Health Savings Accounts Hurt Poor, Care - Report

[Rose Siding]

CHICAGO (Reuters) - Health plans with high patient-paid deductibles, embraced by many Republicans as a market-based solution to quell soaring medical-care costs, lead to poorer quality care and increasing patient debt, a study released on Thursday said.

With the new plans, individuals typically pay the first $1000, or $2000 for families, spent on medical care each year. The plans are coupled with so-called health savings accounts, or HSAs, which allow patients to set aside tax-free funds to defray health expenses.

But a survey of data from 4,000 adults with health insurance found that about half of patients with a high-deductible plan racked up medical debt and were faced with other billing woes, compared with 31 percent of those with more traditional health plans, according to the research group Commonwealth Fund, which studies health policy issues.

"Health savings accounts coupled with high-deductible health plans have potential pitfalls, especially for families with low incomes or individuals with chronic disease," said Karen Davis, president of the foundation, which studies health policy. "The evidence is that increased patient cost-sharing leads to underuse of appropriate care."....

http://www.reuters.com/newsArticle.jhtml?type=politicsNews&storyID=7457700&src=rss/ElectionCoverage

[Pirate Smile]

1. Count me NOT surprised.

[Liberal Veteran]

2. Wow! Ummmmm.....DUH!!!!!!

Do these fuckers have a clue what health care expenses are like for the less than rich?

[sonicx]

3. This just in: water is wet...

[gizmo1979]

4. If you can't afford to feed your family

How in the world are you going to have money to put into a health savings account?!

[Megahurtz]

5. Dumbasses!!!

Just like if you're are poor how in the world are you going to have money to put into a private SS account??? And they expect the poor to be able to afford BOTH???:grr:

[NYC]

7. That's the point everyone seems to miss.

Many people have no money to save.

[zann725]

16. Exactly! And even the Dems in the Campaign kept saying...

they'd generously give families $1,000 tax credit a year to put toward healthcare, and that would make it possible for everyone to afford healthcare. That assumes that most families in "middle-America' have the monies to add to that $1,000 to pay for a family's premiums (plus deductibles) for a year. Or that we'd even be able to pay that $1,000 up front, and wait a year to be reimbursed for that expenditure. Most of us don't have that $1,000 up front either.

Even as much as I liked Kerry and Edwards, they and other Dems too have absolutely no clue what "Middle America" truly is. I guress there's that Middle America that earns $120,000+/year; and then THAT Middle America that has lost their farms, and steel mill jobs, and pensions and Union wages, and savings accounts in S&L scandals. And it's the later that ironically pays nearly ALL the taxes that they are least able to afford, and give their children up to War almost entirely...yet ironically are NOT the Middle America referred to by the Politicians. But instead the $120,000+/year Middle America that gets referred to instead.

[Technowitch]

6. Um yeah - DUH!

A tax-free savings account is pretty friggin' useless if you don't have anything to put into it.

Just another giveaway to the wealthy.

[happyslug]

8. My union is negotiating on this right now.

One of the reason it is being discussed is we have a lot of people who have high health costs. Thus dropping our present health care provider is not an option. If we had a lower level claims we could opt for a new group with lower premiums, but that group is only open to companies with a low history of claims.

I fear this study is bias for the reason set froth above, every business, governmental unit etc that provides health care to their employees has a problem with the escalating costs of health care. There is two ways to address this problem (I will NOT consider just dropping health care coverage as an option).

First is to go to a new group that provide similar services. The problem is that if you are in a company whose employees has a history of high medical claims there are few (if any) plans you can go to. Now for companies whose employees have a low level of claim there are alternative health plans, but these health plans are based on the history of low claims (and they do NOT want to add on a high claim company).

The second option to reduce health care costs are these "Health savings accounts coupled with high-deductible health plans". These offer some savings, but as the article states based on people's inability to pay the initial $1000 deducible (Thus less claims).

I suspect part of the difference between the plans stated in the article is a result of the above producing a bias report. I mean bias is the sense that the report is reflecting the fact that employers must reduce health care costs. If the employer has employees with a history of high medical costs such employers can only keep health care costs low by opting for such high deductible plans. Employers with healthier employees can opt for a more conventional plan (Given the history of lower claims).

The results of the bias I pointed out in the previous paragraph is that the people with the higher deductible are also people who tend to be sicker than the people in the lower deducible plans. Thus this is NOT a real difference in how the plans operate but on who is under each type of plan.

