Republicans Offer Health-Care Plan (http://online.wsj.com/article/SB124286548605041517.html)
There's not a lot of details here but...

Haven't they learned anything? Once again they want to offer tax breaks for health care. Isn't that what Bush did with his stupid HSA plan? How did that help anyone, except people already fairly well off? How is that going to ensure that insurance companies don't cherry pick their customers and leave people who really need it without any insurance or with insurance so expensive they can't afford it.

Here's a better article (http://www.time.com/time/nation/article/0,8599,1900041,00.html)
However, that Republican bill does not purport to assure coverage to all — or even most — of the 47 million or so Americans who now lack it. It does not, for instance, impose a requirement that employers provide coverage to their workers or that individuals who do not get health benefits at work buy them on their own. The tax credits that it provides — $2,300 for individuals and $5,700 for families — fall well short of the average annual cost of a health policy, which is between $10,000 and $12,000 per family, says Robert Blendon, professor of health policy and political analysis at the Harvard University School of Public Health.

It's simple. The Republicans just want to keep funding the broken system, because they are paid off by the people who profit from that system. If you didn't know it before, you should have realized it by the time Medicare Part D was enacted.

But you missed the stupidest part of the plan, the same idiotic idea McCain had:it would eliminate the tax break that employers receive for providing health-insurance benefits to their workersThat would completely unravel the only aspect of American health care for those under 65 that actually works.

The only reason all those young employees now agree to work to support the old employees is that they don't even realize that they're doing it, since the money isn't directly figured into their salary and doesn't count as gross income.

Once they actually pay money out of their own pocket to support old people, you'll see them drop like flies from the corporate health plan, leaving only old people in the pool, sending premiums sky high, and ultimately causing it to dissolve, leaving everyone to fend for himself.

Then everyone would be screwed, except for the young healthy people who don't need health care anyway.

Health care must be a socialist government function or it will never work.

Once again they want to offer tax breaks for health care. Isn't that what Bush did with his stupid HSA plan? How did that help anyone, except people already fairly well off? How is that going to ensure that insurance companies don't cherry pick their customers and leave people who really need it without any insurance or with insurance so expensive they can't afford it.

Our health care system would be fine if everyone used HSAs.

Our health care system would be fine if everyone used HSAs.You either a) have never tried to purchase health insurance, or b) are 20 years old and perfectly healthy.

Try buying health insurance when you're 50+ and "only" middle class.

Try buying health insurance if you have ANY significant preexisting condition.

Try collecting from an insurance company when they don't want to pay.

You don't fix a horribly broken system by simply subsidizing rich people who can easily afford health insurance anyway, and encouraging people to wait until emergencies before they get health coverage, which is what HSAs do. On the contrary, you make it worse.

Huh?

Our health care system would be fine if everyone used HSAs.
That's the problem that people like Pan have with it.

It gives everyone a choice to buy affordable insurance by their own free will. And HSAs are very affordable, the premium portion is less than what I paid Medicare last year by about 800 bucks. And the HSA belongs to the insured as an asset, it does not go to the government or any insurance company. And if an individual put just 2000 into the HSA per year, at year 10 they could pay out of pocket just about any major procedure; including ANY elective procedure not covered by traditional insurance. At year 20, they can pay out of pocket for about 5. And at year 40, they would have over 2 million dollars in a tax free savings accout to which they could live off the interest or borrow against for the rest of their lives.

But people like Pan know that generally people are too ****ing stupid to help themselves. Or do what is right by themselves.
They also believe that these stupid people deserve to be taken care of by you, me, and society.

'Even', if you have to take away free will from them and everyone else in order to do that. I have not actually figured out it if is 'even' or 'especially' because of.

Thirdly, people like her believe that since everyone is equal, that all people, no matter how smart, should be treated just like the dumbest of us. We are all equal, and should be treated equally. Even it if is with the lowest common denominator.

But an HSA gives an insured unprecedented free will with their health and healthcare dollars.

Want a boob job? HSA covers it. You can't be denied.
Want Viagra? HSA covers it.
Want bariatric surgery. Buy 2. And throw in the tummy tuck and Lipo. All covered by an HSA.
Why does the HSA cover it? Because it is YOUR money, in your account.

The only problem with HSAs is that people don't buy them. They would rather spend the money on PS3s and games, and 46 inch LCDs. Or Bingo, or Indian Gambling. That's what the poor people I know do with the money they don't spend on HSAs. And they use the ED for all their hangovers, sprains, and strains(that is to say Medicare, Medicaid, MediCal).

If you FORCED people to buy HSAs, if they did not have other coverage...There would be no problems with HSAs. Other than the use of force.

The vast majority of the 45 million Americans who do not have health insurance coverage DON'T use the healthcare system. So if you force them to buy HSAs, it is essentially a forced tax they will not use. But at least they will be covered, and all the whiners, do gooders, and Commies will stop bitchin about it.

But I would rather force them, and for several years I was one of them, than to have them force you to pay for their sh1t.

You don't fix a horribly broken system by simply subsidizing rich people who can easily afford health insurance anyway, and encouraging people to wait until emergencies before they get health coverage, which is what HSAs do. On the contrary, you make it worse.
Bullsh1t!

It takes less than a year before the HSA fully covers the high deductible.
If you are so sickly that you can't work for a year, putting tax free money into the HSA, then the HSA is not for you.

Everyone knows that. Unless you are forced to, of course, see post 6.
And those people are using Medicare and SSI already for their coverage.

The so-called rich already have coverage, real insurance, group insurance. They don't need HSAs, unless their financial advisors recommend them. For HSAs are a great retirement fund, just like an IRA.

And the so-called rich already pay their fair share in Medicare and SSI to cover all the poor people. And they are paying for their own insurance, out of their paycheck.

And remember, when anyone ever mentions the 45 Million Americans who don't have healthcare, what they really are saying, are the 45 Million HEALTHY Americans who don't use healthcare. And those talking people want those 45 Million Americans to start paying into the system. To help defray the cost of the all the perennially sick people who are using the healthcare system. Because ultimately, if any of those 45 Million Americans ever gets sick, and needs healthcare, Ronald Reagan made sure in the 80s that they could get it.

Not counting the 12 Million or so Mexicans in America. They all can get the same healthcare as you or I, at any hospital with an ED.

It takes less than a year before the HSA fully covers the high deductible.
If you are so sickly that you can't work for a year, putting tax free money into the HSA, then the HSA is not for you.HSA plans by law have to have a minimum deductible to qualify for favorable tax treatment. The minimum for 2009 is $1,150 and actual health plans are usually higher than that (some much higher, like $3,000-$5,000). There is also no flat fee co-pay for a doctor's visit; you have to pay it all.

This is fine if you have an emergency and need a $100,000 surgery, but it also encourages people to NOT get preventative care and do other minor things, since they have to pay all of it out their pocket. And that's on top of the cost of the HSA, which is overpriced on account of the tax benefit.

In the meantime, of course, you can deduct your Viagra, hair weaves, and eyeglasses and stick the U.S. taxpayers with half the bill.

And the tax benefit is practically worthless unless your income is high, when you factor in the cost of the plan versus the level of coverage you get.

HSAs were a dumb idea from the start.

The so-called rich already have coverage, real insurance, group insurance.If they're employees, or run a large business.And the so-called rich already pay their fair share in Medicare and SSI to cover all the poor people. And they are paying for their own insurance, out of their paycheck.They pay their fair share of Medicare, but NOT of Social Security. It's the poor and middle class that bear a disproportionately heavy burden there, compared to their income.And those talking people want those 45 Million Americans to start paying into the system. To help defray the cost of the all the perennially sick people who are using the healthcare system.If we had a sane system, we wouldn't need them to pay into it. They probably couldn't pay much into it in any case, as it's the rich that pay for every government service, not the poor or middle class.

There is also no flat fee co-pay for a doctor's visit; you have to pay it all.

That's the point.

Note, I didn't say "HSAs are perfect," I said "Our health care system would be fine if everyone used HSAs." The cost of everything would be far cheaper if everyone used HSAs, across the board.

That's the point.What's the point? That making health care even more unaffordable for the common person would make everything better?

HSAs don't solve anything in terms of health care. They're just another tax dodge for the upper middle class and higher.

