Health Savings Accounts: the 'psuedo-reform'
In his most recent column, Dave takes the time to extoll the virtues of Health Savings Accounts, th private accounts Dubya touts as the main tool to reform our nation's failing health-care system. Is it just me- or whenever conservatives come out in support of one opinion, does the contrary opinion seem to make itself the more clearer and correct option? I mean, considering all the sqwaking by conservative pundits that Bush's domestic spying program is legally justified, doesn't that make it apparaent that it's obviously illegal as all heck? Anyhoo...
Okay, so let's say you're like two-thirds of the country who claim to be "extremely" or "very" satisfied with your traditional PPO or HMO health plans. Suddenly, your employer switches to the David Reinhard-approved Health Savings Accounts. These accounts are portable, and can designed to meet individual consumers' needs. Everything is peachy, right?
Well, hold on for a moment. Here's the deal on health savings accounts: if you're a healthy, middle-to-upper class white single male, you probably all ready have one, and they fit perfectly into your life. For every one else, not only are costs of health insurance transfered onto the individual consumer, but the burden and risk of these accounts are, as well.
As Dave points out, 3 million people have signed on to new HSAs since 2003, an incredible amount. But it is unrealistic to view these accounts as the major overhaul solution to insure the 45 million people who currently lack health insurance. Eventually, the number of those enrolling in HSAs will level, drawing off healthier, wealthier workers from traditional insurance plans. In turn, this would leave those traditional plans weaker and more vulnerable, full of poorer, sicker people as a result. This will, in fact, raise premiums for those who can't afford neither then or HSAs.
You see, HSAs provide yet another opportunity for tax-prefered savings for Americans- and it needs to be asked just how many savings accounts the average American can afford. With 401(k) plans, IRAs, and 529 plans for education, the total possible amount of Americans' savings can exceed families' income, not to mention whether they even have an amount to save and disperse throughout these accounts.
Typical of all private insurance plans, another risk inherited by the indivudal is of never cashing in on your HSAs. You'll keep socking away left-over funds into your private accounts- possibly at the expense of other needs- but, if you're lucky, you might jsut never need to use them. Ned Flanders from 'The Simpsons' likened insurance to "gambling"- and is your health really something to gamble on? Vice-versa if you have a chronic illness, you will continually deplete the funds in your HSA to cover your expenses, and quite possibly pay out-of-pocket for any expenses over the capped limit.
But HSAs offer "choice." They're "market-based." They allow room for the "individual". All typical buzzwords for Republicans to rally around in support of any hare-brained scheme. In fact, Republicans want these accounts- which they refer to as 'the wave of the future'- to happen sooooo bad, they're willing to force tax-payers' to loan millions of public dollars for those individuals who wish to start HSAs, but need funds available to cover large deductibles. Huh. Government-subsidized Health Savings Accounts? Doesn't seem very "market-based" to me...
If you're going to have government- subsidized health care, why not just go the full ticket and have a national single-payer health care. The health care bureaucracy is weighing down some ofAmerica's best businesses, such as GM, who should be focused more on designing and building top-of-the-line automobiles and less on figuring out the most conducive health plan that fits their employees' needs. Car companies in Europe and Japan, in which health-care is provided by the state, enjoy a built-in advantage in the workplace due to our country's unwillingness to adopt a single-player health care plan.
Dave points out that "employers are on the hook" for their employees' health care plans, and shouldn't be. I couldn't agree more. We need true health care reform, offering a bold vision that allows the basic health needs of all Americans to be met, and, after that, allowing people to buy into affordable plans of their own choice for any further needs or care. Considering that this model has been enacted in every single western democracy, we don't have to look vry far for examples. Health Savings Accounts, for all its buzz, doesn't offer this bold vision. Instead, the reform they offer is to force the neediest, worse off, and chronically ill in a collapsing system with ever-spiraling costs, while those who can afford better do.
Could you imagine Republicans putting their support behind such a plan? For some reason, I find its not that hard....
Okay, so let's say you're like two-thirds of the country who claim to be "extremely" or "very" satisfied with your traditional PPO or HMO health plans. Suddenly, your employer switches to the David Reinhard-approved Health Savings Accounts. These accounts are portable, and can designed to meet individual consumers' needs. Everything is peachy, right?
Well, hold on for a moment. Here's the deal on health savings accounts: if you're a healthy, middle-to-upper class white single male, you probably all ready have one, and they fit perfectly into your life. For every one else, not only are costs of health insurance transfered onto the individual consumer, but the burden and risk of these accounts are, as well.
