline <caroline10027remove[at]earthlink.net> wrote:

- quote -

I certainly agree as to the benefit of more information being
available to patients and premium payers. However, with that in
mind, I have been trying in vain for the past few weeks to get my
doctor's practice group (affiliated with the county's largest
hospital) to disclose their billing rates for 5 randomly selected
CPT codes, both the rates that would be charged to my current
insurer and the rates that would be charged to me if I had no
insurance. Regrettably, they come up with one excuse after
another as to why I don't need to know that and/or they shouldn't
be required to provide it.

IMO, it is impossible for people to make rational economic
decisions when information is withheld or unavailable. And, I
dare say, if any other industry tried to take this stonewalling
approach, I would expect the FTC to be all over them like a bad
smell.

No wonder our medical system is so screwed up!

MTW

Caroline <caroline10027remove[at]earthlink.net> wrote:

- quote -

I certainly agree as to the benefit of more information being
available to patients and premium payers. However, with that in
mind, I have been trying in vain for the past few weeks to get my
doctor's practice group (affiliated with the county's largest
hospital) to disclose their billing rates for 5 randomly selected
CPT codes, both the rates that would be charged to my current
insurer and the rates that would be charged to me if I had no
insurance. Regrettably, they come up with one excuse after
another as to why I don't need to know that and/or they shouldn't
be required to provide it.

IMO, it is impossible for people to make rational economic
decisions when information is withheld or unavailable. And, I
dare say, if any other industry tried to take this stonewalling
approach, I would expect the FTC to be all over them like a bad
smell.

No wonder our medical system is so screwed up!

MTW

Caroline <caroline10027remove[at]earthlink.net> wrote:

- quote -

I certainly agree as to the benefit of more information being
available to patients and premium payers. However, with that in
mind, I have been trying in vain for the past few weeks to get my
doctor's practice group (affiliated with the county's largest
hospital) to disclose their billing rates for 5 randomly selected
CPT codes, both the rates that would be charged to my current
insurer and the rates that would be charged to me if I had no
insurance. Regrettably, they come up with one excuse after
another as to why I don't need to know that and/or they shouldn't
be required to provide it.

IMO, it is impossible for people to make rational economic
decisions when information is withheld or unavailable. And, I
dare say, if any other industry tried to take this stonewalling
approach, I would expect the FTC to be all over them like a bad
smell.

No wonder our medical system is so screwed up!

MTW

Greg Hennessy wrote:
- quote -


WHOA.......... Wrong.......
The primary benefit of MSA/HSA's is the income tax free
build up over time.............

Cal Lester CLU