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Politics : View from the Center and Left -- Ignore unavailable to you. Want to Upgrade?

To: Lane3 who wrote (9614)	1/24/2006 9:16:37 AM
From: Lane3	Respond to of 543625

"HSA in 2006? Kevin Drum is upset about Healthcare Savings Accounts: The debate over HSAs is going to get mighty wonky over the next few months, but always keep this explanation in mind as you're trying to make sense of the charges and countercharges. The fundamental idea behind HSAs is not to provide better healthcare, it's to provide less healthcare. Conservatives want you to think twice before spending a hundred bucks for your regular pap smear. I'm probably going to write enough about HSAs over the next few months to make everyone scream for mercy, especially since I assume the White House will decline to publish an actual plan, leaving us instead to speculate wildly about what they really have in mind. So I'm going to wrap up this post right here. Just remember: if you think more risk, more complexity, and less healthcare are the answer, HSAs are for you. The rest of us will keep pushing for something that actually makes sense. The idea behind HSAs is indeed to make people spend less on their healthcare. Every health care policy analyst out there claims that their plan will cause people to spend less on their health care; single-payer advocates think that they can shake all that extra money out of the pockets of pharmaceutical companies and insurance administrators, while those of a more libertarian stripe are hoping to get it out of consumers. I won't rehash that argument here (say, "Thank you, Jane"). But I really don't understand the opposition to HSAs among single-payer advocates. It certainly won't hurt anyone, will it? If you get a high-deductible policy, and save the deductible in a tax-free account, how are you worse off? HSAs are, after all, primarily targeted at those who find it difficult and expensive to get insurance, such as the self-employed. Or are those people not entitled to have their health care problems solved the way old, sick people are? You might think the programme is underwhelming as a way to address health care costs, but why the vituperation? "Conservatives want you to think twice before spending a hundred bucks for your regular pap smear" actually might not be a bad idea--there's some evidence that annual pap smears don't do any better for most women than a pap smear every two or three years, but hey, why risk it? The insurance company's paying! More importantly, there's a fair amount of health care that isn't necessary: "I have a cold! Write me a prescription for antibiotics!" Such visits are a waste of doctor time; a waste of insurance dollars; and they contribute to antibiotic resistance. Eliminating them would be a medical bonanza. Will that keep health care costs under control? Seems unlikely. The primary driver of health care costs is heroic end-of-life interventions These interventions are not within the budget of all but the very wealthiest of citizens, and given that our society is unlikely to let people die for lack of $300K for ventilator support, they are not going to stop. Given that Medicare has also done almost nothing to restrain these costs, I find it implausible that neither market nor government action will prove capable of restraining the growth of health care costs. Nor does the fact that our health care costs are high, and growing, really bother me. We're basically the richest nation in the world. All of our citizens have enough food, clothes, and a roof over their head. Do we have something better to spend our money on than being healthy? Posted by Jane Galt at January 23, 2006 " janegalt.net