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I'm not opposed to them, but I don't think they did what Republicans said they would do: Force competition and lower prices.
Also, with a $3000 limit per year, they're not exactly a savings bonanza. And then most HSA accounts charge a fee once your balance falls below a certain amount - usually around $2500 to $3000 - which means that most participants have no choice but to pay a monthly maintenance fee for the first year.
I think HSAs are a better deal for banks and insurance companies than they are for individual taxpayers. I do have one, and it's better than nothing, but it's also nothing to get excited about, in my opinion.
Why would they not force competition? With a balance in the HSA, the consumer now has an incentive to shop around and look for the best service for the price. As far as the $3k per year cap, first, the balance does accumulate year to year, and typically a dividend is paid, so the balance increases. As such, long term I'd expect $3k to cover most people's annual HI costs (with some exceptions). Besides, there is no reason not to lift the $3k cap, so say a young worker could contribute sufficiently to have a comfortable balance in the HSA, then scale contributions back.
Procedures can run into the hundreds of thousands. I amputated three fingers in an industrial accident, with two being reattached. The total bill was > $100,000, and this was in 1991. We need insurance for catastrophic expenses.
I am, and have been, a strong supporter of a high-deductible "catastrophic insurance" with preventative care coverage for everyone. The person would be covered if they cut off a few fingers (or had a major illness) and would be able to get an annual physical exam, mammogram, etc. But the routine doctors visit for a sore throat would have to come out of pocket. I know that there would still be people who could not afford a "sore throat" visit and wouldn't pay the bill. But even if it doesn't solve the problem of hospitals having to write-off unpaid medical bills, at least those bills would be relegated to routine visits that have smaller costs instead of having to write off many high-dollar medical bills that push up medical costs for everyone.
I'm sure someone can shoot holes into this approach, but it seems workable to me.
HSAs have been around for many years now. Have health care costs gone down because of them? Not at all.
Actually my cost of premiums, as well as the cost of "allowable charges" and medications, has gone down significantly compared to what it was when I obtained my PPO insurance as a so called "benefit" through my employer.
I have had an MSA/HSA for 14+ years. In the beginning my allowed MSA contribution was as low as $1200. The $3K HSA contribution cap has only been in the past year or two. It has taken many years to build up enough in the HSA, through continuing to save/invest and not spend from that account, to save a reasonable amount to pay for say...a major surgical proceedure.
I am curious why not raise the "cap" to at least match the high deductible?
Actually my cost of premiums, as well as the cost of "allowable charges" and medications, has gone down significantly compared to what it was when I obtained my PPO insurance as a so called "benefit" through my employer.
Your individual experience is not the norm. Health care costs have risen dramatically for most Americans over the last 10 years.
Premiums for employer-provided health care have doubled since 2000 (the earliest year the Medical Expenditures Panel Survey has on record). That year the average family premium was $6,800. By 2008, it had risen to $12,700. This premium growth eats away at wages and pressures firms to reduce coverage.
Re HSA's I tried to open one but was denied because my deductible is not high enough. Under my particular plan (and there are hundreds out there, believe me!) I have to have a $5,000 deductible before I qualify. And for a measly 3k deduction on my taxes!!?? I'm with mogal: RAISE THE CAP!
Re high deductible catastrophic: since the powers-that-be won't allow Medicare-For-All why not model health care insurance after parts A and B, where A covers the costs and B covers the deductible?
Your individual experience is not the norm. Health care costs have risen dramatically for most Americans over the last 10 years.
Premiums for employer-provided health care have doubled since 2000 (the earliest year the Medical Expenditures Panel Survey has on record). That year the average family premium was $6,800. By 2008, it had risen to $12,700. This premium growth eats away at wages and pressures firms to reduce coverage.
Thank you, you have proven my point for me. Healthcare for those who are generally healthy, is less expensive when self-insured over employer insured, with a high deductible plan and a un-taxed health savings account.
Yes, my deductible is $5K but it covers much more than just "catastrophic" events. Even without meeting my deductible most of my yearly "routine" exams and tests are more than 50% covered (mammograms at no cost) and I get about 1/3 off any prescriptions.
So, if Obama-care was really about ensuring lower insurance premiums and improving coverage for Americans, why outlaw the self-insured with HSA plans? Why not in fact promote these plans?
Because it about government control and forcing the self-sufficient to be mandatorily dependant upon government or be fined/jailed!
Example: You have people in HMO's who freak out about a $20-$30 co-pay but are capable of paying for monthly cell phone, cable t.v., and internet. It is about making wise decisions about priorities. Prices rise because the low premiums and co-pays of HMO's do not come near covering the actual costs. So, the larger pool of the employer-insured, including PPO's, have to eat the costs for all.
Last edited by lifelongMOgal; 12-02-2009 at 02:54 PM..
So, if Obama-care was really about ensuring lower insurance premiums and improving coverage for Americans, why outlaw the self-insured with HSA plans???
I don't know the answer to that, but I do know that Republicans have done little or nothing to help average people with health care costs. That's one of the reasons why Democrats were elected over the last two election cycles.
I don't know the answer to that, but I do know that Republicans have done little or nothing to help average people with health care costs. That's one of the reasons why Democrats were elected over the last two election cycles.
And the Democrats created the "employer-insured" health insurance system and gov. run "entitlements of Medicare/Medicaid that have failed so miserably to begin with. What is your point?
1)I guess you can blame,
or
2) you can recognize what does work and build on it.
or,
3) if you are a big-government "entitlement" proponent you can take the failed model and make it even larger so that it not only destroys the personal freedom and doctor/patient privacy but forces Socialist healthcare upon a population in which at least 50% do not want it.
When people take responsibility for providing their own insurance and care it does lower both costs and premiums over those plans which are government run or employer provided. Cutting out the middle-men always saves money. Ever shop wholesale rather than retail?
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When people take responsibility for providing their own insurance and care it does lower both costs and premiums over those plans which are government run or employer provided. Cutting out the middle-men always saves money. Ever shop wholesale rather than retail?