The US needs National Health Insurance just to put everyone in the same pot. The only alternative is to outlaw all health insurance so that everyone has to pay his own way. Yes this will cause great hardship but the price of medical services will drop for the vast majority of people could no longer afford to pay for the medical treatment. This sounds heartless (and sine I have a heart I prefer National Health Insurance) but we as a nation have to control the price of health care. That control either has to be by the Government (and that means saying what health related activity gets paid for) or by the invisible hand of the market place. National Health Insurance will have the compassion of a bureaucrat (Compassion derived from being made to look like an evil person when a denial of medical services hit the papers) or the amoral compassion of the market (which will NOT be affected by any moral outrage of the death of someone who just could not afford a 50 cent piece of medication).

This is the problem, the solution imposed since the 1960s (i.e. subsidies so that people can pay more for health insurance) has only permitted health insurance prices to escalate. Health Insurance price must be controlled (and that includes controls on what health care is provided to people). Without controls more and more people will no longer be able to pay for health care. This is what happens when you provide subsidies to something without some sort of price control. The market will raise the price up and up until people can not longer pay. At that point people will complain to Congress of the high costs and Congress will look at some new way to subsidies people paying for health care insurance. This will force the price up even more. Sooner or later the price increase will get so large people will have to drop health care to pay for other things in life.

I believe that is part of the reason for these high deducible insurance policies, they give the impression of insurance when in reality you have none.....

In a few years I see more and more people into these plans for that is all they could afford. The problem is these high deductible plans give the illusions of health care, but in effect give little or none. After a few years these illusions will disappear and you will have no health care for people below median income (Annual income about $50,000 a year). The invisible hand of the market place will step in with it amoral authority and leave people die for lack of health care. This is what will happen unless we get national health insurance.

[Zebulon]

13. Re: The US needs National Health Insurance

I used to be skeptical of this, but I'm becoming more and more convinced that there is no other workable option. Who can afford annual 15-20% premium increases?

[happyslug]

15. I agree.

What will happen is National Health Insurance OR de facto abolishment of private health insurance. You get effective price control under either system (through a lot more people getting proper medical treatment under National Health Care as opposed to the "open market".

[ninkasi]

9. They don't care...

"The evidence is that increased patient cost-sharing leads to underuse of appropriate care."....

Under the current regime, there will be no laws passed, nor policies implemented, that will lead to help individuals in any way. Everything will be skewed to benefit business and corporate interests. Everything they do hurts the average person...everything.

The error many make is in assuming that if the inequities are brought to light, they may be corrected. They are wrong. The right-wing will never back down, and never admit mistakes, and never fail to funnel money into special interests. The rest of us are screwed.

[CBHagman]

10. And the GOP wants to "reform" bankruptcy laws...

...so that it will be much harder to declare bankruptcy. To be fair, there are Democrats who support the legislation (I believe President Clinton vetoed a version of the bill), so passing it is not a problem.

And of course Bush, who always has been bailed out of each and every misstep, wants to tighten the screws on working families who fall on hard times or make some bad decisions.

On top of that, they want to set up roadblocks on lawsuits.

In short, it's -- pardon my language -- a cluster fuck.

[KT2000]

11. Increased debt?

They are using the amount of debt a person has now to figure car insurance rates and credit card rates. I suppose the medical debt would factor in to that as well.
Brilliant - if the goal is to drive people into destitution and drop them from all insurance.

[VegasWolf]

12. Another Republican economic plan fails. You could knock me over

with a feather.

[lovuian]

14. This is another bright idea like HMO's which FAILED

we need National Health!!!

[struggle4progress]

17. kick

[Lydia Leftcoast]

18. I looked into them as a self-employed person, and I concluded that

they were a bad deal.

I'm supposed to pay over $200 a month for high-deductible ($2000) health insurance (less per month, if I want to have 20% copays after I've met my $2000) AND set aside money in an amount that doesn't cover the deductible?

So I pay $4400 a year, and I get NO benefit from it unless I spend more than $2000 a year on health care, which I hardly ever do anyway?

High-deductible insurance policies are a license for insurance companies to print money.

One reason I supported Dennis Kucinich (immediately after shopping for insurance coverage) was that he was the ONLY presidential candidate favoring single-payer health care that didn't leave in goodies for the insurance companies.