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To: GraceZ who wrote (212042)	7/23/2009 3:40:29 PM
From: neolib	Read Replies (1) \| Respond to of 306849

People are the most responsible when they spend their own money on themselves than in any other possible configuration of spending Quite true. But... 1) Insurance provides a method of spreading statistically unlikely risks across the population, so that rare but expensive hits can be handled by individuals affected. 2) It transforms large infrequent lump sum expenses into small monthly ones, and in particular allows one to take an early large hit prior to saving the money oneself. 3) As a mechanism of payment (OPM) insurance has drastically altered the cost mechanism in medical care, so even when you are paying out of pocket, the care providers are not in tune to that cost aware approach, and in fact are often hostile to it.

To: GraceZ who wrote (212042)	7/23/2009 3:44:59 PM
From: MoneyPenny	Read Replies (1) \| Respond to of 306849

when I was laid off 18 mos. ago I signed up for Golden Rule insurance which has a $5000 deductible (there were many options) and a HSA Mastercard that I put 5k into. I can put in up to 6k this year and any overage will roll over if and when I have Medicare (who knows what will be around in 2 years). So far I am very happy with it. The premiums were affordable and even with a 20% increase in my premium this spring, it still offered a better value to me than my other options. I am basically paying $4k a year to buy a discount in the event that I really get sick or need surgery. MP

To: GraceZ who wrote (212042)	7/23/2009 7:07:47 PM
From: NOW	Read Replies (2) \| Respond to of 306849

which just goes to show that you despite all of your long winded ness know almost nothing of the subject. underutilization has been shown to be a real problem with these kind of accounts despite the improvements in overutilization, and leads to worse outcomes and little savings in the long run. as to your bogus point about medicare denials here are the facts: * Twenty-two percent of privately insured people found that their plan did not pay for care that they thought was covered, compared with 9 percent of elderly Medicare beneficiaries. * Nine percent of privately insured people had difficulty getting a referral to a specialist, compared with 2 percent of elderly Medicare beneficiaries. * Medicare beneficiaries were more likely to be very confident in their ability to get care in the future as those covered by employer plans (60% vs. 37%). * Thirty-three percent of privately insured people were unable to pay their bills or had been contacted by a collection agency, compared with 18 percent of elderly Medicare beneficiaries.

To: GraceZ who wrote (212042)	7/23/2009 9:11:15 PM
From: Oblomov	Read Replies (2) \| Respond to of 306849

My wife and I have been very pleased with our HSA. We have had some large expenses that would not be covered by a typical insurance plan (hearing aids for myself), and by virtue of the tax break, we ended up much better off than we would have been with the usual PPO/HMO. I'm surprised that the center-left does not support HSAs, even a subsidized form of them. They fit the model of the "libertarian paternalism" that Thaler and Sunstein described in Nudge: they create a sequestered account, thus taking advantage of the human tendency toward mental accounting, they increase the degree of "public choice" in how care is utilized, and they create incentives for reducing the cost of care without constraining individual freedom. The reasons I can ascertain for opposition to HSAs on the left are 1) they came to fruition in the Bush Administration, thus are unquestionably bad 2) they do not encourage the insured to regard health care as a "commons" whereby they can increase their own quality of care (or decrease it among unfavored groups) through political means.