• ALIENated said on Oct 05, 2009....

  I think you just described a government takeover of healthcare insurance. The money we pay in is called taxes, and some pay more than others. Where your plan diverges from government coverage is that the government will not keep a tally of what you have paid in and give it back on that basis. What your plan and government takeover does is cut out the middle man -- insurance companies. A lot of our healthcare money is going to insurance companies and admin workers (in the doctor's office and the hospitals) who have to deal with who pays, how much they pay, and collecting those payments, etc. I actually have no problem with government-run healthcare, IN THEORY. However, when the government starts collecting that kind of money (like they do in the form of Social Security and Medicare), there is a tendency for politicians to "borrow" it and squander it. Plus, any agency set up to oversee all that money we pay in, whether government or private, would have administrative costs and we would most likely be back where we are now. Insurance is not the answer to our problem, insurance IS the problem. We simply need to be able to set up our own accounts, and accounts for each family member, at our own bank and then somehow show it on our tax return, and maybe pay a reduced tax on it, or no tax on it like an IRA. For those who have no account, they would have to petition the government for help, if the medical attention was actually necessary. The funds that would have gone to all those bureaucrats would be used to help legal citizens below the poverty line. In other words, a system needs to be set up to only help those who really need help (similar to Medicare) and not a system that will upset healthcare for everyone. If doctors and hospitals have to deal with millions of tight wads looking for the biggest bang for their buck (the way they used to before the advent of healthcare insurance) instead of a disinterested bureaucrat or insurance agent, prices would go down.

  However, the whole deal revolves around expecting people to do the right thing, and, sadly, many will NOT do the right thing, which is the problem we have today. If everyone would just get themselves covered with at least a disaster policy (high deductible, low monthly payment), much of our current problem would go away. Kicking out illegal immigrants would solve another big part of the problem. With your plan or any kind of "you take care of your own account" plan, many people would not sock money away unless they were made to do it. Of course, there could be a tax penalty if you do not sock the appropriate percent away, but then we are back to the government telling us what to do.

  My point is, nothing will work that well unless we are all willing to deny help to those who refuse to plan ahead and help themselves. We must help those who cannot help themselves (as Medicare now does with the elderly), but we have to tell those who CAN help themselves and refuse to do so ... to go fuck themselves. They are the ones causing all this hoopla.

• sheltercrow said on Oct 05, 2009....

  Health savings accounts are a device used to divert attention away from real reform and entrench the current system. That they are favored by industry think tanks supported by the health insurance industry is no coincidence.
  
  Since you have not researched health savings accounts...
  
  
  In testimony before the U.S. Senate Finance Committee's Subcommittee on Health in 2006, Commonwealth Fund Assistant Vice President Sara R. Collins, Ph.D., said that all evidence to date shows that health savings accounts and high-deductible health plans worsen, rather than improve, the U.S. health system's problems.
  
  
  From the Consumers Union, May 14, 2008:
  
  
  Impact of High Deductible Health Insurance And Health Savings Accounts on Consumers
  
  Recent experience with health savings accounts and high deductible health insurance policies has confirmed what economists and policy analysts have predicted for the past decade: In a voluntary health insurance marketplace where lawmakers have let the free market write the rules, encouraging high deductible policies combined with tax favored savings accounts, benefits the rich and increases the financial burden on the sick. It is time for Congress to call a halt to this misguided policy and turn its attention to health system reform that will provide guaranteed coverage to all Americans, while improving the quality of care in the system and constraining costs.
  
  
  PNHP Fact Sheet: Health Savings Accounts – No Savings
  
  
  Why HSAs won’t work:
  
  Health care doesn’t work as a “market.” Economists have concluded that medical care does not and cannot work like a market; it works like a public good. Patients don’t decide what to “buy,” they rely on doctors and nurses to guide treatment decisions, and hospitals to have all necessary personnel, equipment, and supplies at the ready. The information to compare prices and quality (such as when car shopping) does not exist and would be extremely unreliable anyway, since the easiest way for a provider to improve quality and lower price would be to shun the sickest patients. Finally, patients are poorly equipped to “shop around” for health care at the time in their life they are most vulnerable and in need of guidance and compassionate care (3).
  
  Health savings accounts will not control costs. Each year, ten percent of the population accounts for 69 percent of health spending. HSAs do nothing to control costs for these patients, they merely shift costs from the insurers to the patient (4,5).
  
  Financial disincentives lead to rationing, discourage prevention, and result in worsened health outcomes. Exposing patients to high out-of-pocket costs leads to rationing based on ability to pay. Studies have shown that increasing out-of-pocket expenses causes patients to forego needed primary and preventive care. It worsens health outcomes, particularly for low income patients and those with chronic illnesses such as high blood pressure (6,7,8).
  
