[slowhandluke]

A dozen years ago health reformers promoted Health Savings Accounts (HSAs) coupled with high-deductible plans. A fair criticism of HSAs is that hospitalized patients have long since exceeded their deductibles. Moreover, critically-ill patients are unlikely to forgo a potentially beneficial medical service merely because they bear a portion of the marginal cost. Much more needs to be done.

What crap. What the author is saying in the bold section is that it is a problem when high deductible plans work as they are designed. Their purpose is to keep you from going broke when the SHTF. But according to this idiot, it's a problem that you can now afford to keep getting health care after you've paid the deductible. He'd prefer that the seriously ill consider not getting so much care.

And then he talks about policymakers designing the plans. If it was an Aetna policy designer/actuary, then ok. But I'm sure he's talking about a government policymaker, who was the person who got us into this mess in the first place.

[DoughtyOne]

I think a robust savings plan and high deductible policies is the way to go. In effect you will be self insuring for a portion of your own medical care.

By the time a person is thirty and well established, they may be able to cover a $20,000 dollar deductible. That saves a whomping amount of insurance premiums. It will in short time cover your established deductible.

I support this in a plan I’m developing that covers health, cars, and homeowners. It also incorporates a private retirement plan into it.

I think there’s a way a person can start saving, avoid insurance costs, and purchase a home while still retiring very comfortably by 50-55.

[Brian Griffin]

The patient and insurer (or a drug maker/medical center) should always have skin in the game.

High-deductible plans should be replaced by declining percentage co-insurance.

You might put up $X to get a lower premium.

Your first $X of care might be 50/50 insurer/patient, the next $X 75/25, the next $2X 90/10, then 95/5, with interest at 3% and credit extended by the providers for total annual amounts greater than $5X.

Credit on drug amounts greater than $2X would be supplied by the drug seller(s), with no insurance coverage and subject to PPACA style maximum annual out-of-pockets.

Basically that $100,000/year cancer drug would cost you $5,000/year out-of-pocket. And your drug maker would want you to live 20 years for each year of treatment to get its $100,000/year of treatment. Cancer drugs would get a lot better fast.