Wednesday, November 19, 2008

Shortsighted Gummint Tricks

On the face of it, the new CincyCare health benefit program would seem to be a dream come true:
"CincyCare will provide primary care, a prescription drug benefit, and care coordination for 2,000 workers in Cincinnati who need affordable healthcare, but currently are not eligible. Best of all, this program will come free of charge to participating employers."
And how many of those employers will now drop their group cover in favor of this scheme? Yes, it excludes major (read: hospital) claims, but how many employees will understand that? And it's aimed directly at the folks who'll be most affected: groups with high premiums due to major, on-going claims. Heck, who wouldn't bail under those circumstances?
And it's an over-utilization nightmare in the making, featuring unlimited $10 co-pays (whatever happened to "skin in the game?") for primary care. On the bright side, it limits drug reimbursement to $100 a year.
Now, there's a way for this to actually work: couple it with a mandatory high deductible plan to cover those catastrophic claims and non-reimbursed rx expenses (hello chemotherapy?!). But of course, that would involve a) some forethought and b) cash, two things apparently in short supply in the Queen City. As it stands, however, the plan is destined to draw the most claims-prone groups; one wonders how long that "free to employers" component will last.
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