Princeton health economist Uwe Reinhardt published an editorial in last week’s BMJ examining claims made about “consumer empowerment” via health savings accounts.
He wrote: “Not ever mentioned in the marketing of this ‘consumer empowerment’ are two important side effects. Firstly, the approach inevitably delegates most of the expected belt tightening in health care to families in the lower half of the nation's income distribution, whose decisions on health care are most sensitive to high out of pocket costs. In effect, the proposal seeks to ration health care by income. Secondly, the approach would shift more of the financial burden of health care from the chronically healthy to the chronically ill.”
Promoters of health savings accounts talk about giving consumers the information to make smarter purchasing choices. “How readily, however,” Reinhardt writes, “can the ambitious infrastructure for information envisaged by the president be constructed?”
Posted by schwitz at February 13, 2006 09:00 AM | TrackBackThis HSA thing is a cheesy way for Bush to help wealthier people shelter income, while making it look like people are "getting" more control of their health care. Really, they are foisting this illusion of control onto people and saying, in effect--pay for it yourself and good luck with that.
Real world, Bush, real world. Some probs with HSAs:
...Most people cannot afford to fill up the account--they just get the high-deductible policy,
and even that can be underwritten--no prexistings.
Ooops.
...When one does pay the part one "owns," is it at insurance company levels or "real person trying to survive" levels? There seems to be some confusion. Ooops--billed whole amt. That ought to be good for an hour on the phone--or more.
...Do people know this fund is not theirs to keep if they don't run through it every year (as a sick person would). There are conditions on what it can be spent for and when.
...Do people really get all the health care they can bec they are only paying a copay (or coinsurance--this stuff costs plenty)? Would you get an extra colonoscopy bec your insurance covered it? Or wait 13 hrs in the ED if you didn't really need to --or your doctor hadn't
suggested you go there?
...Bush gets his health care free at Bethesda. The Congress has a smokin' plan (OK, bad choice of words).
..I challenge these people to live a year in the real world--and during that year, to get sick.
Chrs,
Star
Posted by: Star Lawrence at February 23, 2006 11:25 AM