If they're employees, or run a large business
I can run a small business and afford health insurance. I did it for years.
I was never rich, and had a full coverage plan for myself and my family. Until my family blew up.


They pay their fair share of Medicare, but NOT of Social Security.
I would say that 18% of what you make is a pretty good tax hit.

ind you, that I have paid more SE and SSI tax in my life, than federal income tax. And most of that time, I was federally taxed on half of it as income.

If you are making over 105K a year, you are not going to be using Medicare and SSI. And if something happens where you can't make 105K a year, say a chainsaw accident and you cut off your legs and arms, or you use to work for AIG or Bear Stearns, you are definitionally poor, then it will cover you. /shrug. You are poor, it will cover you now.


It's the poor and middle class that bear a disproportionately heavy burden there, compared to their income.

They are the ones who are going to be using it. Rich people don't depend on SSI payments when they retire, or to cover their disabilities. They are rich, they pay their own way for their sh1t they get. That is why they wanted to get rich, to buy that stuff.

If we had a sane system, we wouldn't need them to pay into it. They probably couldn't pay much into it in any case, as it's the rich that pay for every government service, not the poor or middle class.

That is what I am saying, we need to tax the poor more. They are getting more services for what they produce proportionately. Makes sense that they should pay more proportionately.

That's what people like Panama is suggesting, or Obama, or Hillary. Or that Doc on CNN. Middle class people who are healthy, who are not paying into the system, should be forced to pay into the system, whether they like it or not. Those 45 Million Americans, are lower and middle class folk. Again, I was one of these folks, from 2001 to 2007. I had no insurance, and did not use the healthcare system, I was poor.

They, those 45 Million poor to middle class Americans, don't pay into the system. And every plan floated, needs to force them to pay into the system. They need to offset all the continually sick people who do use the system.

HSA plans by law have to have a minimum deductible to qualify for favorable tax treatment. The minimum for 2009 is $1,150 and actual health plans are usually higher than that (some much higher, like $3,000-$5,000). There is also no flat fee co-pay for a doctor's visit; you have to pay it all. Absolutely wrong. Your insurance plan pays for everything above the deductible. And you have to be putting the max allowed into the HSA. Which is still less combined than the typical individual health insurance plan.

This is fine if you have an emergency and need a $100,000 surgery, but it also encourages people to NOT get preventative care and do other minor things, since they have to pay all of it out their pocket. And that's on top of the cost of the HSA, which is overpriced on account of the tax benefit. But you have been putting 200 bucks into the account per month when you opened the account. It is your money. You can spend it if you think you need it. You would have been paying the 320 a month anyway into a regular plan, MORE actually. You are not out anything, that you otherwise would have been out. Except that if you don't get sick, you get to keep what you would have been giving the insurance company or government.

In the meantime, of course, you can deduct your Viagra, hair weaves, and eyeglasses and stick the U.S. taxpayers with half the bill. It is all your money. How are you sticking the taxpayers for anything? You already earned all the money. It is yours.

And the tax benefit is practically worthless unless your income is high, when you factor in the cost of the plan versus the level of coverage you get. So you get to keep your money anyways. If you are so poor that you are not able to deduct that income, at least you are putting 2400 into a savings account.

HSAs were a dumb idea from the start. They are an awesome idea. YOU, the insured, become your own insurance company. You are self insured. And after 40 years, if you have not got sick, you own an asset worth over 2 MILLION dollars.

I'm 44 now. I have paid way way more into the coffers of Socialized healthcare, and into insurance companies than I have received out it. If I had the choice to put that money back into my pocket, and still have the same coverage that an HSA allows. I would be rich now.

RICH.

Filthy RICH.

If I started back when I started paying insurance. But instead had an HSA, I would have 1.2 Million in it right now, give or take 100K.

I would say that 18% of what you make is a pretty good tax hit.You mean 15.3%. But because of the social security limit, most of that applies only to the poor and middle class.

If I make a billion dollars, I pay as much into Social Security as a guy who makes $106,800.

A poor guy who makes $10,000 has an effective zero marginal rate, but still has to pay that 15.3% on the first cent he makes (half directly, half indirectly).

edicare, on the other hand, is a flat tax with no limit, just as Social Security should be.If you are making over 105K a year, you are not going to be using Medicare and SSI.Says who? It depends.Middle class people who are healthy, who are not paying into the system, should be forced to pay into the system, whether they like it or not.Fine. But the rich are still going to be doing the heavy lifting, as they always do when it comes to government financed projects.

The bottom 50% of wage earners (~$32K and below) account for 3% of federal income tax revenue.

The top 1% (~$400K and above) account for 40%.

The top 5% (~$150K and above) account for 60%.

Any health care system that relies on poor people to pay into it, to get financed, is doomed to failure, because poor people just don't have enough money to pay the exorbitant prices your industry charges.

edicare works because it's a 2.9% tax on ALL income, with no limit. Socialism at its finest.

Absolutely wrong. Your insurance plan pays for everything above the deductible.Key word is above the deductible.

If you're reasonably healthy and have a $3,000+ deductible, you're NOT going to be motivated to get routine care that falls under that every year. Especially if you don't earn a lot, and your tax advantage is slight.But you have been putting 200 bucks into the account per month when you opened the account. It is your money. You can spend it if you think you need it. You would have been paying the 320 a month anyway into a regular plan, MORE actually.HSAs also cost money, for the plan itself. I have a no deductible plan, but if I switched to an HSA with a deductible, I'd have to pay more per month than I pay now.

It's like municipal bonds: HSAs are priced to appeal to high income earners only.I'm 44 now. I have paid way way more into the coffers of Socialized healthcare, and into insurance companies than I have received out it. If I had the choice to put that money back into my pocket, and still have the same coverage that an HSA allows. I would be rich now.That's the point. This is socialism. If you are young and productive, you should be paying more than you receive.

If we allowed you to funnel that tax money into your private account, it would defeat the entire purpose of the system.

This is why Bush's idea of letting you put a percentage of Social Security tax into a private account was an absolutely idiotic idea.

You call it socialism, I call it a ponzi scheme.

Socialism is not a ponzi scheme. There is no fraud involved. There is also no guy behind the scenes collecting all the money; it is redistributed for the common good.

There is a reason every developed country has a socialist health care system: because it works, and the alternatives don't.

We have a part socialist system, and the free market side is a total mess. Half the socialist side is also a mess, but that's because of a screwed up implementation, not because of an inherent failing of socialism.

There is a reason every developed country has a socialist health care system

Uhh, incorrect.

Which ones don't?

Another things HSA's don't solve is cherry picking and the extraordinary price that anyone who ever had anything wrong with them has to pay for health insurance, even if they are currently healthy.

I had a series of tests done to figure out why there was some mysterious red blood cells in my pee. They never found anything, and probably most of the time that's a meaningless thing, but those tests were used against me when I applied for new coverage and I was denied. I ended up having to pay double the normal premium and get on the state's high risk pool because I was turned down.

Which ones don't?
Reckon your confusing "universal health care" and "socialized medicine." Just about every other developed country has universal health care, yes, and most of them have largely socialized medicine, but many developed countries don't have socialized medicine (Switzerland and Holland come to mind, which have less 'socialism' in their health care systems than we do.)

You don't need to have a massive government controlled ponzi scheme to achieve universal health care.

Reckon your confusing "universal health care" and "socialized medicine."Any system whereby the government redistributes resources to provide health care to those who otherwise couldn't obtain it is a socialist system. From each according to his ability, to each according to his need.

You cannot have universal health care without socialism. It doesn't work.

This is true even for systems that use the mandatory health insurance model. The Netherlands and Switzerland require health insurance, but they set the prices and level of treatment to prevent discrimination, and use taxpayer dollars to make up the difference.

It is still socialism, even though insurance companies are an ostensibly private intermediary. Rich people still pay for poor people. It is NOT a free market system.

If we allowed you to funnel that tax money into your private account, it would defeat the entire purpose of the system.



No it wouldn't.

Everyone would have the funds to pay for every healthcare service they wanted themselves.

You would make the decisions of what doctors you see, how much is paid, what specialists you want to see. What procedures you want done.

That would be an AWESOME system. Everyone would be self insured. Making millions in savings. And NEVER(well after 10 years paying into it) would a healthcare claim ever be denied.