As Dave points out, 3 million people have signed on to new HSAs since 2003, an incredible amount. But it is unrealistic to view these accounts as the major overhaul solution to insure the 45 million people who currently lack health insurance. Eventually, the number of those enrolling in HSAs will level, drawing off healthier, wealthier workers from traditional insurance plans. In turn, this would leave those traditional plans weaker and more vulnerable, full of poorer, sicker people as a result. This will, in fact, raise premiums for those who can't afford neither then or HSAs.
You see, HSAs provide yet another opportunity for tax-prefered savings for Americans- and it needs to be asked just how many savings accounts the average American can afford. With 401(k) plans, IRAs, and 529 plans for education, the total possible amount of Americans' savings can exceed families' income, not to mention whether they even have an amount to save and disperse throughout these accounts.
Typical of all private insurance plans, another risk inherited by the indivudal is of never cashing in on your HSAs. You'll keep socking away left-over funds into your private accounts- possibly at the expense of other needs- but, if you're lucky, you might jsut never need to use them. Ned Flanders from 'The Simpsons' likened insurance to "gambling"- and is your health really something to gamble on? Vice-versa if you have a chronic illness, you will continually deplete the funds in your HSA to cover your expenses, and quite possibly pay out-of-pocket for any expenses over the capped limit.
But HSAs offer "choice." They're "market-based." They allow room for the "individual". All typical buzzwords for Republicans to rally around in support of any hare-brained scheme. In fact, Republicans want these accounts- which they refer to as 'the wave of the future'- to happen sooooo bad, they're willing to force tax-payers' to loan millions of public dollars for those individuals who wish to start HSAs, but need funds available to cover large deductibles. Huh. Government-subsidized Health Savings Accounts? Doesn't seem very "market-based" to me...
If you're going to have government- subsidized health care, why not just go the full ticket and have a national single-payer health care. The health care bureaucracy is weighing down some ofAmerica's best businesses, such as GM, who should be focused more on designing and building top-of-the-line automobiles and less on figuring out the most conducive health plan that fits their employees' needs. Car companies in Europe and Japan, in which health-care is provided by the state, enjoy a built-in advantage in the workplace due to our country's unwillingness to adopt a single-player health care plan.
Dave points out that "employers are on the hook" for their employees' health care plans, and shouldn't be. I couldn't agree more. We need true health care reform, offering a bold vision that allows the basic health needs of all Americans to be met, and, after that, allowing people to buy into affordable plans of their own choice for any further needs or care. Considering that this model has been enacted in every single western democracy, we don't have to look vry far for examples. Health Savings Accounts, for all its buzz, doesn't offer this bold vision. Instead, the reform they offer is to force the neediest, worse off, and chronically ill in a collapsing system with ever-spiraling costs, while those who can afford better do.
Could you imagine Republicans putting their support behind such a plan? For some reason, I find its not that hard....
posted by true_slicky at 8:53 AM
3 Comments:
Every western nation has complaints about their health care systems regardless of how comprensive and available it is. Having lived in Alaska for a bit and driven the Alcan a few times I can attest that Candadians love to complaing about the system Al Gore viewed as a model for us.
So, I would tend to believe there is no comprehensive solution as you would imply. Even if we had a single payer system these savings accounts would be handy. They would be better if the accounts could be a portion of home equity much easier to roll over when retiring or elderly persons roll their home. It would make accruing them much easier for most people.
As for my bet on how to reform our system and make it work. Insure everyone under 18 years of age enrolled in school. That would knock out most of the 45 million uninsured and alleviate many of the worries faced by the heart string tugging single-mothers.
thanks for the feedback, dare!pdx.
I am not going to profess to be a health care policy wonk- as Dave tries to do in this column- and I appreciate points of view on this subject.
it is morally repugnant that children under 18 don't have automatic health care in our country. whenever poor children can afford a lobbyist in D.C., that will change.
to grant them insurance would be taking a first step towards a comprehensive program. the program I outlined calls to have all Americans' basic needs met- and people could then choose to pay into and more for programs that could tailor to specific needs, such as these HSAs.
my gist with the emphasis on HSAs alone is that they obviously benefit those who probably all ready have health insurance. it offers nothing for the millions who don't, except perhaps making things worse for them. it fine-tunes a detail when dramatic, bold leadership is required.
I would be interested in knowing if the Canadians you heard complaining would clamor to trade health care systems with the United States?
is that Dave coming on to defend himself? the depth of the writing gives himself away.
hey- check out the mission statement of the blog. the point of it is to illustrate what a lousy writer. not debate how "nice" he is.
in short, bite me, anonymous- and what kind of name is that? took a while to come up with that one, huh?
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