  HSAs will do nothing to reduce the number of uninsured. Since the primary difference between an HSA and a regular savings account is that the HSA income isn’t taxed, the only attraction of an HSA is its tax-deductibility. More than half of the uninsured have no income tax liability. In addition, skimpy HSA-compatible plans still have high premiums. A recent study estimates that widespread implementation of HSAs will reduce the number of uninsured Americans by less than 100,000 (9).
  
  HSA plans increase administrative costs. Administrative bloat and bureaucracy already consumes 31 percent of our health spending, hundreds of billions of dollars in waste each year. HSA plans, which require the tracking of all out-of-pocket spending by each patient, their HSA corporate manager, and their insurer will only increase these costs (10).
  
  Patients are left exposed to massive debt. Those experiencing an illness or injury find will themselves exposed to high out-of-pocket costs through the required deductible, co-payments co-insurance and uncovered costs. Many patients have been bankrupted well below the “catastrophic” thresholds outlined in some plans (11).
  
  HSAs deplete funds from the insurance risk pool. While the poor and sick quickly deplete their HSA funds each year, the rich and healthy retain their unspent money which would have previously gone to subsidize care for the sick. These health dollars are effectively removed from the system and will need to be replaced by cutting costs or raising premiums. Furthermore, as the subsidy of healthier patients disappears, the stability of insurance plans as a whole are threatened (the “death spiral”)(12).
  
  Patients with experience with HSA plans are dissatisfied with them. A June, 2005 study by the pro-HSA consulting firm McKinsey & Company found that most (56 percent) of patients with HSAs are less satisfied with them than with their previous health plans. In some companies, as many as 75 percent said they were dissatisfied with their HSA-compatible plan (13).
  

• curmudgeon said on Oct 08, 2009....

  Actually I was thinking more along the lines of a "health bank" in which customers have more control over their own spending and treatment plans. Obviously I'd prefer private over public. This way, no bureaucrat of any sort can dictate which treatments or procedures may or may not be made available to the patient.
  
  Shelter - I was not promoting HSAs as they are currently conceived. I wasn't even thinking along the lines of reducing costs or anything of the sort. I was considering a shift in thought from insurance (betting I will get sick when we all know eventually I will get sick on a long enough timeline), to finance (I will be making expensive purchases sometime in the future and wish to plan for that event). Please argue with your imaginary opponent somewhere else.
  
  My wife actually has an HSA in addition to private insurance and both work fine for us. No opinion from some linked think tank with its own vested interests in public policy outcomes can contradict personal experience. If you don't like your healthcare, don't bitch at me or involve me in your dubious political shenanigans. Go do something about your own situation instead of trying to fuck things up for everyone else.
  
  
  

• ALIENated said on Oct 08, 2009....

  The whole problem I see is that insurance has caused the problem and we want to use it as the solution. I think stary-eyed politicians see all the money going to doctors, hospitals, and insurance companies and they cannot wait to get their hands on all that cash. They have no problem dipping into Social Security funds do they? Any time large sums of money are set aside for something, you can bet it is going to be spent. People have to be rewarded for staying healthy, not for getting sick. That is another major problem with all this: the people least able to pay are the ones that usually need it the most. The problems will never be solved if we think the solution is raising more money and making more money available to those in need. The healthcare providers will just raise their prices, which is exactly what has been happening over the last several decades. Supply and demand at work. People have been supplied with more money (via insurance) so they demand more frequent and better healthcare, which impacts the supply (there are only so many doctors), which impacts the costs. It is a viscious cycle. Imagine you are on an island and you can find just the right amount of food to eat every day to keep you in good health. Now imagine a large crate of food and liquor washing to shore every day or so. Are you going to sit on your butt, and eat and drink what is in the crate or go foraging for the local food? The natural balance of things has been disrupted by insurance money washing ashore on a regular basis. The only difference is, a higher and higher bill is washing ashore with it, but we still act like it is "free".

• curmudgeon said on Oct 13, 2009....

  Alien - you hit it right on the head. So long as we think someone else will foot our bills, we will spend however much we like on whatever we like.
  
  Just think of the billions of dollars the tobacco companies coughed up to the States. Every single smoking-related illness in the nation can be treated free of charge with that money. But the States are spending the dough on other stuff and many patients are still left untreated!
  
  How do liberals not see that the government does not take care of people no matter how much is taxed or spent, and no matter who is in the Administration?
  
  Now the current legislation being considered will cost upwards of a trillion dollars and STILL fail to insure everyone in the country!
  
  Makes me want to just grab all I can in the time I have and fuck everyone else, because within three decades or so, Medicare and SS are going to fuck me over in my greatest time of need.
  

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