HSAs Spawn Government Bureaucracies, But Government-Run Health Care is Fine
Lance Burri has been debating the merits of HSAs with our good friend, Jack Lohman. During the debate, Lance “I write better than 96% of the people out there and I still don’t have a column” Burri, noticed this contradiction:
He argues that insurance companies will simply refuse to pay up, once the deductible is spent.
I counter that this is possible with any type of insurance, not just HSAs, and that’s why we have government regulators like the Office of the Commissioner of Insurance.
Say what you want about such government functions, but it’s true.
Jack’s response to that:
...we certainly don’t need another bureaucracy to protect the public.That’s right, this champion of single-payer “universal” health insurance doesn’t like HSAs because they’ll create “another bureaucracy.”
Silly, Lance, linear thought is for suckers. I suspect that Mr. Lohman primarily opposes HSAs because they are NOT government-run health care. Don’t you know that socialized health care is the only rational solution here?
Single-payer national health care is probably the best solution, once you start looking at the actual situation of healthcare in the major industrialized countries, including the US. A good place to start is the book Sick: The Untold Story of America’s Health Care Crisis---and the People Who Pay the Price, by Jonathan Cohn.
Posted by Leisureguy on February 16, 2008 at 1239 hrsMedicare is single pay health care and many primary care doctors are not taking new medicare patients since the reimbursements are so low. Please do not give me the line that doctors are paid too much, given their level of responsibility, family sacrifices, hours of work, many work over 65 hours a week, not including the telephone calls at home, and level of education and debt, their pay is fine
In many of the nations that have single-pay health care, medical education is funded by the government. Also, medical lawsuits and the practice of defensive medicine is much less, since the threat of lawsuits are much less.
Doctor fees comprise about 20% of total health care spending, so reducing doctor fees, which is what most single-pay advocates want to do, will not decrease spending that much.
The problem with physician pay is that their is a wide rage between types of doctors. For example, most primary care docs make between $150,000 and $200,000, while an orthopedic doc can make well over $1 million. In order for that Primary care doc to make their many, they must see between 20-30 patients per day.
For the single pay people out there, would you be against the unionization of doctors and nurses?
The problem is that government is in the way wit
Posted by on February 16, 2008 at 1324 hrsIt should be observed that, though doctor fees may not be reduced under a single-payer system, doctor-office costs will drop a lot: see
Unionization is always a good step.
Posted by Leisureguy on February 16, 2008 at 1331 hrsLeisureguy:
This is the argument hear the most. Let me say this outright, I am not a fan of the insurance companies. However, I am not a fan of the government either. I have seen first hand how much red-tape government can give. If I had better faith in the government, maybe I would support this. The problem with single pay is that now you have said to medical providers that the government is the only game in town. Doctors have to fight with congress every year just so they will not let CMS cut medicare rates. Doctors could just refuse to see medicare patients since they have other options. Under a single-pay model this would be impossible and since it is currently illegal for doctors to strike, they would be at the mercy of the government.
I think that all insurance companies should be non-profit and that no person could be dropped for pre-existing conditions. I do not think we need for-profit medical insurance companies. I also think all hospitals should be non-profit also and all new hospitals should be based on need. I would like to see it possible that employers could buy health insurance in different risk pools in different states. I also think employees should have to pay higher premiums depending of their risk factors, and receive credits for healthy activity.
Doctors should be paid based on realistic postive outcomes. Good doctors should be paid more than bad ones.
I think there are many other steps that can be taken before we have a total government take over of health care. Remember Canada is not the United States, totally different population.
On another note, look at what we spend on education in this country, which the government has control of, and the results we get.
Posted by on February 16, 2008 at 1357 hrsI understand Canada is not the US. And you understand that Canada is not the only industrialized country with national healthcare plans---they ALL have such plans, except for the US.
I can’t think of more red tape than the amount the typical doctor’s office must deal with because of so many health insurance companies. Note that even with existing fees doctors would make more because the overall office expense would drop significantly.
Education is indeed uneven---but of course education is controlled by a myriad of local governments, some eager to push bizarre beliefs. And private education hasn’t seemed to solve all those problems.
Government-run organizations differ tremendously in their efficiency. The Social Security Administration is a model of efficiency, for example, while the Department of Defense is a steaming pile of waste and corruption, lies and coverups. FEMA was great when its head was an experienced expert in disaster response, and a disaster in itself when the head was a political hack.
Obviously, it helps a lot if citizens are interested in and conscious of their government and their elected officials, and elect people of integrity and energy to monitor government (Executive Office) operations, rather than sitting blankly by with an “anything goes” attitude.
All the bad things you associate with a national healthcare system: why are other countries able to do it so well, and why do you believe Americans lack that ability?
Posted by Leisureguy on February 16, 2008 at 1806 hrsYou’ve got it wrong, Owen. That is absolutely NOT what I said. I said that when HSA users exceed their deductible and the insurer’s dollars kick in, the rules that apply in standard policies now apply to the HSA.
Do not assume that you have catestrophic insurance and the company cannot cancel you when the costs get too high, or they cannot implement “utilization rerview” (that’s the gatekeepers that interfere with doctor judgements). High deductible policies simply delay the inevitable.
As well, with a Medicare-for-all system we do not need the government’s oversight commission to make sure Medicare pays. Trust me: MEDICARE PAYS! I was a Medicare provider for 20 years and never had one problem.
Yes, there are some doctors that have grown their practices to the point that Medicare’s “fair” reimbursements are not as attractive as what the industry called “usual and customary,” which kept inching up over time because they were physician controlled. They billed what they could get away with. Sometimes that was quadruple Medicare’s “fair” rates, but what the hell; that’s the free market you espouse.
Posted by Jack Lohman on February 16, 2008 at 2123 hrsAnd Owen, you’ve got to love this: choice and competition!
Posted by Jack Lohman on February 17, 2008 at 0811 hrsI just wonder how you square your belief that politicians are all corrupted by money and yet you want to give them more power and more money to control.
Posted by Owen on February 17, 2008 at 0823 hrsPoliticians are only slightly better than CEOs because they are electable and can be replaced. I’m not happy that politicians supposedly work for the taxpayers but take money from the CEOs that want taxpayer assets. You shouldn’t be either. The right wing is totally ignoring the high taxes that result from our corrupt political system.
That said, if the politicians are under the same healthcare system as the public, I feel they will do the right thing.
But remember that choice and competition is possible with the following proposal.
Posted by Jack Lohman on February 17, 2008 at 0840 hrsAhem. Ninety-six percent?
Best,
Lance
Posted by Lance on February 17, 2008 at 1113 hrsDoctors should be paid based on realistic postive outcomes. Good doctors should be paid more than bad ones.
Posted by software bucuresti on May 14, 2008 at 1224 hrs
Ol' Army
