HOOSIERS AND HEALTH SAVINGS ACCOUNTS

WSJ Opinion Journal ^ | 3/01/2010 | greeneyes

[greeneyes]

As Washington prepares to revisit the subject of health-care reform, perhaps some fresh experience from Middle America would be of value.

[greeneyes]

This article gives a market solution, and seems to make sense to me. Any one in Indiana, know whether this is really working well?

[henkster]

They are becoming more popular in Indiana. My wife has us covered through an HSA from her employer. My town is promoting HSA’s for its employees. It very much makes the consumer of health services conscious of the costs. In fact, we now have some medical providers in the area advertising the prices of their services.

I think HSA’s are the right way to go with reining in health care costs. Covering routine and minor matters through “insurance” is “private sector socialism” and it is what’s driving up costs. All of us have auto insurance but we don’t expect those policies to cover oil changes and new tires. No reason to look at health care costs any differently.

[hoosier hick]

I don’t have any personal experience with it, but I have seen the flip side- where lavish coverage leads to outrageous over-use (both in California and in Indiana). The “covered” person(s) have to have skin in the game to encourage proper use....

hh

[marsh2]

Problem is that for most of the “working poor” an $8000 out of pocket expense is likely to cause bankruptcy. It might be a part of the solution but not the answer. This is the problem when folks who never have had to live on $30,000 a year design plans to solve problems for those who do. What sounds reasonable to them is a financial disaster for the working poor.

[slowhandluke]

$8000 out of pocket expense is likely to cause bankruptcy.

There's a window of risk the first few years, but if you aren't profligate with the HSA account, it builds up a nice cushion. Or that's the theory, anyway. You have to get in on this while you are young to make it work.

Long term chronic illness can burn through any cushion pretty quickly though. Remicade (for arthritis, other autoimmune troubles) can be $7K and up per year.

[DonaldC]

“In fact, we now have some medical providers in the area advertising the prices of their services.”

I wish more providers did this.

[Elle Bee]

and for a nominal amout you can purchase a 'wrap-around' policy wich will cover catastrophic expense

They work very well

Think of them as the School Vouchers of Health Insurance --- and only disliked by the same sort

.

[Skywalk]

One of the primary issues with health “insurance” in this country is we have begun to conflate any health treatments with “insurance.” Of course, government is the main driver of costs through regulations, especially those tied to state mandates, and the Medicare/aid programs. But surely, there are a lot of people who expect to pay a monthly rate while somehow drawing on health services and products at an infinite rate.

HSAs and the things that Whole Foods did are basically a quick remedy for a part of the problem but they will not solve it entirely.

[GailA]

OBAMANOMICS—TRICKLE DOWN DESTRUCTION of the economy

SET THEIR LOCAL AND DC LINES ON FIRE!
PLEASE ASK THEM TO REPEAL THE BIG NEW FEES in TRICARE for Life, the retired Military over 65 secondary health ins. which they passed in a DOD bill. They promised our Military these benefits, and our Military have earned them.

Bambi doesn’t keep his promises...so buyer beware!
Sen Scott Brown’s number is 202-224-4543

Capitol Hill switchboard is 202-224-3121

Lots of local demwit phone numbers on this thread

http://www.freerepublic.com/focus/news/2408217/posts

Rename, repackage, rewrite it a tad smaller, and sell another pig in a poke. NO COLAs for granny, retired Military or retired fed employees. BIG NEW fees for Tricare for Life retired over 65 Military’s secondary health ins.
(DOD bill already passed, delayed but goes into effect 2011 NEEDS TO BE REPEALED!

OBAMA’s WAR ON SENIORS http://www.freerepublic.com/focus/f-news/2433867/posts/

New Dem mantra: Woof, woof eat dog food granny....ala let them eat cake. http://www.lifenews.com/bio3058.html
Friday, February 19, 2010

Obama says slight fix will extend Social Security
http://townhall.com/news/us/2010/02/19/obama_says_slight_fix_will_extend_social_security

Health Care Rationing for Seniors Another Problem in New Obama Plan http://www.lifenews.com/bio3058.html
Medicare tax may apply to investment income (ObamaCare tax hike)
http://www.freerepublic.com/focus/f-news/2460988/posts

SOCIALIZED MED THREAD http://www.freerepublic.com/focus/f-news/2461394/posts
TRI CARE FOR LIFE This from a google search:

http://economicspolitics.blogspot.com/2009/05/tricare-for-life-is-obama-trying-to.html