You cannot have universal health care without socialism. It doesn't work.

If you forced all of the 45 Million Americans not paying insurance to buy an HSA. And forced them to contribute the maximum amount into the HSA each year...

That is definitely force. But not really socialism.

It is force for you to take responsibility for yourself. Instead of force to take responsibility of other people. The former is vastly superior morally and ethically. The former may be force, but the second is force and slavery. In the second you are forcing me to work for someone else, that is slavery.

And if it truly were made universal, that would be the ideal. Everyone would be covered. I would even give you the caveat, that the government cover any cost during that first year of contribution into the HSA.

Another things HSA's don't solve is cherry picking and the extraordinary price that anyone who ever had anything wrong with them has to pay for health insurance, even if they are currently healthy.

I had a series of tests done to figure out why there was some mysterious red blood cells in my pee. They never found anything, and probably most of the time that's a meaningless thing, but those tests were used against me when I applied for new coverage and I was denied. I ended up having to pay double the normal premium and get on the state's high risk pool because I was turned down.

You cover yourself. In only a few short years, your HSA will cover virtually any problem that you might have.

I don't understand how you can't realize how much 2200 bucks, per year adds up.

If you started paying into it when you started working. And needed to tap into it now, you would have about a MILLION dollars in it right now.

You are individually doing what insurance companies do with your money to make more money. You are taking their job away from them, at the same time you are saving your own money.

I can't believe that you don't know how an IRA works. And HSA is a healthcare IRA. You are saying that IRAs are stupid.

No it wouldn't.

Everyone would have the funds to pay for every healthcare service they wanted themselves.If they're rich enough, sure. But we've already established that the rich don't have trouble getting health care anyway.

ost people cannot save up hundreds of thousands of dollars to have on a moment's notice when they have a medical emergency.

And a good number of people will never need such a large amount.

Self-insurance for health care is a really dumb idea.I can't believe that you don't know how an IRA works. And HSA is a healthcare IRA. You are saying that IRAs are stupid.Except that retirement is almost entirely controllable and predictable (in terms of expenses) whereas health care is almost entirely not.I don't understand how you can't realize how much 2200 bucks, per year adds up.

If you started paying into it when you started working. And needed to tap into it now, you would have about a MILLION dollars in it right now.If you save $2,200 per year, assuming a generous 8% rate of return, it will take you 48 years to break $1 million, WITHOUT inflation.

If you assume an inflation rate of 3%, it will take you 68 years.

It would also kind of suck if you get hit by a bus tomorrow, and only have $2,200 in there.

Honestly, your idea is retarded.

I heard last night 30% of the costs are administrative costs right now and the administration necessary for doctors and hospitals to deal with insurance companies, and visa versa, is just huge. Most of that would be eliminated if there were a single payer system, which is, of course, why insurance companies are fighting it tooth and nail. Doctors like the idea because they believe they can go back to what they originally signed on for, treating the patient, not their insurance company.

Bill Moyer's interview (http://www.pbs.org/moyers/journal/05222009/watch.html) with doctors on single payer.

I heard last night 30% of the costs are administrative costs right now and the administration necessary for doctors and hospitals to deal with insurance companies, and visa versa, is just huge. Most of that would be eliminated if there were a single payer system, which is, of course, why insurance companies are fighting it tooth and nail. Doctors like the idea because they believe they can go back to what they originally signed on for, treating the patient, not their insurance company.

Bill Moyer's interview (http://www.pbs.org/moyers/journal/05222009/watch.html) with doctors on single payer.

Single payer =/= 0 administrative costs. From the doctors point of view, it is far cheaper, from the taxpayers point of view, not so much.

Everything with the government involves way more paperwork than is needed. Why in the world would health insurance be the one instance where the private sector has more paper work than the government? Because the private sector, unlike government, needs to make a profit and can't be throwing away a huge portion of it's money to fraudulent claims.

People who work for medicare get their promotions and bonuses even if they throw away $60B a year (which is the conservative of what they do on average.) So sure, the doctors who do honest work save money, but we need to pick up the tab for their lax oversight none the less.

The best way to attack administrative costs by far is HSAs. The best way to encourage price competition is HSAs making patients actually act like consumers, not bureaucratic price controls.

It would also kind of suck if you get hit by a bus tomorrow, and only have $2,200 in there.

Honestly, your idea is retarded.

Honestly?.

Talking to you people is like conversing with Lewis Carroll characters.

If you get hit by a bus, your premium covered insurance will cover you. And since you have already covered your deducible, you would not be paying anything.

There plays Dee and there plays Dum
They both talk about one thing
And on the other plays mum
One can't see the wicket
The other can't see the ball
And no matter how you hit it
Neither one makes sense at all

The best way to attack administrative costs by far is HSAs. The best way to encourage price competition is HSAs making patients actually act like consumers, not bureaucratic price controls.Do you have any idea what an HSA is?

HSAs require you to also buy health insurance. There is no administrative savings whatsoever.

Do you have any idea what an HSA is?

HSAs require you to also buy health insurance. There is no administrative savings whatsoever.
It is quite obvious that it is you who does not have an idea what an HSA is, or how it works.

When you present your HSA debit card to pay for your incidental medical costs, there is no administration. No claims, no claims rejections.

It is money just coming out of your HSA account, just like your debit card or like a prepaid credit card. And while it is quite obvious that their is overhead in administration of debit accounts or prepaid credit cards, it is also quite obvious that it is much much less than what is current overhead for that same incidental introductory coverage.

If I have a prepaid credit card, there is no huge group of people who get to deny my purchases or not, whether I need this or need that, or that I should be buying stuff at this place or that place.

Insurance companies have those huge bureaucracies of people employed just to do such things.

You can spend your HSA card money, on any healthcare related service or good. And there is no one that prevents you from doing so.

Of course that could be abused, you might want to stock up on cases of Fleets enemas before a big party you have planned. Or buy a TENS machine for your dungeon. Neither of which are really healthcare related, the chance of abuse is there.

But really, how big is that. Maybe like 10 people in California would spend their HSA money to shock their subs for sexual satisfaction.

Someone might want a face transplant, if you can get a doc to do the work, it will come right out of your HSA, just like if you were buying a case of beer at the Quickee Mart. There is not bureaucracy set up to decide what claims are denied from the HSA account(only the premium covered portion).

You can buy a box of condoms on your HSA card.
Plan B on your HSA card.
Boob jobs.
Viagra.
You can buy over the counter items with it. Herbs, vitamins, supplements. Ace bandages, Neosporin. Aspirin.
Think of anything remotely related to healthcare or health, virtually anything an insurance company would deny you, you can pretty much buy it with your HSA debit card.

Does your insurance plan cover those things now? I doubt it. But with your HSA account, you are now your own insurance company. You are your own claims adjuster. You get to decide which claims are denied or not. Not some insurance company suit.

Right... Also, how do you encourage price competition when the consumer can't see the prices? Try getting a price list from a hospital sometime...

If you save $2,200 per year, assuming a generous 8% rate of return, it will take you 48 years to break $1 million, WITHOUT inflation.

If you assume an inflation rate of 3%, it will take you 68 years.


First, it is pretaxed money.
That 2200 is only really only some 1475 bucks to you, at the lowest tax bracket. Give or take.

Second, 10% return over the long haul is very conservative and realistic, not 8. If it is for you, you should change funds, stocks, or managers.

The HSA portion works just like an IRA.
Here is an IRA calculator to make it easy. You can put whatever numbers you want into it.
http://www.planningtips.com/cgi-bin/annuity.pl

I put these numbers into it, using your 3% inflation, with my 10% return...
http://www.planningtips.com/cgi-bin/annuity.pl?abal=200&pymt=200&time=40&intr=10&ryld=10&infl=3&raiz=4.5&wdrw=&Calculate.x=54&Calculate.y=15

Do you have any idea what an HSA is?

HSAs require you to also buy health insurance. There is no administrative savings whatsoever.

For non-catastrophic care, there is less paperwork that needs to be done by the doctors for HSA payments than either traditional insurance or single payer insurance.

Right... Also, how do you encourage price competition when the consumer can't see the prices? Try getting a price list from a hospital sometime...

