Monday, January 31, 2005

This story (from Yahoo News, originally published in the L.A. Times) infuriates me:

Healthcare Overhaul Is Quietly Underway

Emboldened by their success at the polls, the Bush administration and Republican leaders in Congress believe they have a new opportunity to move the nation away from the system of employer-provided health insurance that has covered most working Americans for the last half-century.

In its place, they want to erect a system in which workers — instead of looking to employers for health insurance — would ... buy high-deductible "catastrophic" insurance policies to cover major medical needs, then pay routine costs with money set aside in tax-sheltered health savings accounts.

Elements of that approach have been on the conservative agenda for years, but what has suddenly put it on the fast track is GOP confidence that the political balance of power has changed....

"My view is that this is absolutely the next big thing," said former House Speaker Newt Gingrich, whose consulting firm focuses on healthcare. "You are going to see a continued move to trying to get people involved in the process by owning their own health accounts." ...

Indeed, Bush's health insurance agenda is far more developed than his Social Security plans and is advancing at a rapid clip through a combination of actions by government, insurers, employers and individuals....

The article isn't particularly clear on what's going to push us into this brave new world -- presumably the administration wants to make it a lot more advantageous, taxwise, for employers to offer catastrophic-plus-HSAs than to offer the health care plans we know.

I don't see how we won't wind up with a lot more uninsured (or essentially uninsured) people.

Obviously, workers earning Wal-Mart wages aren't going to buy health insurance or establish an HSA if doing so leaves them with less of their meager take-home pay -- the tax incentives are going to have to be extremely good, and you know they won't be. But in addition, many people who now have health insurance will forfeit it in the brave new world -- young white-collar people just entering the workforce, people paying off student loans, people who've gotten too far into debt.

And people who do maintain HSAs will underfund them, just as many people underfund 401(k)s. They won't want to draw the accounts down, so they'll put off needed care. They'll cash the accounts out, if allowed to, when other life crises hit.

The right-wing response is, "That's their problem. This is an issue of personal responsibility." But ultimately we're just going to see a sicker country. And a wealthier Fortune 500.

No comments: