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Healthcare's high cost

October 30, 2008

Re "Insurers see banking future," Oct. 22

The promotion of high-deductible health insurance plans -- via health savings accounts or otherwise -- is one of the worst trends in American healthcare today. These plans provide a barrier to needed care more draconian than even the meanest HMO gatekeeper.

The notion that large out-of-pocket expenses selectively block unnecessary health expenditures is wrong. They are more likely to block the treatment of very serious conditions without symptoms at first, like hypertension and diabetes, than benign temporary conditions that produce discomfort, like colds and muscle strains. This may greatly add to overall healthcare costs, not to mention suffering and death.

We have become a society that spends lavishly on marginal, ineffective or even worse treatments and tests for, say, a stroke, but refuses to support the highly effective, inexpensive basic treatment of hypertension, which would have prevented the stroke in the first place. A fundamental flaw in American healthcare today is that it selectively supports and subsidizes high-ticket expenses, whether worthwhile or not, but neglects basic, effective, less-expensive care. Very high-deductible health insurance is only making that worse.

Hyman J. Milstein MD

Studio City


Re "The battle over bills," Oct. 23

Why does healthcare have to coexist with private insurance? Look at the hard figures for what insurance companies and healthcare facilities need to generate a sufficient profit. Deduct this amount, and I'm guessing you'll have a solvent system.

Premiums streaming into insurance coffers could go directly into a National Health Service. Private insurance will always exist as an alternative for the wealthy. While the majority would be in coach, we would all get to our destination alive.

Greg Hilfman



In light of The Times' recent health insurance series, readers should know that California leads the nation in the number of people with individual health insurance and offers some of the country's lowest-cost plans. About 2.6 million Californians have individual coverage at an average annual cost of $2,565 -- that's less than the national average.

To keep a lid on costs, health plans use underwriting, or risk assessment, to determine coverage. With underwriting, 89% of people in the individual market pay the lowest rates available. For those not offered coverage because of their health status, we need a strong and thriving high-risk insurance pool to provide coverage.

We were disappointed The Times devoted little space to the underlying cause of higher healthcare prices: the skyrocketing cost of doctors, hospitals, prescription drugs and other medical services. Rising at two to three times the rate of inflation, medical costs account for 89% of insurance premium increases nationwide and 86% in California, the California Health Care Foundation reported. It also found that health plans' administrative costs were 12%, far less than the number in the outdated source quoted by The Times.

California health plans are committed to reining in medical costs so more Californians can obtain coverage and enjoy a healthier future.

Chris Ohman


The writer is president and chief executive of the California Assn. of Health Plans.

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