When the consumer is actually paying for things, you can bet that they will see the price list.

People now go in, and say, if its covered what do I care what it costs. The insurance company is paying for it.

Does not make a difference to the consumer now, if it costs 10 or 10,000, when someone else is paying for it.

That is one of the biggest reasons for healthcare inflation. Not the biggest, but one of them.

The consumer is not educated and does not care to be educated. Because someone else is paying the bill. 'I'm covered, what do I care what it costs'. It is like some rape victim spread eagle saying, 'come and get it boys'.

For non-catastrophic care, there is less paperwork that needs to be done by the doctors for HSA payments than either traditional insurance or single payer insurance.

There is NO paperwork.

You slide your card, and its done.
It is a debit card.

Right... Also, how do you encourage price competition when the consumer can't see the prices? Try getting a price list from a hospital sometime...

ake a time machine and go back say... 8 years ago and go to a lasik eye surgeon. Then in your time machine, move up 1 year at a time and see the same guy. You'll notice that the service gets better and better and cheaper and cheaper overtime.

What mass HSAs would do is make people consumers of all surgeries the same way they are of lasik eye surgery.

First, it is pretaxed money.
That 2200 is only really only some 1475 bucks to you, at the lowest tax bracket. Give or take.The lowest federal tax bracket is 10%. The lowest state tax bracket varies; it can be 0%, but in California it's 1%.

1475 is not 90% of 2200.

Payroll taxes you pay anyway.

This is the point, that is flying over your head. HSAs are a tax dodge for wealthy people, but do nothing to help the people who actually have trouble getting insurance in the first place.

It is quite obvious that it is you who does not have an idea what an HSA is, or how it works.Actually, I think you don't.

You still have buy to insurance. Go read the law, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, it's under 26 U.S.C. § 223(c)(1)(A)(i).

You still have all the administrative costs of insurance.

You still have all the problems associated with buying, and using, insurance.

If you get run over by a bus and need a $100,000 surgery, you're not going to pay for it with a debit card. You're going to use your insurance. You're going to have the same old paperwork.

Stop pretending it's some form of self-insurance. It's the same old insurance with a small tax advantage twist for wealthy people.

When the consumer is actually paying for things, you can bet that they will see the price list.

People now go in, and say, if its covered what do I care what it costs. The insurance company is paying for it.In most reasonably priced individual health plans, there is a deductible, or percentage copayment of the fee, which is negotiated down by the insurance company.

So the consumer certainly does care how much it costs, because he's paying for it out of his pocket. He doesn't need an HSA to care.

For example, I pay a copay for a doctor's visit, but for most everything else I pay a percentage up to a annual maximum.

The people with plans that have everything covered are generally those with group coverage from a large company with good negotiating power, or those who simply want to spend a lot of money upfront on an expensive plan.

But those people don't have trouble getting coverage in the first place, and aren't the issue.

Second, 10% return over the long haul is very conservative and realistic, not 8. If it is for you, you should change funds, stocks, or managers.I don't want to get too off topic, but I have to chuckle at that comment.

Historical returns are NO guarantee of future returns, and 10% is not a "conservative" estimate for returns, even in risky investments.

The S&P today is at the same level as it was in 1997.

Where's that 10% return, Fyyr? :rolleyes:

Make a time machine and go back say... 8 years ago and go to a lasik eye surgeon. Then in your time machine, move up 1 year at a time and see the same guy. You'll notice that the service gets better and better and cheaper and cheaper overtime.LASIK is a special case because the cost is almost entirely dependent upon the cost of the laser technology, which has declined dramatically in recent years.

It's the same reason a DVD player costs $25 today, not $1,000 as it did 10 years ago.

That's not true for most health care.

I don't want to get too off topic, but I have to chuckle at that comment.

Historical returns are NO guarantee of future returns, and 10% is not a "conservative" estimate for returns, even in risky investments.

The S&P today is at the same level as it was in 1997.

Where's that 10% return, Fyyr? :rolleyes:

Yeah, because investors blindly hold onto their stocks during bear markets.

LASIK is a special case because the cost is almost entirely dependent upon the cost of the laser technology, which has declined dramatically in recent years.

It's the same reason a DVD player costs $25 today, not $1,000 as it did 10 years ago.

That's not true for most health care.

The increase in cost for all medical treatments not covered by insurance lags far behind insurance-covered medical treatments. This is largely because people are frugal consumers when spending their own money and generous consumers when spending other peoples money.

Even cosmetic surgery has lagged the consumer price index since 1992, and has greatly lagged general health care.

http://www.ncpa.org/images/1247.jpg

And the problem with your argument is that technology can lower costs in just about every aspect of medicine, but it doesn't happen because there's no pressure from the consumer. That's the entire point.

Yeah, because investors blindly hold onto their stocks during bear markets.Oh yeah, you're one of those wizards who can time the market.

Now all you have to explain to me is why you aren't the richest man in the world.

The increase in cost for all medical treatments not covered by insurance lags far behind insurance-covered medical treatments. This is largely because people are frugal consumers when spending their own money and generous consumers when spending other peoples money.Or because stuff that isn't covered by insurance is generally optional/luxury stuff, like cosmetic surgery.And the problem with your argument is that technology can lower costs in just about every aspect of medicine, but it doesn't happen because there's no pressure from the consumer. That's the entire point.No. In the case of LASIK, it's nearly 100% technology driven. The "surgeon" does almost nothing and needs little additional training to run the machine.

The costs of much traditional medicine is driven by consumable goods and services. Technology can sometimes lower the cost by making a procedure simpler or by mechanizing something that was previously done by a person, but it can also increase it, by providing an additional layer of services that can be performed.

And lawyers are a big element behind the cost of our health care system -- an element hidden behind terms such as "administrative costs," which were crafted by lawyers to downplay their role in all this.

The S&P today is at the same level as it was in 1997.

Where's that 10% return, Fyyr? :rolleyes:

Well, when I started working, the DOW was at 1300.

It is now 8500.

After going up to 14,000.

You can't tell me that if you added 45 Million people to the Stock Market, adding 2000 a year in investment, that it will go down.

Even if you moved your account to a Capital Preservation status, with no up or down motion, you are saving MORE money than you are now. One, you are saving what you are giving to an insurance company to invent, and make money for themselves. Second, you are saving on taxes that you would otherwise be spending, saving you a third of the cost.

You as well as I know that 10% per year over a 40 year period is fair. Quit bitchin spuriously.

LASIK is a special case because the cost is almost entirely dependent upon the cost of the laser technology, which has declined dramatically in recent years.

It's the same reason a DVD player costs $25 today, not $1,000 as it did 10 years ago.

That's not true for most health care.

You could use Orthodontia as a similar model.

Cash payer.
Lower prices.

Braces were 2K when I was a kid.
Braces were 2K when I had one who needed them.

There has been no DVD type revolution with braces in 40 years. Same technology. While they have not really gone down, they have not gone up to keep up with the CPI. That means they have gone down in price.

Cash payers keep the price down. Insurance payers allow prices to go up. His point is a valid one.

With an HSA, you are a cash payer. And you can use your HSA for Orthodontia.

And the problem with your argument is that technology can lower costs in just about every aspect of medicine, but it doesn't happen because there's no pressure from the consumer. That's the entire point.

The lawyer tax is a significant reason why that curve goes up.

For all of the graph lines.

There was a huge across the board increase in cosmetic surgery prices because of the Dow Corning settlements.

The lowest federal tax bracket is 10%. The lowest state tax bracket varies; it can be 0%, but in California it's 1%.

1475 is not 90% of 2200.

Payroll taxes you pay anyway.

This is the point, that is flying over your head. HSAs are a tax dodge for wealthy people, but do nothing to help the people who actually have trouble getting insurance in the first place.
Shut up.

You know as well as I do, that 15% is the real base Federal tax, and that you are going to be paying SSI between 15 and 18%.

I was being conservative, 30 percent tax is a conservative number. And you know it. After Federal, SSI, and State, 30 percent is fair. You know that, it's low even. STFU.

HSAs can't be a tax dodge for rich people, you already acknowledged and posted that they do not need them. They already have insurance. We both know that. Hell, rich people don't even need insurance, they can just write a check.

