Health savings accounts mostly help well-heeled
09 05 08 - 14:24
Speaking of Americans "going it alone" in purchasing health care, how are those health savings accounts, pushed by President Bush a few years ago, working out for the American people?
Paired with high-deductible insurance, the plans allow people to save in tax-advantaged accounts and spend it on medical care. These accounts are touted as "consumer-driven" vehicles that allow people to shop for their own health care and buy only what they need. If people are spending their own money, the thinking goes, they'll be more prudent consumers of health care.
There are many good reasons for concerns about these plans. As all uninsured Americans already know, it's virtually impossible to shop for the best price for an appendectomy or heart surgery. When you're in an emergency room hooked up to monitors, good luck finding the least expensive surgeon to take out your appendix.
Also, the majority of health spending is for chronic illnesses and end- of-life care not frivolous trips to the clinic.
Those with health savings accounts may delay or avoid getting needed care, which can result in more expensive care later. Such accounts risk luring healthy people with few medical expenses from insurance pools and driving up the cost of insurance for others. Also, the accounts work only for those who have money to save.
Yet they remain a cornerstone in the Republican agenda for reforming health care. So it's worth taking a look at a new report from the Government Accountability Office.
Popularity of the accounts has increased, but only about 2 percent of people with private insurance have one, congressional investigators found. More than 40 percent of Americans with an eligible plan didn't sign up, and more than one-third of employers offering them made no contribution to them.
Perhaps the most interesting finding: Taxpayers with health savings accounts had incomes of about $139,000, compared to $57,000 for all other tax filers.
Much more money is deposited in the accounts than is being taken out for health expenses.
They are, in fact, plans for the healthy and wealthy - which is exactly what Americans will need to be if this country adopts an "every man for himself " approach to health insurance.