Government shutdown looms over ObamaCare

[ivwshane]

Incentivizing people spending their health care dollars intelligently, and at places that are cost competitive.

I look at hospitals and I see the same issues I see with colleges: out of control spending because there's no reason to control costs.

Now, in the spirit of bipartisanship, how about you propose something instead of just whining?

Yes, I have. You've replied to it you sanctimonious ass.

That's your plan or is that a goal? Its no wonder you follow the right, they like saying things with zero substance too!

"My plan to lower healthcare costs is for people to buy cheaper healthcare", sounds pretty fucking stupid doesn't it? I've read essays by forth graders that had more substance than that!

Thanks for the effort...I guess. Shall I send you a gold star or a participation trophy?

Lol!

 

[ivwshane]

Well I have a bit of time now. First, I've been a provider for decades and have witnessed the influence of managed care and government policies during that time, so I've had more time to think about this than Congress, and certainly more knowledge of what happens in the real world than most of them. I also don't give a crap about partisanship. In fact I don't want it getting in the way.

So- First of all a top down approach is about as stupid as a mud fence. All of health care comes down to the fundamental relationship between provider and patient. That's what's important, and everything else is fluff.

That being the case things which enhance it are good, those which harm it are bad. If a patient cannot communicate effectively to the provider and the provider is handicapped in giving proper care for whatever reason then we are less likely to have a satisfactory outcome.

This is all pretty basic stuff that seems to elude those who are making laws and regulations. Not surprising, because they are ignorant. How could they not be?

So what to do. First we need more time, not less to spend on each patient. The idea of increasing work per unit time is absolutely insane. We aren't making marshmallows, we're trying to help people, real people, not some averaged statistics. It's been demonstrated that the most effective thing to improve outcomes is for a trained person to spend a minimum of an hour with someone gathering patient history, observing the person, questioning them and so on. So they have a pain in the knee. Well, that's grand. Get them in and out like fast food. How economical. Unfortunately you missed that obvious melanoma, or the asymmetric motor function indicative of a stroke, or a hundred other things that might be present, but because it's not the principle complaint gets missed so we get em in and out. That means future visits for things which could be addressed when they weren't so serious becomes a major personal and financial ordeal later. There's also the problem that many people have no idea why they are taking a medicine, or forgot they were supposed to make an appointment, or they are seeing multiple practitioners who really don't know about the other because the patient forgot to mention them. I don't see that in the ACA.

This leads into the next problem. There is little interconnectedness in the system as a whole. Hospitals call me routinely to find out what medications those admitted are taking. The patient doesn't recall exactly and just who prescribed what. OK I can answer that, but what about services provided by someone else for which I have no access? Was something already ruled out? Was some test done and the results someplace somewhere? What is the relevant medical history of the admitted? Ignorance isn't strength. It's a hazard to those treated. So we could fund a centralized database updated in real time which practitioners could access when needed. Getting into the database is restricted to whose giving care, not Uncle Sam or insurance except for what is needed for billing purposes. The security would be a challenge, and an effective and reliable system would cost billions, but the two things I mentioned would save an incredible amount, far more than what they cost and the patient benefits.

That reduces the costs of treatments and that makes health care more affordable, not by some artificial means which is already having adverse consequences, but as a natural consequence.

That's two things that make a huge difference. Being something that addresses fundamental needs there are minimal unintended consequences.

That's a start.

And know what? I'm one person with decent reasoning skills. Imaging a concerted effort by those who know far more than myself and infinitely more than Congress, which by my suggestion would still be the ones voting on anything proposed. If they want to slaughter it for political purposes then it's entirely on their heads, but they were given the best possible solutions created by the best people in relevant fields spending the time needed to do the job right.

While your wonderfully competent representatives are rejecting alternatives, why don't you suggest they come up with a comprehensive theory of quantum gravity, or design a fusion plant, you know something equally amenable to political hackery.

Alright! First off, thanks for responding. You have some valuable insight into the "system" and it's problems.

Let's talk about what it seems we agree on: a universal billing system accessible by those providing care. We agree a universal database of medical history is needed for many reasons (one of which is more efficient care). We agree that it needs to be highly secure with access to it given only to those that are providing care to the patient.

Based on what you wrote do we agree on what I think we agree on?

First question for you; you said doctors (or the relevant person) needs to spend more time with patients so that a total diagnostic and a total solution can be provided [ie a broken arm leads to you finding out you have cancer(btw I agree with this which is what I was referring to being compensated by the cure and not by the treatment)]. How do you make this happen? In the current system there is no incentive to A) treat anything more than what the patient came in for and B) there is no incentive to cure people, the money is in the treatment.