Your wealth envy and jealousy is clouding your thoughts. You are not making sense. Coming from someone who lives in SF, that is kinda funny.

With an HSA, you are a cash payer.With many insurance policies, you are a cash payer up to the deductible or annual maximum. Including mine. Nothing special there.

On the flip side, with an HSA, like any other insurance policy, you are not a cash payer for anything other than trivial things.

If you get hit by a bus and need a $100,000 surgery, you are not going to pay $100,000. So just like any other insured, you don't directly care how much it costs. And those big procedures drive up health care costs.

You can spend your HSA card money, on any healthcare related service or good. . . Herbs, vitamins, supplements. Ace bandages, Neosporin. Aspirin.
Think of anything remotely related to healthcare or health, virtually anything an insurance company would deny you, you can pretty much buy it with your HSA debit card.


I have a FSA, and they do not allow vitamins, supplements, i.e. preventative health care. (Keeping your body well stocked in all the essential vitamins and nutrients, in my strong belief, keeps a great variety of health problems at bay)
I believe in this strongly enough, to where I routinely spend about 100/ month out of my pocket to ensure I have all the vitamins I think I need to prevent disease and illness.

I thought FSA's, and HSA's more or less followed the same rule structure. If not, I need to start an HSA immediately. Having my vitamins paid for by an IRA earning tax free interest for me sounds too good to be true.

And I agree with Fyyr on this to a large extent. I am leery about the "force" part, however. My suspicion would be partially assuaged, if during the passage of a mandatory HSA payment plan, a rule was passed that everyone that is legally competent is completely responsible for their own health care, thus shifting the burden back where I believe it rightly belongs. Only then would forcing HSA payment be agreeable to me.

Except one nagging thought occurs to me: What about those that have medical problems now, and haven't built up the savings? I suppose the hypothetical bill would need a phase-in period, while we phase out Medicare, Medicaid, etc, mirroring the DTV switchover, to give everyone ample time to make preparations accordingly.

I am a believer in taking responsibility for one's own actions. I believe this would improve the morale of the country as a whole, perhaps even cause people to believe in themselves again, rather than in some Big Momma government to swoop in and kiss their boo-boo's.

You know as well as I do, that 15% is the real base Federal tax, and that you are going to be paying SSI between 15 and 18%.I understand now, you simply are clueless when it comes to taxes.

By your "SSI between 15 and 18%" comment I take it you're talking about a self-employed person, who pays 15.3% up to the SSI limit (for SSI and Medicare) and 2.9% thereafter (for Medicare only).

In that case, take a look at your Form 1040 SE. You'll see that that percentage comes directly from the net profit or loss from your Schedule C or K-1, not your Adjusted Gross Income.

Your HSA deduction is not figured into this, but rather goes on Line 25 of the 1040, reducing your AGI. It lowers the income tax but not the payroll tax. The same is true for self-employed IRAs (Line 28) and traditional IRAs (Line 32).

In other words, your IRA and HSA are not reducing that 15.3% you're paying.

As for 10% not being the lowest bracket, the IRS seems to disagree with you (http://www.irs.gov/irb/2008-45_IRB/ar14.html).

So back to my example of the working guy, he's not going see any real advantage with an expensive HSA that only offers a marginal tax benefit. And he is the one who has trouble getting health insurance, not the wealthy people who do benefit from HSAs.HSAs can't be a tax dodge for rich people, you already acknowledged and posted that they do not need them. They already have insurance. We both know that. Hell, rich people don't even need insurance, they can just write a check.

Your wealth envy and jealousy is clouding your thoughts. You are not making sense. Coming from someone who lives in SF, that is kinda funny.Where do you see envy in my posts? I'm one of them. I, personally, have no trouble buying health insurance or health care and it's a trivial expense overall. Over the past few years I have considered an HSA but it doesn't make sense for me, just yet, given my situation.

And not all rich people have group plans, by the way. For self-employed and many small business owners, it's not worthwhile.

Even if you moved your account to a Capital Preservation status, with no up or down motion, you are saving MORE money than you are now. One, you are saving what you are giving to an insurance company to invent, and make money for themselves. Second, you are saving on taxes that you would otherwise be spending, saving you a third of the cost.Those are valid arguments in favor of an HSA for a high bracket payer (well, except for the first, since you're still giving the insurance company a lot of money to invest for themselves at your expense). However, you're ignoring the cost of the HSA itself, and the lower benefits it offers.

In my situation, for example, the money I save with the smaller premiums and the fixed co-pay outweigh the tax benefit of the HSA, particularly since I almost never need to use the services of your industry, and the HSA funds are illiquid. And if I do need a small service, I pay only 40% of the cost, instead of 100% up to the deductible, as with an HSA.

A second point you're missing is that for self-employed people, premiums are deductible, which also offers a tax benefit.

There's also the lingering question of what will happen to these accounts in the distant future. If we come to our senses as a nation and enact a normal universal health care system like every other first world country, we won't need HSA accounts at all, and who knows what we'll be allowed to do with that money, or how much we'll have to pay in taxes.

If I were the average fat, lazy American who takes a medicine cabinet full of drugs every day to counteract my bad habits, or if i were age 50+, then yeah, I'd probably be using an HSA right now.

But even for wealthy people, HSAs are not exactly a slam dunk.

and the HSA funds are illiquid. And if I do need a small service, I pay only 40% of the cost, instead of 100% up to the deductible, as with an HSA. They are as liquid as any retirement account.
You can take money out of it. Pay the tax on it, and the 10% penalty.
You can borrow against it.
That is very very liquid.
You can withdraw from it in retirement penalty free.
You control it, and where it goes.


A second point you're missing is that for self-employed people, premiums are deductible, which also offers a tax benefit. Well, that is new, of course. When I was self employed, healthcare insurance was not deductible. Believe me, I tried. They have changed the law since then.
Regardless, the amount that you are putting back into your pocket, instead of sending to an insurance company makes up for that difference.

Additionally, when I was self employed, I had to pay tax on the SSI money taxed.

And that was just 10 years ago. An HSA is designed to run 40 years. Get the point?

There's also the lingering question of what will happen to these accounts in the distant future. If we come to our senses as a nation and enact a normal universal health care system like every other first world country, we won't need HSA accounts at all, and who knows what we'll be allowed to do with that money, or how much we'll have to pay in taxes. If everyone without insurance had an HSA, then we would not need your socialized medical system, would we.

Of course that would mean force. Again forcing someone to be responsible for themselves, is more ethical and right, than forcing someone to be responsible for strangers.

But there are too many people who like forcing people to do things.
Anyway, it is conceivable in your Marxist mind, to nationalize people's savings accounts. I know that. The fact that you even mention it means that there is someone in power, in government, thinking the exact same thing right now.

But I don't see that as a real threat to the savings accounts. People would just pull the money out.

If I were the average fat, lazy American who takes a medicine cabinet full of drugs every day to counteract my bad habits, or if i were age 50+, then yeah, I'd probably be using an HSA right now. They make more sense for someone just starting to work to start one. They are healthy, wont be using the system. And starting earlier on the HSA means a bigger pot at the end. Just see the IRA calculator above.

But even for wealthy people, HSAs are not exactly a slam dunk. Wealthy people don't need HSAs. They have other ways of dodging cash from tax and paying for healthcare.

The average of the 45 Million Americans without healthcare insurance makes 75K a year. An HSA is perfect for this group of people. They can't afford a full coverage plan, or don't want to afford it. And they make too much money for Medicare.

Face it, every objection that you have mentioned is wrong. It is like you are making things up, or are in Wonderland.
And you failed to mention the real objections to it.

Regardless, the amount that you are putting back into your pocket, instead of sending to an insurance company makes up for that difference.How am I putting money in my pocket if I have to pay the insurance company more and the hospital more for the same stuff?

The only counterbalance to the more that I am paying to insurance companies and hospitals is the less that I have to pay the U.S. government.

And in my case, the more outweighs the less. Maybe in your case, it doesn't, but don't generalize your situation as if it applies equally to everyone.If everyone without insurance had an HSA, then we would not need your socialized medical system, would we.If you force everyone to carry insurance, then you're already a socialist. Because what do you do with the people who can't afford insurance (poor, age 50+, preexisting conditions, etc.)? They are the ones taxing the health care system, not healthy 20 year old productive workers.

