More Healthcare Shenanigans

First, they try to wreck Social Security, then they throw a giant monkey wrench into Medicare (and bounce it off your grandma's head in the process), now, Bu$hCo is trying to fuck with the rest of our healthcare.

It appears that the 'keynote' of Shrub's upcoming State of the Union speech will be to announce a plan to phase in Healthcare Savings Accounts. While I don't argue that most of us probably should set aside something for a medical emergency (do as I say, not as I don't do!), HSAs, as proposed, have a raft problems attached to them. I will address the two I see as key problems.

1) They will increase medical insurance costs for the rest of us. HSA benefit primarily the young and the healthy. They have fewer medical problems and less need for medical insurance, so their contributions to insurance, by way of premiums, are probably higher than they would be in an absolutely flat system. This is, however, sort of the whole point of insurance. Everyone goes into a pool, which lowers the overall cost to everyone, and spreads the risk around. If the ones least likely to make use of the system are withdrawn, the costs for those left in the system will rise, and rise dramatically. Additionally, with the exception of employer provided healthcare, the young pay much less than the old for their insurance (pull up any private insurer to see the increasing premiums as you age), so it's not that out of balance to begin with. What will happen if HSAs become a reality is the the old, infirm, and poor, will be left out to die. But, hey!, they generally vote Dem anyway, so fuck 'em. Right?

2) Setting up an HSA system, as currently proposed, will exacerbate the main problem with medical care in America today: lack of preventative coverage. Insurers today are much more focused on covering solutions to problems rather than preventing problems from occuring. With the exception of basic checkups, most insurance programs don't cover prevention. If you're overweight, once you develop diabetes, you're covered; any medical attempts to help you prevent geting diabetes, weightloss programs, counseling, etc, are, for the most part, left to the patient to deal with.

The proposed system will exacerbate this. There is a human tendency to look at what we have and want to keep it, and ignore the might bes. A large number of people will ignore that nagging cough and not see the doctor, and if we have a financial 'reward' (ie, more money in the 'bank') for not going to see the doctor, then we're going to be even less likely to go. Once we start coughing up blood and lung cookies, THEN the doctor seems like a good idea. So we end up in the hospital for a week, when a shot of penicillin might have solved the problem.

A final note. Think about the GREAT ideas that have come out of Shrub's previous SOTUs: Iraq as an axis of evil needing to be overthrown, Social Security reform, and Medicare reform. Considering the rousing successes those pigs turned out to be, contemplate HSAs in that light.