While I think you have addresses the core issue of what makes good healthcare I feel you haven't provided an overall plan.

What is the perfect system or what system do you envision would get you to your goal? Would it be a modification of what we have now? Are you for a single payer system?

I feel that my proposal would get us to your vision and the tweaking would be towards compensation. What issues do you see with my proposal?

Lots of questions but I hope you answer them all.

 

[Hayabusa Rider]

Alright! First off, thanks for responding. You have some valuable insight into the "system" and it's problems.

Let's talk about what it seems we agree on: a universal billing system accessible by those providing care. We agree a universal database of medical history is needed for many reasons (one of which is more efficient care). We agree that it needs to be highly secure with access to it given only to those that are providing care to the patient.

Based on what you wrote do we agree on what I think we agree on?

First question for you; you said doctors (or the relevant person) needs to spend more time with patients so that a total diagnostic and a total solution can be provided [ie a broken arm leads to you finding out you have cancer(btw I agree with this which is what I was referring to being compensated by the cure and not by the treatment)]. How do you make this happen? In the current system there is no incentive to A) treat anything more than what the patient came in for and B) there is no incentive to cure people, the money is in the treatment.

While I think you have addresses the core issue of what makes good healthcare I feel you haven't provided an overall plan.

What is the perfect system or what system do you envision would get you to your goal? Would it be a modification of what we have now? Are you for a single payer system?

I feel that my proposal would get us to your vision and the tweaking would be towards compensation. What issues do you see with my proposal?

Lots of questions but I hope you answer them all.

I'll be glad to continue this conversation, but off to bed I go! I'll think more about this and get back probably tomorrow or the next day in detail.

BTW, I think you get what I'm getting at.

 

[ivwshane]

I'll be glad to continue this conversation, but off to bed I go! I'll think more about this and get back probably tomorrow or the next day in detail.

BTW, I think you get what I'm getting at.

No problem.

I think most people want the same thing, it's the "how do we get there" that everyone disagrees or complains about.

Have a good night!

 

[sportage]

Love how the op phrases this, like its some Obamacare problem.
Thats like saying "Black kid shot by neighborhood watchman because the kid should have known better than to be walking in that area".
Potential government shutdown has no link and nothing to do with Obamacare.
Potential government shutdown has everything to do with bone headed republicans.

 

[TerryMathews]

That's your plan or is that a goal? Its no wonder you follow the right, they like saying things with zero substance too!

"My plan to lower healthcare costs is for people to buy cheaper healthcare", sounds pretty fucking stupid doesn't it? I've read essays by forth graders that had more substance than that!

Thanks for the effort...I guess. Shall I send you a gold star or a participation trophy?

Lol!

No, you can't even summarize right.

(One of) my ideas was to put people in charge of their own health care costs, by incenticizing it in some manner. One idea that has been throw around a lot is HSA accounts plus catastrophic coverage insurance.

Liberals love attacking profit and corporate officer compensation. Yet they only really go after banks and oil companies. Why don't they ever look at the health care industry or colleges?

Two of the largest hospital systems in my area paid their CEOs over $2 mil each in total compensation, $1 mil in cash. For a "nonprofit". I'm not in a big, affluent area. I wonder what the compensation is like in San Francisco or Los Angeles?

 

[ivwshane]

No, you can't even summarize right.

(One of) my ideas was to put people in charge of their own health care costs, by incenticizing it in some manner. One idea that has been throw around a lot is HSA accounts plus catastrophic coverage insurance.

Liberals love attacking profit and corporate officer compensation. Yet they only really go after banks and oil companies. Why don't they ever look at the health care industry or colleges?

Two of the largest hospital systems in my area paid their CEOs over $2 mil each in total compensation, $1 mil in cash. For a "nonprofit". I'm not in a big, affluent area. I wonder what the compensation is like in San Francisco or Los Angeles?

It's like pulling teeth!

Ok so people now have a health savings account, how does that lower costs? How does it ensure more people or everyone has coverage? How would the poor be able to use this system? How do consumers get educated enough to make smart decisions? How would life long health issues be handled if the consumer doesn't have a big enough fund to cover their costs?

It appears HSA's are a type of investment, what happens when the market takes a crap?

To lower costs through the market, in the matter you are suggesting, requires the consumer to not only have enough options to be able to freely choose where to go but they also need to be smart enough to make those decisions. Based on history, consumer choice tends to shrink over time and consumers (in the US anyway) are horrible at voting with their wallets, how do you ensure the system will not only work now but will also work in the future?

