John Stossel provides another simplistic look at health care. Previous articles by Stossel were discussed here and here. Stossel repeats the usual Republican argument promoting Health Savings Accounts, claiming that people will be more responsible in spending money if they see it as their own money.
One problem is that many people choose not to pay for preventative and routine care if they see it as coming out of their own pocket, increasing the cost of care in the long run. Stossel writes:
Harvard Business School professor Regina Herzlinger says studies show that “people who have these high-deductible health-insurance policies take a lot better care of themselves. They have more yearly physicals. Because they’re saying, ‘If I keep myself healthy, in the long run, I’m going to be spending less money.'”
The studies are far from clear on this point. It depends upon who you are comparing. If you are working with the types of plans Stossel discusses, where the employer both provides the plan and also places a generous amount of money into the plan, then some will use it for annual physicals. Many others either cannot afford the out of pocket expenses or chose not to spend their own money. Stossel describes the plan at Whole Foods:
Five years ago, the Whole Foods grocery chain switched to a high-deductible plan. If an employee has a sore throat or a sprained ankle, he pays. But if he gets cancer or heart disease, his insurance covers it.
Whole Foods puts around $1,500 a year into an account for each employee. It’s not charity but part of the employee’s compensation. It’s money Whole Foods would have otherwise spent on more-expensive insurance. Here’s the good part for employees: If they don’t spend the money on medical care this year, they keep it, and the company adds more next year.
That’s a good deal if you can get it, but those who have employers who are able to both purchase the plan for them and put $1,500 annually into their account are not those suffering under the current system. Some Republicans argue that, as Health Savings Accounts cost less than low-deductible plans, more employers will be able to provide them to their employees. If that is the case, we wouldn’t have seen a growing number of employers dropping or reducing coverage, and more people who are uninsured and under-insured, over the past few years, as HSA’s have become more aggressively marketed by the insurance industry.
HSA’s are of benefit to some, although they are often utilized more as a tax shelter than as an insurance program. They offer little benefit to those who currently do not receive coverage from an employer and who cannot afford either the premiums or the out of pocket expenses required by these plans.
