Bloomberg on Healthcare: "Don't Consume Services, Pay Anyway."
Today's "Bloomberg TOP Liberal Inanity of the Day" is directed at Bush's HSA-centric healthcare reform proposals. Far be it for me to outline the major points of why these reforms hold promise, great arguments by the likes of Milton Freidman and Glenn Hubbard are widely available. But the Bloomberg article pounds home a point that, well, has a high degree of stickiness in my craw, and it is this: the proposal would, HORRORS, benefit the healthy!! I don't know where to begin with this but let's take a stab...why the hell would we NOT want to provide incentives for people to be healthy? We ban smoking and sue McDonald's into the mud in an attempt to make people healthier, why not try to achieve the same result via tax policy? (Of course, that presumes that promoting health is a worthwhile goal. Maybe it isn't. Maybe freedom means being able to be a fat, artery-clogged slob who gets winded climbing stairs if one so chooses, but that is a topic for another day.) Of course, tax policy only creates incentives while ultimately leaving it up to people to make choices, and we can't have that. People must be forced to do what is good for them. That is the essence of so much debate in our society today - freewill vs. coersion, faith in people vs. faith in rules.
Also, the general premise of this opposition to HSAs on economic grounds, seems to be that HSAs would allow these dastardly heathly people to actually not pay for services that they don't consume. Without paying into the system for servies that they don't consume, the inherent subsidy to the unhealthy will decrease. This argument that HSAs will benefit the healthy avoids the uncomfortable fact that "the healthy" are getting royally screwed under the current system. Removing the steel rod from the posterior of "the healthy" can hardly be viewed as a grievously unfair benefit. Let's take a simple example. The Baseball family, consisting of two adults under 40 and two children under 5, went to the doctor a grand total of 7 times in 2005. All seven visits were for the under five crowd and involved weighing, peering into mouths, ears and nostrils, and/or getting a total of four vaccinations. For this amount of medical services, the Baseball family paid over $16,000 in healthcare premiums, or roughly $2,300 per visit, and some small out-of-pocket expenses. That is half a year's tuition at a private school for said tykes or food for 10 years for a starving Cambodian family of four, take your pick. Contrast this with Donny Baseball's beloved father-in-law who went to the doctor over 25 times and had an innovative surgical procedure and racked up insurance premiums of roughly $8000, and modest out-of-pockets. To boot, said father-in-law engaged in terribly irresponsible behavior vis-a-vis his health over the years, and continues to do so, without regard to risk. I am of the opinion that in a society where the financial consequences of such irresponsible behavior are actually borne by the individual, we might see less such behavior. But I digress. The point is that the heathly are subsidizing the unheathy. This is unfair and needs to be corrected. HSAs are a way to do that, and more importantly they are a way to do so that have multiple follow-on benefits such as driving down healthcare costs. But probably the greatest benefit is that they would make enormous improvements to our healthcare system without having to fundamentally change the system, which right now offers extraordinary access to healthcare if you happen to be poor and unhealthy. HSAs are actually a damned good compromise that "the healthy" are offering the socialized medicine crowd via the legislative process. The alternative could be alot worse for the bleeding hearts.
Also, the general premise of this opposition to HSAs on economic grounds, seems to be that HSAs would allow these dastardly heathly people to actually not pay for services that they don't consume. Without paying into the system for servies that they don't consume, the inherent subsidy to the unhealthy will decrease. This argument that HSAs will benefit the healthy avoids the uncomfortable fact that "the healthy" are getting royally screwed under the current system. Removing the steel rod from the posterior of "the healthy" can hardly be viewed as a grievously unfair benefit. Let's take a simple example. The Baseball family, consisting of two adults under 40 and two children under 5, went to the doctor a grand total of 7 times in 2005. All seven visits were for the under five crowd and involved weighing, peering into mouths, ears and nostrils, and/or getting a total of four vaccinations. For this amount of medical services, the Baseball family paid over $16,000 in healthcare premiums, or roughly $2,300 per visit, and some small out-of-pocket expenses. That is half a year's tuition at a private school for said tykes or food for 10 years for a starving Cambodian family of four, take your pick. Contrast this with Donny Baseball's beloved father-in-law who went to the doctor over 25 times and had an innovative surgical procedure and racked up insurance premiums of roughly $8000, and modest out-of-pockets. To boot, said father-in-law engaged in terribly irresponsible behavior vis-a-vis his health over the years, and continues to do so, without regard to risk. I am of the opinion that in a society where the financial consequences of such irresponsible behavior are actually borne by the individual, we might see less such behavior. But I digress. The point is that the heathly are subsidizing the unheathy. This is unfair and needs to be corrected. HSAs are a way to do that, and more importantly they are a way to do so that have multiple follow-on benefits such as driving down healthcare costs. But probably the greatest benefit is that they would make enormous improvements to our healthcare system without having to fundamentally change the system, which right now offers extraordinary access to healthcare if you happen to be poor and unhealthy. HSAs are actually a damned good compromise that "the healthy" are offering the socialized medicine crowd via the legislative process. The alternative could be alot worse for the bleeding hearts.
posted by Donny Baseball at 11:34 AM
1 Comments:
HSAs for the most part address the inherent unfair of the system for a large chunk of the population, which is a political force acting against better health coverage for the poor, which for political purposes is simply lumped in with socialized medicine. HSAs are the bone that gov't could throw to the large number of healthy middle and upper class folks to ease the political demands for a more free market approach to healthcare. Within this framework, I do think that costs will come down and we will has less rationing of healthcare, which would make it wasier for the government to target programs specificially for the poor and uninsured. So HSAs don't address the poor and uninsured directly but they get a fair and legitimate beef of a large swath of the population off the table so they can actually deal with the problems of the poor and uninsured.
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