Does the system you envision work in conjunction with the current system or does it replace it? If it replaces it, how does the change over occur?


Now we are cooking!

 

[berzerker60]

Liberals love attacking profit and corporate officer compensation. Yet they only really go after banks and oil companies. Why don't they ever look at the health care industry or colleges?

They do. Just because you don't pay attention doesn't mean it doesn't happen. http://en.wikipedia.org/wiki/UC_Davis_pepper-spray_incident https://www.baycitizen.org/news/education/protesters-demand-uc-regents-raises/

 

[glenn1]

It's like pulling teeth!

Ok so people now have a health savings account, how does that lower costs? How does it ensure more people or everyone has coverage? How would the poor be able to use this system? How do consumers get educated enough to make smart decisions? How would life long health issues be handled if the consumer doesn't have a big enough fund to cover their costs?

It appears HSA's are a type of investment, what happens when the market takes a crap?

To lower costs through the market, in the matter you are suggesting, requires the consumer to not only have enough options to be able to freely choose where to go but they also need to be smart enough to make those decisions. Based on history, consumer choice tends to shrink over time and consumers (in the US anyway) are horrible at voting with their wallets, how do you ensure the system will not only work now but will also work in the future?

Does the system you envision work in conjunction with the current system or does it replace it? If it replaces it, how does the change over occur?


Now we are cooking!

So in short, because progressive constituent populations are so stupid that you can't make smart decisions, you're going to assume the rest of us are also? And thus force us into goverment run system that's likely going to produce no better results than the inner city schools which are producing such stupid and illiterate morons to begin with.

If we're all that stupid we can't handle this ourselves, how is some $40k/year government bureaucrat supposed to be smart enough to figure out this out on my behalf?

 

[werepossum]

It's like pulling teeth!

Ok so people now have a health savings account, how does that lower costs? How does it ensure more people or everyone has coverage? How would the poor be able to use this system? How do consumers get educated enough to make smart decisions? How would life long health issues be handled if the consumer doesn't have a big enough fund to cover their costs?

It appears HSA's are a type of investment, what happens when the market takes a crap?

To lower costs through the market, in the matter you are suggesting, requires the consumer to not only have enough options to be able to freely choose where to go but they also need to be smart enough to make those decisions. Based on history, consumer choice tends to shrink over time and consumers (in the US anyway) are horrible at voting with their wallets, how do you ensure the system will not only work now but will also work in the future?

Does the system you envision work in conjunction with the current system or does it replace it? If it replaces it, how does the change over occur?


Now we are cooking!

Health savings accounts have nothing whatsoever to do with the market. The individual and/or his employer set aside pre-tax money for the individual's and family's health care needs. The plan is administered by an insurance company as the vast majority of consumer savings are from "network savings", meaning steep discounts negotiated by the insurance company using its aggregate buying power. A conventional high deductible plan sits on top of that once you've met your deductible. (Incidentally Obamacare attacks HSAs; my deductible went from $2,700 annually to $3,700 because the Dems think my plan is too good.) As an individual I am free to ask about costs and choose what I think represents the best value, and from a health care provider standpoint they get their money immediately up to my deductible and on the same basis as any insurance company beyond that. An HSA gives the consumer maximum control and savings without sacrificing protection against ruinous medical bills.

 

[EagleKeeper]

So in short, because progressive constituent populations are so stupid that you can't make smart decisions, you're going to assume the rest of us are also? And thus force us into goverment run system that's likely going to produce no better results than the inner city schools which are producing such stupid and illiterate morons to begin with.

If we're all that stupid we can't handle this ourselves, how is some $40k/year government bureaucrat supposed to be smart enough to figure out this out on my behalf?

Because the $40K/yr bureaucrats have a $4M consulting firm on call to tell them what the Democrats thought they meant when they wrote the regulations

 

[ivwshane]

Health savings accounts have nothing whatsoever to do with the market. The individual and/or his employer set aside pre-tax money for the individual's and family's health care needs. The plan is administered by an insurance company as the vast majority of consumer savings are from "network savings", meaning steep discounts negotiated by the insurance company using its aggregate buying power. A conventional high deductible plan sits on top of that once you've met your deductible. (Incidentally Obamacare attacks HSAs; my deductible went from $2,700 annually to $3,700 because the Dems think my plan is too good.) As an individual I am free to ask about costs and choose what I think represents the best value, and from a health care provider standpoint they get their money immediately up to my deductible and on the same basis as any insurance company beyond that. An HSA gives the consumer maximum control and savings without sacrificing protection against ruinous medical bills.

