More On Health Savings Accounts

Russ Roberts has posted some interesting thoughts about the healthcare system in Canada. Just keep scrolling. He references the development of fully private medical care facilities that are cropping up in the wake of a Supreme Court ruling in the Great White North. This ties in with some comments from the readership (it's gotta be at least five of you now) regarding my post about HSAs. Let me be clear, HSAs are not a panacea for our healthcare system, but they represent a senstional political compromise for both sides of the political spectrum (although I am not sure that one of the sides recognizes this fact). You have to view HSAs as an alternative to what is happening in Canada, which is a natural evolution of a two-tiered system, one which provisions care through the government and one which accepts all major credit cards. This two-tiered structure invariably means better quality and availability of care for those who have the means to pay. I'm not sure that this is what liberal policy makers would like to see and I am certain that some will attempt brute force legislation aimed at stopping this evolution. An alternative would be HSAs which, as I mentioned in my posted comments, is a bone that the political left could throw to the large swath of the population that is clamoring for more fairness. This swath consists of the young, healthy, and middle to upper class, and they are desirous of a better healthcare system, principally a more fair one where the heathy don't subsidize the unhealthy. While a more free market system is probably the ideal choice for many in this group, people understand political reality and would be happy for an incremental advance that fixes the inherent unfairness and/or offers some reward for being responsible for their own health. This desire is a powerful political force that isn't going away, but could be blunted with HSAs, which would leave the current system intact and open to tinkering to maintain and improve access and quality for the poor and unhealthy in this country. I imagine that if a politician like Daniel Moynihan were still around, this would be the strategy that he would advocate, but (and this is a symbol of the establishment Democratic Party on nearly every issue) it is his successor, unfortunately, who is driving her party into uncompromising policy positions on healthcare. If you are concerned about things like "access" and "safety nets" and "the needy" in our healthcare system, a blooming "cash 'n carry" healthcare marketplace ala Canada, is far worse than offering HSAs.