There is a difference between supporting a candidate, like Senator Obama, and turning out to vote for him. This was Senator Obama’s fate yesterday.

Some of Obama’s supporters thought, he is going to win anyway, so what if I don’t go vote, my one vote is not going to count.

The young people who were supporting Senator Obama did not turn out to vote.  And, the baby-boomer women did turn-out to vote for Senator Clinton.  And there was a +13 point turn out of women, in favor of Senator Clinton.

The net effect was to put Senator Clinton over the top in New Hampshire. Some will likely attribute Senator Obama’s loss to Democrats and Independents lying to pollsters, or to those who made up their minds at the last minute, or to the pollster’s sample being skewed towards Senator Obama. But the youth vote is always great for television B roll, but when it comes down to turn-out, like unmarried women, the youth record of actually voting is awful.

Plus, Senator Clinton’s voter turnout machine simply out-performed Senator Obama’s.

Wal-Mart’s Employee Health Benefit Plan Talking Points

Taking a beating for the health plan that you give your employees does not even begin to describe what Wal-Mart has been through — in one case, a state passing a single law aimed at Wal-Mart. In the interest of general fairness, here are some salient talking points about Wal-Mart’s current health plan:

• Wal-Mart will match dollar for dollar an employee’s savings in their HSA;
• Wal-Mart will contribute up to 20% of the deductible in an employee’s HSA — between $250 and $1,200 annually;
• Prescriptions for 2,400 generic drugs are available for $4;
• Employees can customize their own health benefit in 50 different ways, to be able to choose the best plan for their own needs;
• Some health plan premiums are $5 to $8 a month.

Report: Notwithstanding a Slow Start, HSAs Poised for Rapid Growth

Celent, a Boston-based consulting firm issued a recent report that concluded the cultural shift to HSAs was “monumental” in its difficulty, and at the base of the slow start to HSAs. (This slow start is highly debatable, given the fact that when IRAs were first introduced, it took seven years to sell 100,000 of them.) Celent’s report concludes that notwithstanding the enormous cultural anchor on the growth curve, redesigned market offerings and experience at the cultural transition will result in a rate of growth of 40% to 50% over the next five years — with about 13 million HSAs in place in 2012 — four years from now.

Here is the key take away (not in the report): HSAs are the fastest growing new banking and insurance product in the United States today.

Self-Appointed Watchdog say Some HSA Qualified Health Insurance is Subprime

Although it is not quite like asking “have you stopped beating your wife?” applying the word “Subprime” to high deductible health insurance is a stroke of propaganda genius. It is completely wrong, incorrect, not right, in every sense — which is why it qualifies as propaganda, but it is effective. Should the real estate/mortgage and the credit card/consumer lending crisis get any worse — we will likely hear much more about the word Subprime. (Who wants a Subprime health plan, anyway? Somehow it does not sound so bad if it is a mortgage, but applied to a health plan it sounds icky — which is the point.)

Health Access California, writing in the California Action Report of Progressives, writes:

“Some [health insurance plans] represent a trade-off that some wealthier people can afford to make, to have greater cost-sharing in order to get cheaper premiums. But other plans are, frankly, close to consumer fraud, and should not be certified to be sold in the market.

They name the Tonik plan by Blue Cross, for example.

Will the progressives allergic and knee-jerk reaction to HSA qualified health plans ever end? Do they think that the 25% to 30% of uninsured people buying HSA qualified plans are wealthy? How many wealthy uninsureds do you know? Do they object to these buyers having access to affordable health insurance? Would a larger uninsured population better server their political goals? Have they done the math showing that a less health (sick) person actually is financially better off with an HSA than will one of their traditional insurance plans they advocate? Is it really that they cannot stomach market based reforms instead of government run ones?

Inventions of Prudence

Out of all the health care articles I have read over the last year, this is one of the best. It is great. It is long overdue. It is clear. It is persuasive and it challenges us.

Blue Cross Blue Shield Association recently concluded 30% of American’s health expenditures are “ineffective, redundant or unnecessary.”

Jackie Avner, writing in the Denver Post states:

“Most Americans choose to overeat. According to the World Health Organization, 74 percent of U.S. adults are overweight or obese. Obesity contributes to expensive, chronic conditions such as diabetes, hypertension and heart disease.

“Americans over-consume pharmaceutical drugs, tests and procedures from the buffet of health care options, including those our doctors think will be marginally effective. Our reasoning is, “If it doesn’t cost me anything extra, why not try it?”

“We over-consume emergency room services. One extensive study showed 74 percent of patients who sign themselves into the ER have health issues that could be treated by a primary care doctor. Most ER visits occur during hours when less expensive alternatives for care are available. When surveyed, patients explain their preference for the ER by citing easy access to diagnostic testing, higher quality of care, access to specialists, and convenience. There’s little incentive to take overall cost into consideration.

“Annual U.S. health care expenditures are $5,711 per person, far greater than in any other country. But spending the most money doesn’t give us the longest lifespan. We rank 38th in life expectancy. Cuba ranks 37th — and has a per capita health care expenditure of $229.

“All of us should be more responsible. We should acknowledge that death, pain and illness are a part of life and can’t be avoided through copious consumption of health care services. We should have a living will so we won’t be subject to treatments we consider inappropriate. We should show a greater willingness to care for our elderly parents at home, rather than placing them in expensive assisted living or nursing care facilities.

“But we’re all spoiled, and pointing it out isn’t likely to transform our “health care consumer” mind-frame into a “good citizen” mind-frame.”

In a nutshell, that is what most of the world thinks. Americans are fat and spoiled and spend too much on health care. We over-consume everything; and in order to save us what is normal pain and suffering in life, which in our case is often brought on by our own lifestyle and actions we try and buy our way out of the health consequences — and we expect someone else to pay for it.

So what to do about this? Jackie Avner writes:

“Our own history may offer a solution. America’s founding fathers designed the Constitution around an ingenious concept: Don’t fight human nature; work with it. Harness our selfishness with “inventions of prudence” such as checks, balances, and wide dispersal of power, and make self-interest work for the public good. Why not apply the same principle to health care reform?”

I will leave you to read her conclusion.