Thanks for the clarification (that's why I left that statement by itself, I was unsure if it was true).

Would you mind answering my other questions?

It seems like HSA's must be paired to high deductible plans. For those that are healthy they would be setting money aside for their HSA but they wouldnt get to use it as they would be more likely to never spend more than their deductible. Other than getting to choose where to get services from it doesn't seem like much of an advantage from them. In fact I'd guess that some would forego preventative care (or check ups) because of having to pay out of pocket.
But the biggest losers in this plan seem to be poor people. Not only are they using what little money they have to build up their HSA but they also have to come out of pocket before it kicks in.

 

[ivwshane]

So in short, because progressive constituent populations are so stupid that you can't make smart decisions, you're going to assume the rest of us are also? And thus force us into goverment run system that's likely going to produce no better results than the inner city schools which are producing such stupid and illiterate morons to begin with.

If we're all that stupid we can't handle this ourselves, how is some $40k/year government bureaucrat supposed to be smart enough to figure out this out on my behalf?

Because the $40K/yr bureaucrats have a $4M consulting firm on call to tell them what the Democrats thought they meant when they wrote the regulations

Yes we get it, you hate the left. Perhaps you guys could include in your posts the words "piece of shit liberal" to contribute even less to the discussion.

 

[TerryMathews]

Thanks for the clarification (that's why I left that statement by itself, I was unsure if it was true).

Would you mind answering my other questions?

It seems like HSA's must be paired to high deductible plans. For those that are healthy they would be setting money aside for their HSA but they wouldnt get to use it as they would be more likely to never spend more than their deductible. Other than getting to choose where to get services from it doesn't seem like much of an advantage from them. In fact I'd guess that some would forego preventative care (or check ups) because of having to pay out of pocket.
But the biggest losers in this plan seem to be poor people. Not only are they using what little money they have to build up their HSA but they also have to come out of pocket before it kicks in.

Not necessarily. Some of the proposals pair it with what is called "catastrophic coverage" insurance. It's more limited in scope but the things it covers, it covers fully. In many respects, it's a better deal than what most middle class people deal with now, in that even 15-20% of a $200k hospital bill can still be ruinous.

And to your other point, regarding preventive care, the coverage only has to be structured that way if we choose to. There are many high deductible plans that cover office visits and wellness checks fully. My employer offers one. The thinking behind it is that if you are often well, and don't go to the doctor for every runny nose, you can come out ahead even if you need to pay for a visit or two out of pocket.

The crux of this argument goes back to personal responsibility. Right now, there is no incentive to be responsible with your health care money, especially if you are on some form of government health care.

I want to be clear here. I'm not trying to take people's health care away. I'm not trying to force them into spending less. I do, however, strongly believe that if there was an incentive to spend more responsibly, overall spending would go down and you would begin to see some competition in the marketplace.


Maybe there could be an EITC-ish schedule based on family size, and if non-emergency, non-materinty spending was kept at or below a certain $ amount, they get a refundable tax credit equal to 10% of the difference?

Hell, I'm feeling generous. Make it 20%.

 

[werepossum]

Thanks for the clarification (that's why I left that statement by itself, I was unsure if it was true).

Would you mind answering my other questions?

It seems like HSA's must be paired to high deductible plans. For those that are healthy they would be setting money aside for their HSA but they wouldnt get to use it as they would be more likely to never spend more than their deductible. Other than getting to choose where to get services from it doesn't seem like much of an advantage from them. In fact I'd guess that some would forego preventative care (or check ups) because of having to pay out of pocket.
But the biggest losers in this plan seem to be poor people. Not only are they using what little money they have to build up their HSA but they also have to come out of pocket before it kicks in.

Terry nailed it. There is no reason that HSAs cannot work for poor people, but government would have to kick in money and/or provide a Medicare-type policy above the HSA to make it practical. One thing an HSA would do for the poor is disincline them to take routine health care matters to the emergency room; if it's YOUR money, you'll usually choose a $50 doc-in-the-box over a $300 emergency room visit or maybe even decide that it's just a cold. HSA cards would also have to be ruthlessly enforced as healthcare-only (similar to WIC) to minimize fraud. And probably the Medicare-type policy would need to cover routine check-ups and diagnostic work to protect stupid and/or overly optimistic healthy people from saving that money against some future need - for instance, passing up check-ups to finance LASIK wouldn't make much sense if one later is diagnosed with advanced cancer.

