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Old Feb 8, 2013, 03:07 PM   #1
ugahairydawgs
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Obamacare alternative: Give everyone a HSA at birth

Yesterday morning a doc from Johns Hopkins offered an interesting solution to health care issues in America.

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DR. CARSON: Here's my solution: When a person is born, give him a birth certificate, an electronic medical record, and a health savings account to which money can be contributed -- pretax -- from the time you're born 'til the time you die. When you die, you can pass it on to your family members, so that when you're 85 years old and you got six diseases, you're not trying to spend up everything. You're happy to pass it on and there's nobody talking about death panels.

Number one. And also, for the people who were indigent who don't have any money we can make contributions to their HSA each month because we already have this huge pot of money. Instead of sending it to some bureaucracy, let's put it in their HSAs. Now they have some control over their own health care.
Its a very interesting idea and one that puts the individual in charge of their own care.

Any thoughts on why this wouldn't be a good idea?

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Old Feb 8, 2013, 03:15 PM   #2
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Medicare part E. "E" for everyone. Lower the eligibility from 65 to birth.
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Old Feb 8, 2013, 03:20 PM   #3
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Originally Posted by ugahairydawgs View Post
Yesterday morning a doc from Johns Hopkins offered an interesting solution to health care issues in America.



Its a very interesting idea and one that puts the individual in charge of their own care.

Any thoughts on why this wouldn't be a good idea?

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People don't save now. They won't save under this system either. They'll blow all their money elsewhere, then go to the ER, or bankrupt themselves, or forego care, or just die, for any healthcare needs.

Cost inflation. Even above what we're currently seeing. You know those $40k hospital bills people get, that get settled with the insurance company for only $10k? We'd be getting that $40k bill, and that's that.
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Old Feb 8, 2013, 03:21 PM   #4
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Don't see how that would change anything for the better...

You'd still lots of bureaucracy to determine who should get how much put into that account when the can't pay for it themselves.

Then you'd neeed more bureaucracy to determine what should and should not be paid out of it (cos otherwise lots of people will blow it on "medical" pot or some esoteric crap).

Next you need to make sure that doctors don't overcharge once they see a ripe account.

Finnally one would make sure that kids don't put pressure on a patient to safe more of that money for the time when they might need it.

Problem of the US health system is NOT bureaucracy or that it partly financed by a tax, problem is that it allmost 100% relys on for-profit-companies both when it comes to collecting payments for health (read insureance companies) and when providing services.
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Old Feb 8, 2013, 03:33 PM   #5
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I'm curious about this part:

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Number one. And also, for the people who were indigent who don't have any money we can make contributions to their HSA each month because we already have this huge pot of money. Instead of sending it to some bureaucracy, let's put it in their HSAs. Now they have some control over their own health care.
Who can make contributions? What huge pot of money? What counts as someone not able to pay enough into their own?

Someone who makes $25,000 a year who can only contribute maybe $2500 a year to the fund would have only $100,000 in their account by the time they were 40, provided someone was chipping in $2,500 from their birth. That's not much to cover an actual medical stay. The birth of our son was pretty routine and still cost over $40,000. A single complication, and that would have shot up quickly.

Then what?
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Old Feb 8, 2013, 03:50 PM   #6
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Originally Posted by samiwas View Post
I'm curious about this part:



Who can make contributions? What huge pot of money? What counts as someone not able to pay enough into their own?

Someone who makes $25,000 a year who can only contribute maybe $2500 a year to the fund would have only $100,000 in their account by the time they were 40, provided someone was chipping in $2,500 from their birth. That's not much to cover an actual medical stay. The birth of our son was pretty routine and still cost over $40,000. A single complication, and that would have shot up quickly.

Then what?
Unless I was misunderstanding him, we'd still have the same insurance system in place for people to get, only instead of paying the co-pay out of your pocket you'd pull the money out of this health savings account.
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Old Feb 8, 2013, 03:56 PM   #7
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Unless I was misunderstanding him, we'd still have the same insurance system in place for people to get, only instead of paying the co-pay out of your pocket you'd pull the money out of this health savings account.
Which is out of your pocket... This doesn't sound like a solution to anything. Just a different way of going about it for those who can manage to keep up an HSA.

A solution is something that makes healthcare more affordable, more widespread, and more available to all people overall. Not just something that might help them pay the still-astronomical costs.
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Old Feb 8, 2013, 04:00 PM   #8
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Any thoughts on why this wouldn't be a good idea?
You'll have tons of people who won't ever contribute any money to their accounts. Yet, when they need treatment, they'll go to the hospital and get it. Hospitals won't ever deny them the treatment, and then the taxpayers will be on the hook for the bill just like they are when this happens now.


