Hits & Misses – 2009/7/2
Social Security sends 6,733 checks to dead people. But some people classified as deceased may be alive.
Private clinics are booming in Canada. Woman pays out-of-pocket rather than wait a year for an MRI scan.
Health Savings Accounts appeal to the uninsured. As a percent of new accounts the uninsured are 40% (Assurant), 33% (EHealth Insurance) and 37% (AHIP).
52% say people with unhealthy habits should pay more for health insurance. 76% say a person’s health is within his/her own control.
The Massachusetts poll is stunning. This is the basis for Sen. Kennedy’s national plan.
As Canada becomes more capitalist, we are preparing to become more socialist.
Agree with Stephen. The Massachusetts poll is a shocker.
“Private clinics booming in Canada”: Most of the reports indicate $500 to $700 for a MRI scan. If it was part of an co-ordinated care initiative, it would be lower, but the price is artificially high because it is similar to “key-money” for NYC rent-controlled apartments: It moves you to the front of the line.
I have mixed feelings about this development. It allows the government to avoid responsibility for the problem and pretend that it knows what it’s doing, and Canadians who used to scream bloody murder about inadequate access to care can now just say to each other: “You can’t fight city hall. Let’s just pay a few hundred bucks and work around it”.
Where is the Commonwealth Fund to sound the alarm for the “underinsured” when you need them?!?!?
Why wouldn’t an HSA (even non-deductible) appeal to anyone who would have trouble paying for a low-deductible policy? Anyone who can’t afford a $1500 deductible could even less afford to pay the high premium for a low-deductible policy. That is unless the individual’s premium is subsidized, either by tax dollars, by fellow policy holders, or both.
That said, to me the main reason for a tax deductible HSA is to ameliorate the bad effects of the employer tax exclusion. In that regard it has proven very effective. But if the tax exclusion were replaced by a tax credit specifically designed not to cause a great deal of price distortion, then there shouldn’t be as much need to have HSA deposits also qualify for the tax credit. In that case Roth-style HSAs would be easier on the Treasury.
Bart, there are economic reasons for the Roth approach. With a fixed sum tax credit, additional third party insurance is paid with after tax dollars. So we want additional self insurance (via an HSA) to also be aquired with after tax dollars. That way, third party insurance and self insurance trade off on a level playing field and individual choice and the market can determine the outcome.
John, I have no problem with liberal use of a Roth HSA. As I attempted to say above, a non-deductible HSA should make sense for many people, absent too many perverse incentives.
It was the pre-tax HSA that I partially questioned in my second paragraph. If there’s a serious need to use it in order to balance incentives, this can only mean that there are significant undesirable incentives to be balanced. Which is clearly the case at present.