Personally I think the societal goal should be to produce educated, empowered, smart consumers capable of making informed health care choices. The alternative, assuming that people are idiots incapable of making our own health care decisions yet somehow wise enough to elect people who will appoint others to manage our lives for us, just encourages people to be idiots.

 

[ivwshane]

Not necessarily. Some of the proposals pair it with what is called "catastrophic coverage" insurance. It's more limited in scope but the things it covers, it covers fully. In many respects, it's a better deal than what most middle class people deal with now, in that even 15-20% of a $200k hospital bill can still be ruinous.

And to your other point, regarding preventive care, the coverage only has to be structured that way if we choose to. There are many high deductible plans that cover office visits and wellness checks fully. My employer offers one. The thinking behind it is that if you are often well, and don't go to the doctor for every runny nose, you can come out ahead even if you need to pay for a visit or two out of pocket.

The crux of this argument goes back to personal responsibility. Right now, there is no incentive to be responsible with your health care money, especially if you are on some form of government health care.

I want to be clear here. I'm not trying to take people's health care away. I'm not trying to force them into spending less. I do, however, strongly believe that if there was an incentive to spend more responsibly, overall spending would go down and you would begin to see some competition in the marketplace.


Maybe there could be an EITC-ish schedule based on family size, and if non-emergency, non-materinty spending was kept at or below a certain $ amount, they get a refundable tax credit equal to 10% of the difference?

Hell, I'm feeling generous. Make it 20%.

I hear what you are saying about personal responsibility and I agree that people need to do more for themselves however punishing people for being stupid usually ends up affecting everyone in a negative way.

In my proposal I tried to address that in a couple different ways. In one way I had a higher fee/payment required for those that engaged in unhealthy behavior, another thing I proposed was for the consumer to be given a copy of their bill. Perhaps other penalties could be assessed whose goal is to "force" personal responsibility.

An HSA plan seems perfect for those that are already about taking personal responsibility but I don't see how it would incentives people into being more responsible. And that's just the reality of it. Humans are lazy and more often than not will take the easiest path unless they are being watched constantly (and I feel that with regards to healthcare that over "watching" people starts to cross that line of the right to privacy).

So in conclusion would you agree that any new system would need to have some balance to it and not just be a free for all or exclusive to only those that are the most responsible?

 

[ivwshane]

Terry nailed it. There is no reason that HSAs cannot work for poor people, but government would have to kick in money and/or provide a Medicare-type policy above the HSA to make it practical. One thing an HSA would do for the poor is disincline them to take routine health care matters to the emergency room; if it's YOUR money, you'll usually choose a $50 doc-in-the-box over a $300 emergency room visit or maybe even decide that it's just a cold. HSA cards would also have to be ruthlessly enforced as healthcare-only (similar to WIC) to minimize fraud. And probably the Medicare-type policy would need to cover routine check-ups and diagnostic work to protect stupid and/or overly optimistic healthy people from saving that money against some future need - for instance, passing up check-ups to finance LASIK wouldn't make much sense if one later is diagnosed with advanced cancer.

My point was that even a $50 doctor visit would be too much for a poor person and would be skipped, at least until the issue became catastrophic. That's not good for the person, it's not good for the business they work for, and it's not good for the country as a whole.

Personally I think the societal goal should be to produce educated, empowered, smart consumers capable of making informed health care choices. The alternative, assuming that people are idiots incapable of making our own health care decisions yet somehow wise enough to elect people who will appoint others to manage our lives for us, just encourages people to be idiots.

I absolutely agree with what you wrote that I put in bold. The question is how do you do this? (take any industry where consumers play a large role, how would you achieve your goal of a smarter more empowered consumer?)

 

[TerryMathews]

I hear what you are saying about personal responsibility and I agree that people need to do more for themselves however punishing people for being stupid usually ends up affecting everyone in a negative way.

In my proposal I tried to address that in a couple different ways. In one way I had a higher fee/payment required for those that engaged in unhealthy behavior, another thing I proposed was for the consumer to be given a copy of their bill. Perhaps other penalties could be assessed whose goal is to "force" personal responsibility.

An HSA plan seems perfect for those that are already about taking personal responsibility but I don't see how it would incentives people into being more responsible. And that's just the reality of it. Humans are lazy and more often than not will take the easiest path unless they are being watched constantly (and I feel that with regards to healthcare that over "watching" people starts to cross that line of the right to privacy).

