Skip to comments.Need Freeper Help on Healthcare Paper (Shameless Vanity)
Posted on 04/14/2006 9:55:03 AM PDT by duckbutt
Freepers - - I'm working on my dissertation topics which is "Should the US institute a single-payer health care system similar to Great Britain and Canada" and the subtitle is something like "An Agenda for Solving America's Health Care Crisis using Health Savings Accounts".
I'm in need of Freeper help. This is the last leg in this middle-aged Freeper's journey toward an MBA, so be gentle.
I'm looking for Freeper inputs regarding your feelings about the health care system in America, as it stands today. I'm looking for Freepers from all walks of life; Doctors, small business owners, retirees, those on Medicare and/or Disability, policy makers, and just those with strong opinions.
Please feel free to Freepmail me and we can start a dialogue. I'm most intersted in responses to the following questions:
1) Have you had any experience with Health Savings Accounts and how do you feel about them, if you have?
2) Has your employer offered a HSA as an alternative to your health care choices?
3) I'm interested in Freeper Canadians who've had experience in the Canadian health care system. Any success/horror stories? Same with our European Freeper brothers and sisters.
4) If you are a Doctor, what do you see as a viable solution to the health care situation in the US?
5) Would you switch to an HSA if offered along with a cheap, high-deductible insurance policy?
6) Anything else you wish to chime in on.
I'm nervous as this is my first Freeper vanity. I hope JimRob will allow me this indulgence as this is important not only for me, but the dialogue is important for the country.
Freepers Rule! I know you won't let me down!
Thanks - - Duckbutt
If you are unable to research a topic like this on your own, you certainly wouldn't be much help to an employer!
Mary Baker Eddy solved these problems years ago.
You may wish to ask yourself, or conduct research to determine, how many Americans travel to Canada or GB for their nationalized healthcare versus how many Canadians or British citizens come to America for healthcare. In Canada, for example, when the money runs out near the end of each month, doctors simply close their offices; but, you can still have a CT scan done on your cat, if needed, at a hospital, just not for your child. In the USA, "uninsured" people can walk into any hospital ER and receive the same care as insured folks, in too many cases costing the taxpayers. Now, if you're for 90% marginal tax rates, I suggest the European model. That should be enough to answer your questions.
boy mr. negativo, did you even read the questions? duckbutt is looking for the human side of the research--uh, as in personal experience. geesh.
I would suggest reading a little about the now defunct TennCare program in Tennessee. Often dubbed Hillary care Lite the program was enacted with input from Al Gore when as VP he had some clout in the Tennessee Legislature.
The program was ended recently by a Democrat Governor over the horrendus cries of thousands who lost the coverage. TennCare was literally bankrupting the state.
This will get you started.
It is a learned vanity.
Don't forget many peoples health care plan-----"Don't Get Sick".
My employer offered HSAs and a payment if you dropped insurance all together. I dropped my insurance through work and joined my husband's HMO.
HMOs and PPOs are a pain of bureacracy sometimes. But 3000/year taken PRETAX + 500-1000 out of pocket for regular visits is cheaper than the 5000 minimum for the HSA that is out of pocket.
My company's HSA has been taken mostly by healthy people who use extra money for lasik and massages. Older people stay in the HMO, which drives up premiums.
After age 50, people reasonably think you'll need a back surgery and cancer screenings and glasses and perhaps a heart bypass. in that case, the HMO is drastically cheaper out of pocket than the HSA.
As a side note HSA are some of the most complicated vehicles to understand when I researched switching to 'em. They are not user friendly IMHO and thus have gimmick status.
shameless bump - -thanks to all who have responded thus far!
My daughter was born in Canada, and her dad had knee surgery there (football injury) We both did okay, but when our young son was sick, it was hard to find a doctor to get into see, and I was not impressed with the service.
Our small town in NE TX had a Canadian doctor open an office. He came down here to make some money, but has retired back up there.
I am on disability/Medicare/Worker's Comp and don't recommend it to anyone. Trying to find doctors who will take it is not easy. Some things I just pay for out-of-pocket because no one wants to go through the hassle of trying to get any procedure approved.
You might find some good info here:
If you think health care is expensive now, wait until you see what it costs when it's free.
One of the big problems I see is that many patients are just a number. The "family" doctor with 20 years of experience with a single patient or family no longer (or is rare) exists.
I have had good luck with HMOs. But I "shopped" for a Doc and then stuck with him (even to the tune of paying far more in medical insurance for the privilege).
