Stanley Feld M.D.,FACP,MACE
The fastest growing health insurance plan in the private healthcare market is Health Saving Accounts (HSAs). HSAs are also available in Health Insurance Exchanges.
Consumers love HSA’s because the money not spent for their yearly deductible expenses go into a personal trust fund, which goes to pay future medical expenses. Consumers, employers or government can fund the deductible. Healthcare coverage starts after the deductible is reached. The trust fund can grow tax-free until funds are withdrawn.
HSAs are not ideal but they do act to provide a mild financial incentive to consumers to be responsible for their health and healthcare dollars. Consumers decrease their overuse of the healthcare system.
Health Savings Accounts are not as powerful as my ideal Medical Savings Accounts. Medical Savings Accounts provide greater financial incentive for consumers to be responsible for their healthcare and healthcare dollars.
Consumers seem to lack the desire to prevent obesity, which is responsible for many chronic diseases and their complications. These diseases are responsible for 80% of the healthcare dollars spent.
With my ideal Medical Savings Account consumers or the consumer’s sponsors (government or employers) pay a high deductible. The sponsor then buys first dollar reinsurance for healthcare coverage. The unspent deductible goes into a Medical Saving Account tax-free retirement fund. It does not stay in the healthcare system.
The Medical Saving Account provides greater financial incentive for consumers to become more responsible for their health care and healthcare dollars.
Why and how does Obamacare want to regulate Health Savings Accounts out of existence?
In case you missed it, final regulations published on March 8 will make it impossible to offer HSA-qualified plans in the future.
The health insurance industry has been opposed to HSAs and MSAs because the premiums the healthcare insurance industry receives is lower than regular healthcare insurance premiums.
Once the premiums are put into a trust it does not belong to the healthcare insurance industry to invest.
The healthcare industry has tried to influence HHS to dissuade consumers from buying HSAs through Health Insurance Exchanges since the exchanges began.
However HSS has done nothing “(a) to help consumers identify HSA-qualified plans on the exchanges or (b) provide information to individuals that choose HSA-qualified plans about where to get more information about opening and contributing to an HSA.”
Last year’s proposed standardization of healthcare plan design rule gave no hint that the proposal would eliminate the possibility of HSAs surviving.
This year’s rule change made it clear that this was President Obama’s goal.
1)” Plans must apply specific deductibles and out-of-pocket limits that are outside the requirements for HSA-qualified plans.”
2) “Plans must cover services below the deductible that are not considered “preventive care.”
“ Regarding the deductibles and out-of-pocket limits, no Bronze, Silver, or Gold plans adhering to the standardized benefit designs will likely be HSA-qualified for 2017.”
The first step was for HHS to change the definition of a qualified plan. The next step was to force the plan design to be incompatible with HSAs.
HHS and CMS have given the healthcare insurance industry another gift. Maybe it is a payback for CMS short changing the insurance industry on its reinsurance payback promise.
In any event HSAs look doomed. The Obama administration has succeeded in destroying the development of a viable healthcare system that the free market, not the central government controls.
John Dunn M.D.,J.D. wrote a wonderful summary of Obamacare’s failed attempts to control the healthcare system to his chat group followers.
He has summarized all the policies that have failed in the Obama administration’s goal to destroy the private healthcare market and eliminate the free market system.
“ Subject: HSAs being eliminated?
Yep, Obamacare strikes again to accomplish the real goal, elimination of private capitalist free market healthcare.
Now let’s tally up the failures of Obamacare in its attempt to destroy the healthcare system—
- more expensive, less accessible,
- restrictions on hospitals and care givers,
- promotion of mid level practitioners, extraordinary inefficiencies created by computer mandates,
- penalties for hospitals and physicians that are created by apparatchiks,
- no decline in the uninsured,
- in fact there might be an increase in the uninsured because of the cost of premiums and deductible,
- more movement of people to Medicaid where coverage is free,
- bankruptcies of COOP insurance programs,
- exchanges failing with insurers leaving the market for taking big economic hits from adverse selection,
- and most of all—the death spiral of private market insurance—with the goal being to destroy the private market ????
- Why of course, Medicaid for all.
The goal of government bureaucrats is control and power, achieved in this case by the growth of single payer government controlled medicine—Medicaid on steroids—
The result will be mediocrity as far as the eye can see, and destruction of innovative and creative health care,
but also the loss of the ethics and patient consideration that comes from physician guided health care,
instead a trade for mandarins with frowns and red pencils,
Checking the data banks that aren’t secure from hacking.
It leaves one almost breathless, but it started a long time ago.
Good intentions and unanticipated results—Bastiat von Mises, Fredrick Hayek warned us about the fatal conceit and the problem of government actions to protect certain interests or promote a cause—ignorant of the realities of markets and the benefits of free markets.
Socialism and statism will produce mediocre, expensive healthcare run by bureaucrats and apparatchiks who aren’t interested in good patient care,
They are only interested in control.
Looks like I am not the only one who has figured it out.
I do not understand why the political establishment cannot understand why Americans are getting ready to cast a protest vote against them.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
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