Hits & Misses – 2008/12/03

How Much Is Your Life Worth? Would you pay $54,000 for 6 more months of life? The British government won't pay more than $22,750. And that's the system Tom Daschle wants to use as a model for America. [link]

Medical Residents Are Still Not Getting Enough Sleep. [link]

Worried About Being Uninsured in the Future? United lets you secure your right to future insurance today. [link]

Does Your Doctor Have Financial Conflicts of Interest? The Cleveland Clinic bares all. [link]

One in Ten Doctors Lose Money Giving Children Vaccines. Next step: stop doing it. [link]

Comments (9)

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  1. Joe S. says:

    As I said in a previous post,the British health board (which rations care to British patients and denies them accesss to drugs routinely available to Americans and people on the European continent)is called the National Institute for Clinical Evidence, or NICE.

    How’s that for an oxymoronic name?

  2. John Goodman says:

    And as I said on a previous post, there is a lively discussion about Sen. Daschle’s plan to copy NICE in the United States at the National Journal health blog here:


    There are comments by yours truly, Stuart Butler and others.

  3. Drew says:

    On the United Health plan, allowing you to insure for future insurance, it’s a good idea.

    But it’s not as good as personal and partable insurance — which would make the whole issue moot.

  4. John Goodman says:

    See Tyler Cowen’s comment on “Insurance in Insurance” and the comments to his comment here:


  5. Bart Ingles says:

    I’m assuming United Health offering has the same shortcoming as guaranteed renewability, in that it only guarantees access to a specific United Health product. Essentially it guarantees the right to purchase from a monopoly.

    The HIPAA Title I requirement for group plans is more robust in that respect. As an employee, you are guaranteed access to any plan offered by your employer, so long as you have maintained continuous group coverage.

  6. Joe S. says:

    Bart, you are confused. HIPAA does not gurantee access to any particular plan. It merely says that if you have been paying into the system you cannot be excluded from the system after a change of employment. Enforcement, however, is completely up to the states.

    Most states give people access through a state risk pool. If they have health problems, that may be their only option.

  7. Bart Ingles says:

    Joe, how does one become an employee without first having had a change in employment? What do you mean by “the system” if not “employer’s group plans”?

    Of course in the case of terminated employment, HIPAA guarantees are less robust in the sense that after COBRA rights are exhausted, the so called “HIPAA plans” that remain are likely less desirable & more expensive than what an employer would offer.

  8. Joe S. says:

    Just to clarify. In most states if you have a preexisting condition that causes you to be denied coverage and if you are HIPAA protected because you were previously insured at a place of work, the only option you will have is risk pool insurance — usually paying 150% to 200% higher rates. This plan is often administered byh Blue Cross.

    From what I understand, United Health is offering a more attractive deal. There will not be a higher rate and coverage will be comparable to what you already have.

  9. Bart Ingles says:

    My original point was merely that a HIPAA-protected employee has access to any group plan offered by his employer (subject to enabling events, etc), while the United Health offering (as well as guaranteed renewal for individual coverage) only guarantees access to the designated product.

    Perhaps I should have been more explicit as to the scope of the comparison. Obviously it breaks down if the insured is no longer an employee. I was originally only referring to HIPAA protections within the workplace, not post-employment coverage.

    I agree that the United Health plan is preferable to risk-pool insurance, but what happens if United Health goes under, or if medical technology evolves beyond what is covered under the specific plan. I assume premiums can increase per some inflation clause; could U.H. increase rates in the future while attracting new customers by offering separate, lower-priced coverage?

    Still, it’s an interesting product if you are in good health but unsure of your future employment status. It unbundles the renewability clause from the underlying insurance product, in much the same way that Blue Cross is apparently unbundling its power to negotiate with providers.