And even if you subsidize them, in true socialist fashion, you'd just be perpetuating an utterly broken system that costs the taxpayers a fortune and gives them the least bang for the buck of any system in the developed world.

We need to reform this system from top to bottom, so it's as efficient as the systems of every other first world country.

I know you'd naturally be opposed to that, because that would put your job in jeopardy. But experience has proven that the only health care system that works is a socialist one. HSAs don't get us there, or do anything to solve the real problems.

The average of the 45 Million Americans without healthcare insurance makes 75K a year. An HSA is perfect for this group of people. They can't afford a full coverage plan, or don't want to afford it.If you can't afford a regular plan, you won't be able to afford an HSA either.

HSAs are deliberately overpriced (in terms of the coverage you get compared to the premium you pay), to appeal to high bracket taxpayers who actually get a big financial benefit from the tax advantage.

For example, a 44-year-old male in San Francisco will pay $232 for Kaiser's HSA plan with zero coverage up to a $1,500 deductible, or $244 for a regular plan with $30 co-pays and a $1,500 deductible.

The regular plan is actually cheaper for most people. The only advantage of the HSA is the tax benefit, and as I've just shown you, low bracket taxpayers benefit the least from that.

Group Says Families Pay 'Hidden Health Tax' (http://online.wsj.com/article/SB124353194170163283.html?mod=googlenews_wsj)
WASHINGTON -- The average family with health insurance in 2008 paid a "hidden health tax" of $1,017 to cover the health-care costs of the uninsured, according to a report released Thursday by advocacy group Families USA.

The report by the group, which promotes universal health insurance, found that a total of $42.7 billion in care for those without insurance was passed on to health insurers. The insurers, in turn, passed on the costs through higher premiums, the report said.

The report comes as Congress debates proposals to provide health-insurance coverage to all Americans -- a key part of President Barack Obama's legislative agenda. The report uses data primarily from consulting firm Milliman Inc.

When those without insurance sought care, often in emergency rooms, government and charities picked up more than a quarter of the $116 billion tab last year, the report said. More than a third was paid for by those seeking the care, and the rest was passed on to health insurers and eventually to insured people through higher costs, it said.

"There is something clearly that affects the pocketbook as a result of the hidden health tax," said Ron Pollack, executive director of Families USA. "I think the key to it is having a system that will make health more affordable."

r. Pollack appeared with Aetna Inc.'s chairman and chief executive, Ronald A. Williams, on Thursday at the National Press Club.

r. Williams, like many leaders in the health-insurance industry of late, has expressed support for expanding health coverage. He discussed such "cost-shifting" to health insurers as a major reason for covering more people.

"For every person who has private health insurance, there is a tax that is based on paying for the uncompensated care that these community hospitals have to collect," Mr. Williams said.

Proposals in Congress have centered on establishing a health-insurance "exchange," in which individuals who don't currently have insurance could purchase it. Most lawmakers anticipate that private insurers would play a major role in the exchange, and the insurers have indicated a willingness to participate in talks on the legislation.

Sen. Max Baucus (D., Mont.), who has taken the lead on crafting health-overhaul legislation in the Senate, said Thursday the report showed the health-coverage "tax" will continue to grow unless Congress acts.

"We must repeal this hidden tax and lift the burden from American families and businesses by ensuring quality, affordable health care for all Americans," Mr. Baucus said in a statement.

Insurers have stopped short of supporting a public health-insurance plan that would compete with them in a health-insurance exchange. Mr. Williams said his company's spending in areas such as health technology had improved health coverage to the extent that it could play a major role in covering the uninsured.

"We've invested in tools, technologies and capabilities that really help close gaps in care," Mr. Williams said, adding that "generally, we much prefer private and public partnerships" to the public-plan option.

Nothing that no one knew.

I am a grocer.
I sell apples.
When I started my business, I bought apples for 10 cents a piece.
Then with my overhead, advertising, staff, the apples cost an additional 9 cents.
Now I charged 20 cents an apple, and I made the 1 cent profit from each apple sold.

Now everyday, I started out, and put my 12 apples out on the sidewalk for people to buy. In the beginning, people just paid me the 20 cents for the apple.

Some would buy 2, some 1. Most people would just walk by and not buy any apples at all. But everyday, I sold my 12 apples.

Then one day, the government said, No one has to pay for apples anymore. No proof of payment. And even if you want apples, you still don't have to pay for it. And at the same time the government said, that I had to by law continue selling apples. But they would pay me 5 cents for every apple not paid for.

But not everyone heard what the government said, but many did.

Soon, people who were not buying my apples, now just walked by and starting taking them. I would sell out by noon. So I started putting out 24 apples. And because the government was only giving me 5 cents for the ones not paid...I had to raise my prices on the apples that were paid for. I have the more overhead, the costs have increased because I have had to hire more staff. Take two deliveries of apples instead of one. Etc.

But I am still making my same 12 cents each day.

So now it has gotten to the point that the apples each cost 1.50 a piece because of all the people just taking apples. And the government not covering the real cost of what they cost, and not replacing ALL of the apples taken for free because they say that some people make enough money to pay for their own apples.

Now some guy, who is in that last group, at the end of the day, I have one apple left, and he buys it for 1.50. But he says that he can't afford it, he remembers when apples only cost 20 cents. He still takes the apple, and pitches a fit. But he needed the apple.

And he will think one of two things. That I am really making 1.50 for each of the 24 apples that I am selling. Thinks that I am getting rich off of gouging people for apples. OR, he will think, hey I know so-and-so, and she only paid 5 cents for apple, or nothing for it. And he knows someone else who paid 20 cents for an apple. And that is not fair. What does she only have to pay 5 or 20 cents for an apple, and I have to pay 1.50. That is not right, that is not fair.

Now he thinks that I am the bad guy for making him pay 1.50 for an apple. When it really was all the people who came before him, taking apples, and not paying for them who are the real bad guys.

I could shut my doors. Many apple vendors have already because of the law. I can reduce my services, say sell smaller cheaper apples. Or those with worms in them, or bruises on them. Or I can lay off some of my staff, or not hire more to keep up with the demand, now that other vendors are no longer selling apples.

Thinks that I am getting rich off of gouging people for apples.Maybe you are. Those massive profits come from somewhere.OR, he will think, hey I know so-and-so, and she only paid 5 cents for apple, or nothing for it. And he knows someone else who paid 20 cents for an apple. And that is not fair. What does she only have to pay 5 or 20 cents for an apple, and I have to pay 1.50. That is not right, that is not fair.Of course it's fair, because it's socialism. It's the same reason a rich guy has to pay a lot more in taxes than a poor guy.

Only libertarian nutjobs would think it's unfair to provide basic social services to people who can't afford them.

Fortunately, you nutjobs are in the extreme minority.

Corrected.

Only Libertarian nutjobs would think it's unfair to provide basic social services to people who can't afford them.

Maybe you are. Those massive profits come from somewhere.Of course it's fair, because it's socialism. It's the same reason a rich guy has to pay a lot more in taxes than a poor guy.

Only libertarian nutjobs would think it's unfair to provide basic social services to people who can't afford them.

Fortunately, you nutjobs are in the extreme minority.

I think that reasonable people would think that taking apples without paying for them is stealing.

Reasonable people are obviously in the minority.

I think that reasonable people would think that taking apples without paying for them is stealing.It's only stealing if they're not allowed to.

When you collect unemployment, you're not stealing the money.

When you drive on a public road, you're not trespassing.

When your kids go to public school for free, they're not defrauding the school.

You can even get apples for free, without stealing, using food stamps.

Reasonable people all agree to this, and it is why we have a government that redistributes wealth in this socialist fashion, for the greater good.

You are not reasonable. You libertarians want total anarchy, where it's every man for himself.

Well, I take that back, you claim you want anarchy, but what you really want is all the benefits of our government without any of the responsibilities. If any of you libertarians had a taste of true anarchy, you wouldn't be able to come running back to socialism fast enough.

All ideology and rhetoric aside, there are basically two ways to handle financing large scale payments: Insurance or Savings. Both have their advantages and disadvantages.

Insurance works on the principle of estimating the total annual payout required, dividing that by every participant and charge them that amount of money.
Savings works on the principle of estimating the total individual payout required at a future date then, based on the estimated average interest rate over that period, put aside enough money to build up that amount of money.