This option would help reduce the costs of TFL, as well as costs for Medicare, by introducing minimum out-of pocket requirements for beneficiaries. Under this option, TFL would not cover any of the first $525 of an enrollee’s cost-sharing liabilities for calendar year 2011 and would limit coverage to 50 percent of the next $4,725 in Medicare cost sharing that the beneficiary incurred. (Because all further cost sharing would be covered by TFL, enrollees could not pay more than $2,888 in cost sharing in that year.) http://www.cbo.gov/ftpdocs/99xx/doc9925/12-18-HealthOptions.pdf

http://www.vawatchdog.org/09/hcva09/hcva110609-1.htm
Bill Would Restrict Veterans’ Health Care Options 11/06/09
Buyer and McKeon Offer Amendments to Protect Veterans and TRICARE Beneficiaries

Congress plans to block Tricare fee increases
http://www.armytimes.com/news/2009/10/military_tricarefees_blocked_100709w

http://www.navytimes.com/news/2009/10/military_tricarefees_blocked_100709w/

By Rick Maze - Staff writer, Oct 7, 2009

Tricare fee increases imposed last week by the Defense Department will be repealed by a provision of the compromise 2010 defense authorization bill unveiled Wednesday by House and Senate negotiators.
Snip The fee increases were announced on Sept. 30 and took effect on Oct. 1, but the defense bill, HR 2647, includes a provision barring any fee increases until the start of fiscal 2011.

Snip

Retired Army Maj. Gen. Bill Matz, president of the National Association for Uniformed Services, said the announcement of fee increases was shocking considering that the Obama administration promised earlier this year to hold off on any new fee Tricare fee increases until fiscal 2011.

“President Obama and DoD assured NAUS and the entire military family earlier this year that there would rightly be no increases in any Tricare fees” in fiscal 2010, Matz said. “We took them at their word, and I can’t believe that a co-pay increase like this was allowed to go forward,” he added.

[conservativegranny]

I was just going to mention that while an $8000 one-time out-of-pocket medical expense may not bankrupt someone it will if you have expenses like that on a yearly basis and some people do.

We have had major medical expenses like that every year for the last 10 years. One heart attack, two back surgeries, several kidney stone surgeries and others.

Like someone said, when you are living on $30000-50000 a year you can end up homeless or eating cat food.

Someone mentioned the auto insurance analogy where people pay out of pocket for normal procedures. While I can get an oil change for around $30 at our local Walmart and new tires for a few hundred try getting in the door of any physician’s office for $30.

I’ve had to pay for minor procedures and I could have purchased two sets of new tires for my car for what I paid for ingrown toenail surgery. There just is no comparison.

I do not mind having some skin in the game but the costs have to be reasonable for the average middle class family. A set of MRI’s ended up costing me more than several house payments. Any health savings account I would have had would have been exhausted a long long time ago.

I remember over 30 years ago when we had very limited insurance. No dental. We paid for all 3 of our children’s braces on our own. Only coverage for major medical expenses. No pharmacy coverage. I paid for all office visits. Limited coverage for child birth. I came home 24 hours later so I wouldn’t have to pay more.

I could take my child into the doctor for an ear infection for $25. The antibiotics were probably $20-25. And I remember friends who had union jobs that bragged about not having to pay a penny for any doctor visits and $5 copays on scripts. I truly believe this type of coverage helped cause these problems with costs being so out of hand an average family can’t afford a simple visit to the pediatrician and a prescription.

The next thing you knew insurance was covering eyeglasses, dental, braces, oral surgery and weeks in rehab. Some insurances were covering gym memberships for crying out loud.

[greeneyes]

Does your wife’s employer make a deposit to the HSA, or match her contribution, or does she have to put all the money into the plan?

[greeneyes]

The article states that there is a cost sharing of the $8000. It did not give the percentage. If it was the typical 80/20 that would mean that the total Health cost would be $40,000, with $32,000 paid by the insurance plus whatever else is due.

That would likely involve a major illness. Americans on average, only encounter this once every 12 years. If the lower income can not pay the $8000, they can fill out financial aid forms, and get some of the expense waived, as well as set up a payment plan.

My insurance costs me $9612 annually for a $5000 deductible, cost sharing on all expenses there after until $10,000, and no Rx. I make way less than $30,000. So I am sympathetic to what you are saying.

[greeneyes]

How many of this state’s employees are working poor? They are also given a choice between traditional PPO and HSA.

It looks like a reduction of the tax burden to me.

[slowhandluke]

My point was that the HSA works if as a young person you can tuck a lot of money away. It doesn't work if you aren't healthy when young.

And it doesn't work if your company switches to an HSA plan just before you retire.