HEALTH SAVINGS ACCOUNTS ARE STUPID!!!

From TAPPED courtesy of Eschaton:

The idea here is simple. Conservatives believe Americans have too much health insurance, that they spend heedlessly and wastefully on care, procedures, and medications they would simply forego if insurance plans didn't pick up the tab. Ergo, HSA's, which end risk pooling, forcing care to come directly from pockets. Newly responsible for their medical bills, consumers will be spurred by the Magic of the Market to make smarter decisions, show more prudence, lead healthier lifestyles, smile more often, and smell springtime fresh. It's gonna be awesome.

At least if you're healthy. Because what HSA's really do is separate the young from the old, the well from the sick. Currently, insurance operates off of the concept of risk pooling. Since health costs tend to be unpredictable and illness isn't thought a moral failing, we all pay a bit more than we expect to use in order to subsidize those who end up needing much more than they ever thought possible. The well subsidize the sick, the young subsidize the old, and we all accept the arrangement because one day we will be old, and one day we will be sick, and no one wants to shoulder that alone.

But HSA's slice right through this intergenerational, redistributionist arrangement: they're a great deal for young, healthy folks because they don't force subsidization. Just don't get sick. And if you're already sick, don't think you can hide by remaining in traditional insurance plans: when the healthy rush towards HSA's, older plans will hold only the ill, and insurance companies will send premiums skyrocketing to recoup the difference.

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This nutty idea, the health savings account, has been floating around for a decade or so, but nobody's really taken it seriously until now--apparently, Bush is going to be pushing it pretty heavily during his upcoming state of the union address. As far as I've been able to tell, the idea is something of a right-wing think tank reaction to the very real issue of exploding health care costs and decreasing access. The problem is that health care saving accounts won't work, or, at least, they're not going they won't do what they're supposed to do. Actually, HSAs will make things much worse. There about a billion reasons why this is the case, but probably the most obvious is that Americans currently have a negative savings rate--that is, nobody's saving any money now, so why does anybody seriously believe that they're going to participate in this ill-conceived plan? The biggest problem is that HSAs just won't do any good for anybody with serious health problems, like cancer or HIV, or chronic issues like lupus or arthritis. In short, HSAs are just so much rhetoric. There's nothing to them, just some more smoke and mirrors to cover the rich while they fuck everyone else.

And for the next few months we're going to have to listen to reporters, pundits, and politicians on TV talk about HSAs as though they had some kind of legitimacy. It'll be as though people are suddenly like "hey, maybe the world really is flat!" Why are our leaders so fucking stupid?

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