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July 31, 2008

The ownership society is unhealthy — literally

In Texas, at least, one of the key components of President Bush and other alleged fiscal conservatives and their “ownership society” has been health savings accounts.

Well, they’re pretty unhealthy here and everywhere
Today, with only 5 percent of the 114 million Americans covered at work opting for such health plans, their future is in question. In Texas, regarded as the birthplace of the HSA, only 387,000 people have signed up out of the 12 million with employer-provided insurance.

Hmm, at 3 percent, Texas is below the national average, even!

The reason HSAs are flopping like a Texas catfish in summer heat?

Lack of employer support:
To be successful, an HSA must have employer support, said John Goodman, president of the National Center for Policy Analysis in Dallas. “If employers don't put money in the HSA, all you have is a high-deductible plan” — something unlikely to appeal to many employees, he said.

Given that Schmuck Talk Express is likely to tout HSAs as part of the solution to American healthcare needs, this bears watching. Indeed, that’s already happening:
Mr. Goodman said high-deductible plans get at the heart of the health cost problem — overuse of medical services by people who, if they paid with their own money, might decide against that trip to the doctor.

“If a mother wakes up in the middle of the night with a sick child, we want her to think about the cost of the emergency room visit," said Mr. Goodman, dubbed by many the “Father of Medical Savings Accounts.”

Mr. Goodman is now a health policy adviser for Republican presidential candidate John McCain.

But, as noted elsewhere in the story, HSAs favor the healthy. And richer.

And, at least here in Texas, there’s yet another problem. Insurance companies (shock me) not passing on all the savings:
Kevin Whitney, chief operating officer for Dallas-based Flexible Benefit Group Inc., … said that HSAs should be cheaper and that insurers are not passing on the savings from the fewer claims they get.

Read the full story; it’s a good one.

Oh, and the insurance issue? IMO, we need federal regulation of insurance companies. A no-brainer.

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