Insurance typically is preferable in situations where the individual payment can not be reliably estimated and is bigger than an individual can be expected to be able to pay. It also only works if the number of people participating is as big as possible.
Savings is preferable in situations where the risk is low and the time and amount required to be paid out can be reliably predicted. It does not need more than one person to participate and is subject only to the amount of money that can be put aside and the amount of time between starting to save and when it needs to be paid out.

Health care (as well as disasters) typically are better covered by insurance as the number of people who need it is relatively low, but those who do need it have to pay far more than they can reasonably be expected to save.
Retirement plans and buying houses on the other hand are better covered by savings as they are individual, easily predicted and have a long duration.

The biggest problem with insurance is to control the spending, especially in the case healthcare where the demand for better (and more expensive) care has no negative feedback. People are not inclined to take no for an answer when it comes to a small hope to improve health.
The biggest problem with savings is that it takes a long time to build up a buffer which means that young people generally can not use it for much, unless it is in the form of a mortgage system. It also does not deal at all well with repetitive payments (e.g. chronic illnesses).

Any insurance based system is going to have trouble with keeping the cost down and is inevitably going to lead to a certain (or fair) degree of burocracy. The second disadvantage is that it needs to be mandatory to be effective, and the third is that it takes away a certain degree of free choice in the participants (both in the choice of treatment and in that they can be reasonably required to change their life style if it interferes with the care they are receiving).

Any savings based system is going to have trouble keeping dead bodies off the street when people have an accident before they could save enough to afford the necessary treatment, and also when people suffer from a chronic illness that requires medical treatment or medicines for a long time. As with any economic system, the more capitalist you make it the worse it will turn out to be for those who are powerless under it.

* * * * * * * * *

Personally I think that no single solution is going to work out. There need to be at least three complementary systems in place. One mandatory insurance that everybody needs to participate in that pays out for accidents, disasters and generally unforseeable medical events, above a certain baseline cost.
Second is a voluntary system for additional costs not covered by the mandatory system. This can be an insurance, individual or mutual savings account. Everybody is free to opt in or out of it, and decide what risks they wish covered. While there must be a certain acceptance requirement for the healthcare providers, it should not be unlimited. Government supervision is required to ensure that the providers do not abuse their power to force their customers a higher premium than is necessary.
Thirdly there must be a separate system for chronicaly ill and impaired people, as their requirements go beyond direct health care. They also need assistence in finding work and to support themselves, amongst other things.

I am aware that this, too, is not an ideal solution. Most notably it needs to put a brake on the healthcare providers to prevent them from milking the system by prescribing unneccary treatments and tests. It also needs to put a brake on the people to stop expecting them to receive any treatment no matter how obscure and/or expensive. And they need to be encouraged to do what they can to reduce the cost, by living healthily.

And of course it involves a fair amount of government supervision (if you are allowed to spent somebody else's money they have the right to see if you spent it on necessities), and that is not going to go over well with those who disagree with any form of government control.
Still, the hallmark of a good compromise is that it makes everybody equally unhappy, but not unhappy enough to reject it ;)


Eri

Eri,

If an 18 year old put only 200 a month into an HSA.

At 40 they would have $270K, or $140K adjusted for inflation, to cover any healthcare expenses.

And they would be able to pay for virtually any healthcare problem they have.

And the HDIP would cover any other 'bus accidents' that would happen before then.

And HSA is BOTH insurance and savings. Something that critics in this thread just can not wrap their little minds around. It is just too big of a concept, I suppose.

Eri,

If an 18 year old put only 200 a month into an HSA.

At 40 they would have $270K, or $140K adjusted for inflation, to cover any healthcare expenses.Putting aside your faulty math and n00bishly flawed assumptions about investing, you're missing the point.

THEY WOULD STILL NEED TO BUY INSURANCE.

any people CANNOT get insurance, or cannot afford to get it, especially since qualifying HSA insurance plans are pretty expensive for the level of benefits they offer.

And the people who actually benefit from the tax advantage of HSA plans are the rich, who can afford regular insurance anyway.

HSAs are just a tax dodge for the rich, and do absolutely nothing to solve any of our health care problems.

I swear, your skull is about a meter thick when it comes to this issue.

THEY WOULD STILL NEED TO BUY INSURANCE. Well, I understand that. It is you and Pan who don't seem to know it.
You need a High Deductible Insurance Policy-HDIP in order to qualify to put money in tax free into the HSA in the first place. Unless they just changed that, they just changed the max amount per year, and the max deductibles.

An HSA includes a HDIP. I have been saying that since post one. It is you critics who don't seem to understand that.

OMG what if I get hit by a bus in year one, and I don't have no insurance...
psst, that was a thing to say.


Honestly,
If I had 270K in the bank right now in a Health Savings Account, I would not need insurance.

As for the math, I just used a commonly available IRA calculator. I posted the link in an earlier page.

You can put in any numbers you want.

The Dow, even after dropping from 14000, is still 700% what it was when I was 18, I think I posted a graph of it in a previous post in this thread. I think a 10% return per year is a fairly conservative number for return, over 20 or 40 years. If you don't, put your own number in.

HSAs are just a tax dodge for the rich, and do absolutely nothing to solve any of our health care problems.

I swear, your skull is about a meter thick when it comes to this issue.
We just have a difference of philosophy.

You want me to pay for other people's healthcare and my own.

And I want an affordable way to pay for my own, and others to affordably pay for their own.

I just don't believe that your philosophy is ethical.

y philosophy is more ethical, there is no way around that. I don't want to force you to work for my healthcare, and I don't want you force me to work for yours.

But that is only ethical if you believe that slavery and forced servitude is bad.

Since you are a Commie, I don't doubt that you find forced labor acceptable and ethical. But that is the difference of our philosophies, isn't it?

Well, I understand that. It is you and Pan who don't seem to know it.
You need a High Deductible Insurance Policy-HDIP in order to qualify to put money in tax free into the HSA in the first place.That is what I've been trying to tell you for the last, oh, 10 posts.

What if you can't afford the insurance, or no company will take you (age 50+, preexisting condition, etc.)?

Then what? How does your HSA system help that person? THAT is the person who is having trouble with the system, not you, or me.

Do you get it now?

We just have a difference of philosophy.Sure we do.

I want a system where everyone contributes a fair share and can expect health care when they need it.

You want a system where you don't contribute your fair share but you still expect everyone else to, so that you can expect health care when you need it.

You are the classic hypocritical libertarian, wanting all the benefits of taxation, but without contributing anything to it.

Group health coverage is socialism, by the way. Marxism at its finest.

Insurance is Capitalist. Invented by Capitalists.

For at least 5 hundred years before Marx was born.

People have bought insurance to distribute risk and costs for a very very long time.


You can't give your Commie hero credit, Tudamorf.

Insurance is Capitalist. Invented by Capitalists.Pay attention now:

Group health coverage is socialism, by the way. Marxism at its finest.

It's a standard tax all employees pay, for the greater good of all of the employees of the company, and which flows to those who need it the most.

If you're an employee in such a company, you are already a Marxist, and you don't even realize it.

It also happens to be one of only two health care systems in that country that actually works (Medicare, another socialist system, is the other).

Capitalism is fine for some things, but in this case, where the public interest is in direct conflict with the business interest, it will never work. That's probably why only the socialist systems work, worldwide.

Actually, it is group rates which have to go. No matter what reform takes place. It is group rate monopolization which also makes it unaffordable for individuals to buy insurance.

If WalMart, or any large company, can subsidize its cost of insurance per person on the backs of individual payers, that is essentially a monopolistic capitalist exploit. It is unethical. And has nothing to do with Marx.

An individual pays more in health insurance because employers are paying less per person than they should be otherwise.

And if you look at it, besides the track of history, the notion that employers even pay health insurance in the first place is rather idiotic. They don't pay my car insurance, my liability insurance, my homeowners insurance. The connection between employers and insurance should be destroyed.

Insurance companies should not be allowed to discriminate against individuals, the risk pool of 'everyone' is large enough to disperse risk evenly enough.