Personally, I still think we have one of the best medical systems in the world. There is a reason Canadians are crossing the border for health care here in the states.
Thanks Travis - - PJ's quote is on the front page of my paper :-)
I am the owner of a small business, I was paying $850 per month for a standard health care policy until two years ago when I got an HSA with about a $5000 deductible. The premium on that policy is under $400 per month, so even with my $400 per month funding of the deductible, I am still a little ahead. With the previous policy, we never reached our deductible, so we were paying a few thousand a year in out-of-pocket medical expenses above the premiums.
So, the HSA for me is much better than the previous method, plus things like eyecare and dentist are able to be funded from the HSA account.
To clarify, in my last post this is a family policy for five of us.
Conservatives have the right solution in HSAs but for the wrong reasons. The contemporaneous benefits that these accounts afford will be significant but they are exxagerated. Half of the US population consumes only 3% of all health care resources and 10% consumes something like half. The former would be more careful with their money once they have HSAs, but the impact will be negligible for the simple reason that they don't spend much to begin with. The latter will hit their catastrophic thresholds and the HSAs would have little or no impact.
HSAs are of contemporaneous value only in instances where individuals think that they will have little likelihood of hitting the insurance threshold but still spend enough that there are significant savings to be realized. These folks just aren't numerous enough to come anywere close to solving the health care crisis.
As Gary Becker points out on his blog, savings and insurance aren't the same thing: People are interested in insuring against bad health because of uncertainty about the incidence of various diseases. Borrowing also offers insurance by redistributing spending over time, but borrowing is in most cases, and certainly in the health case, a very imperfect substitute for explicit insurance.
The problem with Becker's thinking (and I point this out realizing that Becker is the best economist of the past few generations) is that the reasoning goes both ways, and the other way is more compelling:
1. Insurance is a horrible substitute for savings.
2. Both the level and the variation in health care spending are mostly life cycle related; and nearly all non-catastrophic care is life cycle related.
I wish I could make an accurate estimate, but I can make a guess that 80%+ of all non-catastrophic health care resources are spent on birth or advancing age. Thus, for example, three in ten hospital admissions in the US are for pregancy, childbirth, and newborns. These admissions are almost always ignored in studies/reports of health care, in no small part because they would swamp all other "diseases." If you think childbirth is inexpensive, note that about a quarter of deliveries are by C-section, which involves major surgery; and that as a nation we are making astonishing strides in neonatal intensive care -- at an astonishing cost. Newborns' costs are now as expensive on average as their mothers'. We tend not to realize this because a very small fraction of NICU patients run up very, very, very high bills while the vast majority of newborns are discharged with a bill < $1500.
One huge problem with health care financing in the US is that we use insurance in lieu of savings. Young people pay far more than is actuarily justified for their health insurance and in doing so "save;" and as they get older they pay far less and thereby "dis-save." But of course, because this arrangement isn't really savings at all, many young people opt out -- ending up with neither insurance nor savings.
The point of having health SAVINGS accounts is to disentangle insurance from savings. The catastrophic component is a hedge against adverse health outcomes; the HSA is a vehicle for smoothing life cycle variations in spending. This is EXACTLY the right way to go. There isn't space to elaborate here, but once we have HSAs all sorts of other financial benefits will be ensue over time.
Now that I've fixed health care financing, would anyone be interested in knowing that health care is a fixed cost business? Managed care has failed because it works exclusively on variable costs, when in fact the expenses are astonishingly fixed and sunk.
hmm.... well I can agree with the jist of what your saying. Perhaps what is needed is a combination of HSAs and insurance. Meaning that people can, if they so choose, purchase catastrophic insurance that will cover expenses greater than 100K. Then, for the little stuff, the vast majority of expenses that they go through in life, they will have their HSA.
This will help bring down costs and market competition for at least a portion of the health care system.
Also, as they age, their HSA nest egg will build so they may choose to raise the limit on the type of catastrophic health insurance they want - to a 500K limit or something.
Of course, I do not suggest that government attempt to construct such a system - merely that it get out of the way and let people fashion it themselves as they so choose.
FSAs (HSAs) are helpful as a supplement if you can predict your health care costs. But as a primary form of Health Insurance they will fail miserably.
Post #34 provides some insight on some basic flaws in any insurance-based approach to health care.
FWIW, Michael Reagan had an analogy 'bout 6 years ago i.e. How expensive dining out would become if it was mandated (like health care).
I didn't find it on his web site, but maybe you could email him.
I want to bump this one more time to see if anyone has anything else to add to the health care discussion.
Thanks one and all!
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