So in conclusion would you agree that any new system would need to have some balance to it and not just be a free for all or exclusive to only those that are the most responsible?

I did not punish anyone in my proposal, did you read all of it? I was paying 20% of the leftover balance in a refundable tax credit.

I disagree with you about lazy. Some people are just lazy. Others work to get ahead. They save, they build, and they prosper. Those are the people my proposal would speak to the most.

 

[ivwshane]

I did not punish anyone in my proposal, did you read all of it? I was paying 20% of the leftover balance in a refundable tax credit.

I disagree with you about lazy. Some people are just lazy. Others work to get ahead. They save, they build, and they prosper. Those are the people my proposal would speak to the most.

You could give them a 100% refund but that doesn't change the fact that the poor would have a tough time paying for things up front.

Don't take it personal, I wasn't saying you wanted to punish people just to attack you. I said it because it's an un intended consequence.

As to your last statement, again, I see where you are coming from, unfortunately that mentality doesn't make things better for anyone and would actually make things worse.

We all wish lazy people would just go away but the reality is that will never happen, we can choose to ignore them and deal with the comsequences or we can accept the fact that they exist and minimize their impact on the rest of us.

 

[TerryMathews]

You could give them a 100% refund but that doesn't change the fact that the poor would have a tough time paying for things up front.

Don't take it personal, I wasn't saying you wanted to punish people just to attack you. I said it because it's an un intended consequence.

As to your last statement, again, I see where you are coming from, unfortunately that mentality doesn't make things better for anyone and would actually make things worse.

We all wish lazy people would just go away but the reality is that will never happen, we can choose to ignore them and deal with the comsequences or we can accept the fact that they exist and minimize their impact on the rest of us.

Fine. Your objection seems to be that "poor people" can't pay upfront, which is an objection for HSFAs, not HSAs but let's split the baby so to speak.

Keep medicare and Medicaid exactly the same, refundable tax credits for keeping annual spending under regional average. 20% of difference, averages for each family size like the EITC. No penalty for going over average.

Would you support a plan like that?

 

[ivwshane]

Fine. Your objection seems to be that "poor people" can't pay upfront, which is an objection for HSFAs, not HSAs but let's split the baby so to speak.

Keep medicare and Medicaid exactly the same, refundable tax credits for keeping annual spending under regional average. 20% of difference, averages for each family size like the EITC. No penalty for going over average.

Would you support a plan like that?

Not yet, there simply isn't enough info to decide.

How would consumers compare doctors? How do people who live in rural areas get access to competitive care and what would be in place to ensure they get good competitive prices in the absence of competition?
What about administrative costs? Does the consumer still go through a middleman who makes payments to healthcare providers from their HSA? Do healthcare providers still have to deal with multiple billing systems?
Is there any central medical database in your plan?

So under your proposal consumers would be paying A) a deductible up until a certain amount B) required HSA contributions (would they be required? If so, how would that be implemented?) C) consumers would still need to pay for catastrophic insurance? If so whats the average cost for that?

With all the above costs will the total costs for healthcare be lower for those that are healthy?

Currently some employers contribute voluntarily to their employees HSA, under your proposal would employers be required to contribute?

 

[rudder]

I absolutely agree with what you wrote that I put in bold. The question is how do you do this? (take any industry where consumers play a large role, how would you achieve your goal of a smarter more empowered consumer?)

That is what HSA's were doing. With health insurance as it is...there is a big disconnect between the consumer and what is being paid for. With HSA's you would be more in tune with where your healthcare dollars were going.

 

[ivwshane]

That is what HSA's were doing. With health insurance as it is...there is a big disconnect between the consumer and what is being paid for. With HSA's you would be more in tune with where your healthcare dollars were going.

I understand that but now knowing how you are getting screwed doesn't necessarily stop you from getting screwed.

If all the players in the current game are the same players in the next game exactly what do you think will change?

By saying consumers will be in tune with what healthcare costs and will be able to "shop around" you are admitting that the players in the game are the problem. If you know someone who is cheating what do you do? Go to another table where some other player is cheating?

In an ideal market an HSA would be a game changer and would force the different players to compete on quality and costs but we don't live with an ideal healthcare market place nor would we if government played no role in it. Things might be good for a while but as history has shown us, where there is an opportunity to exploit people and businesses will exploit that opportunity.

HSA's sound like a good alternative for some in the current market but it doesn't work for everyone and it does nothing to fix the issues we are facing.


If you are saying that HSA's are changing the market and shifting the power to the consumer I'd like to see some data on that.