And unlike car insurance which bases risk on probability of accident and increased cost of payout via zip code discrimination, I don't think that age based health insurance premium discrimination is all that equitable. It is more likely that you living in SF will have more expenses if you have a car accident, with a greater chance of accident because the drivers in SF and the Bay are ****ing nuts.

Extreme preemies are very very expensive patients. Some of THE most expensive, and they are just weeks old.

Young adults have a much higher probability of accident than most other age groups.

Genetic ailments are costs spread across all ages of a person. DM is gonna cost as much when you are 8 as 80. An AVM can hit a person at any age, a brain aneurysm at anytime, a AAA at anytime.

1) Remove any extra incentive for employers to buy insurance for employees, remove any tax benefits. Don't make it illegal, if a company still wants to offer it as a benefit, they should be allowed to.
2) Make it illegal to offer one person one price, and another person a higher price.
3) Remove all age based pricing schemes in health insurance.

ake the group that all insurance companies have to deal with all Americans. It is a big enough group to share the risk equitably. Sure, some people would have increases in their premiums, but those people are unfairly taking advantage of the others already, I have no pity for them.

All things being equal, if Mary and Jane were offered different pricing on books, manicures, on hotels, on gas, on movie ticket pricing, and big screen TVs, on a car wash they would up in arms, with pitchforks and torches demanding equality. They don't for health insurance.

And group pricing essentially equates to price fixing, which has been capitalistically unethical since what, the 20s. Sherman Anti Trust Act et al. Hell, you could even prosecute them with existing law, the RICO Act, if you can't get a new one through Congress.

Your ideation that group rates are Marxist is wrong, it is monopolistic, or more properly oligopolistic Capitalist exploitation. Marxism requires force, there is not force. It is choice and exploitation. Those are Capitalist traits. Regulation of Capitalism is not only Marxist, and not just Marxism ideas cause changes or reform in Capitalism. I'm sure you believe that it is definition, of course. It can do it within itself.

You can defend your Commie ideals all you like, somehow defend that any reform to the system is coming from your Commie philosophy. You would just be wrong in doing either.

Actually, it is group rates which have to go. No matter what reform takes place. It is group rate monopolization which also makes it unaffordable for individuals to buy insurance.I take it you have no experience in actually buying group health insurance.

It is very expensive. As an employee, you can get a taste of just how expensive by looking at the cost of your COBRA coverage once you've been axed.

Granted, huge companies like Wal-Mart can negotiate great rates, but it still comes out as very expensive.

The only reason companies provide health insurance to employees is that the taxpayers of the United States heavily subsidize it. That is, incidentally, one reason it is expensive, because health care providers know you're getting a tax break and therefore jack up the prices to compensate. Think of it as a subsidy to the health care industry.

If you strike out just one sentence in the Internal Revenue Code, these employer-sponsored plans will disappear overnight, because they are not competitive with individual plans.If WalMart, or any large company, can subsidize its cost of insurance per person on the backs of individual payers, that is essentially a monopolistic capitalist exploit. It is unethical. And has nothing to do with Marx.Group health insurance is Marxist because all the employees pay roughly according to their ability to pay, and the benefits flows to those who need it most.

The company's entire health insurance pool is averaged, and the cost is absorbed as an expense to the employer, which reduces the employees' salaries in whatever manner the employer sees fit.

Healthy, non-tobacco-addict 20-year-old stock boys at Wal-Mart are paying a huge amount relative to their health care needs to support a few 60-year-old fat executives with heart conditions, who are paying very little relative to their health care needs.

And it is FORCED on everyone, unless you want to leave the company of course.

If that isn't socialism, I don't know what is. Now if we could only expand that model to cover the entire United States, we'd be all set.And if you look at it, besides the track of history, the notion that employers even pay health insurance in the first place is rather idiotic. They don't pay my car insurance, my liability insurance, my homeowners insurance. The connection between employers and insurance should be destroyed.I agree, it's fairly arbitrary to subsidize that, and not other things.

Unfortunately it's one of only two systems that works (both socialist), and if you suddenly disrupt it without a backup system you're going to have a health care crisis on your hands.Insurance companies should not be allowed to discriminate against individuals, the risk pool of 'everyone' is large enough to disperse risk evenly enough.In some states, they're not allowed to. And to compensate, they jack up prices even more, making the whole situation worse for everybody. Again, the problem is the fundamental conflict between the business interest and the public interest, that can never be fixed through a capitalist system.1) Remove any extra incentive for employers to buy insurance for employees, remove any tax benefits. Don't make it illegal, if a company still wants to offer it as a benefit, they should be allowed to.
2) Make it illegal to offer one person one price, and another person a higher price.
3) Remove all age based pricing schemes in health insurance.

ake the group that all insurance companies have to deal with all Americans. It is a big enough group to share the risk equitably. Sure, some people would have increases in their premiums, but those people are unfairly taking advantage of the others already, I have no pity for them.It sounds like we want exactly the same socialist system. Everyone pays their fair share and everyone gets coverage. Why didn't you say so in the first place?

Eri,

If an 18 year old put only 200 a month into an HSA.

At 40 they would have $270K, or $140K adjusted for inflation, to cover any healthcare expenses.
And they would be able to pay for virtually any healthcare problem they have.


That would not do me any good when I am 22 and pregnant of my first child.
Or when I get hit by a car when I am 19.


And the HDIP would cover any other 'bus accidents' that would happen before then.

And HSA is BOTH insurance and savings. Something that critics in this thread just can not wrap their little minds around. It is just too big of a concept, I suppose.

No need to be insulting too. I will immediately admit having no clear idea what HSA, HDIP and all the other acronyms bandied about in this discussion mean exactly. This is why I keep myself to the general principles and avoid discussing the specific implementations.

But you are incorrect in saying that something can be insurance and savings at the same time (*). An insurance has a large number of people all pooling a relatively small amount of money together to cover the expenses of a very small percentage of those people. A savings account gets fed with a small amount of money so that at some point in the future the accumulation of savings and interests covers a single large expense.
Savings will not work in situations where there may be need of more than one payout. It also will not work if the moment, and the amount, of the expenses can not be fairly accurately predicted.
Insurance systems on the other hand will only work if the amount of people that need a payout is a small fraction of the amount of people that pay a premium to cover for that possibility. As health insurance covers more and more the number of people receiving a payout increasingly approaches the entire group of premium payers. Much of the easily predicted recurring expenses should have been covered by a savings account and not be part of the insurance.

This leads to a third system of paying for health care that I had not previously mentioned because it is such a hotbutton for many Americans: taxes. If done correctly it is a mandatory 'savings account' on national level that covers recurring costs like annual checkups, preventive health care and small scale medical interventions (like e.g. stitches) that now clog up the emergency room and the accounting systems. It should also cover certain other aspects that do not fit into neither an insurance nor a savings regime. E.g. people suffering from chronical illnesses and innoculations and vaccinations. Some other things that should be covered by such a scheme are going to be even more controversial, but I am going to let those undiscussed as they are to a certain degree negotiable and would drag the discussion off course from technical into the very muddy area of morality.


Eri
(* Saying that insurance and savings are mutually exclusives is not -quite- correct. A national trust system would to a degree combine the two, in that the trust is a huge savings account that everybody pays into and out of which incidental payments are made. The problem here is that if the trust fund is big enough to be meaningful it is also a prime target for plundering by an overspending government. Sooner or later it will either be abandoned entirely or it will degenerate into a regular insurance system when the government finishes spending all the trust money).

I will immediately admit having no clear idea what HSA, HDIP and all the other acronyms bandied about in this discussion mean exactly.HDIP is an acronym for a high deductible insurance plan. It's a bare bones plan that offers coverage for catastrophes and little else.

HSA is an acronym for a health savings account. It requires that you buy a the above mentioned insurance plan, and allows you to put a few thousand dollars each year in a tax-free savings account that you can only withdraw for medical expenses (not covered by the insurance).

So instead of being 100% insurance, an HSA is more like 90% insurance and 10% tax-advantaged savings (which is only advantaged for high income people, of course).

HSAs do not address ANY of the problems we currently have with our health care system, such as costs spiraling out of control, too many fat people, lack of preventative care, or administrative inefficiency.

If every American tomorrow opened an HSA and put the maximum into his savings account each year, we'd be in exactly the same predicament we're in now.