Health care costs are ridiculously high in this country because it's all run by for-profit healthcare corporations.

We need to completely eliminate anything regarding healthcare being for profit. Companies shouldn't be making money off of people's health.

I don't care if it's the government running it or if we establish separate, non-government entities operating as non-profits, but it's clear that for-profit health care doesn't work.
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Old Feb 8, 2013, 04:01 PM   #9
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What happens to sick children in this scenario? They probably won't have contributed much to their HSA from their paper routes and allowance if they are unfortunate enough to get sick before they become employed.
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Old Feb 8, 2013, 04:22 PM   #10
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Any thoughts on why this wouldn't be a good idea?
So now we'd add unequal health to our unequal wealth?

No thank you.
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Old Feb 8, 2013, 04:27 PM   #11
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"When you die, you can pass it on to your family members, so that when you're 85 years old and you got six diseases, you're not trying to spend up everything. You're happy to pass it on and there's nobody talking about death panels."

This part is perhaps the most unrealistic in the entire scheme. The entirety of that HSA will be exhausted by most people in trying to hopelessly extend life hours at the end rather than passing it on.
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Old Feb 8, 2013, 04:29 PM   #12
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" God didn’t say, “If your crops failed, don’t give me any tithes.” He didn’t say, “Have a bumper crop? Give me triple.”"

Oh yes he did:

Luke 21:1-4

[21:1] As he looked up, Jesus saw the rich putting their gifts into the temple treasury. [2] He also saw a poor widow put in two very small copper coins. [3] "I tell you the truth," he said, "this poor widow has put in more than all the others. [4] All these people gave their gifts out of their wealth; but she out of her poverty put in all she had to live on."
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Old Feb 8, 2013, 04:58 PM   #13
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What happens to sick children in this scenario? They probably won't have contributed much to their HSA from their paper routes and allowance if they are unfortunate enough to get sick before they become employed.
Lower the working age to 8
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Old Feb 8, 2013, 05:12 PM   #14
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Lower the working age to 8

Remember Newt Gingrich suggested we use poor kids as janitors at schools. Maybe we should arm them too.
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Old Feb 8, 2013, 05:22 PM   #15
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Health savings accounts already exist and don't really take care of everything. Is his suggestion one of simply adjusting tax policy around them? One hardly makes up for the other when you look at it from the standpoint of when you're 85. It sounds like another form of IRA split off into another naming convention, when health concerns are unpredictable. You could be hit by a car tomorrow, yet If this was an extremely common occurrence, the concept of insurance wouldn't really work.
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Old Feb 8, 2013, 10:21 PM   #16
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Old Feb 8, 2013, 10:56 PM   #17
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Except for members of Congress and their families. They're exempt.
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Old Feb 8, 2013, 11:39 PM   #18
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Do the math. How much can an average middle class family contribute to an HSA. How much does an average hospital stay cost in the US. It's a ******** idea from someone unqualified to make statements about financials.

HSA's were another invention from the likes of the people that brought you HMOs. All designed to limit access to care and reduce costs to employers no matter what the impact to employees may be. Considering the crimes on public health committed by the Nixon, Reagan and Bush administrations against employees on healthcare it is baffling that working citizens are willing to elect any more of these crooks.
I would say 5% is a good starting number. So a family making $40k a year should easily be able to put back $2k in a given year.
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Old Feb 9, 2013, 05:22 AM   #19
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Old Feb 9, 2013, 07:39 AM   #20
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Dude, that's a sprained ankle... read 1. Maybe a bit of change for cold medication....
Maybe I'm missing something. Where are you getting charged $2k for a sprained ankle?
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Old Feb 9, 2013, 08:10 AM   #21
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I would say 5% is a good starting number. So a family making $40k a year should easily be able to put back $2k in a given year.
A family making only $40,000 a year hardly can afford to save 5% of their income for healthcare. And even if they could $2,000 for a family could get wiped out in a single illness or emergency room visit.
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Old Feb 9, 2013, 08:23 AM   #22
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I would say 5% is a good starting number. So a family making $40k a year should easily be able to put back $2k in a given year.
OK. So what percentage of families under this scenario would be able to afford the health care they need? (Note also, this guy's proposal is for individual health savings account, not family ones).

How much below 100% do you find to be acceptable?

If an individual does not have sufficient funds in his/her HSA for a needed treatment, what happens then?
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Old Feb 9, 2013, 08:32 AM   #23
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A family making only $40,000 a year hardly can afford to save 5% of their income for healthcare. And even if they could $2,000 for a family could get wiped out in a single illness or emergency room visit.
I disagree with the first statement. Healthcare should be a top priority for all families. Putting money aside for that should rank right up there with putting money aside for the mortgage, food, water, and keeping the lights on.

As far as how far your money would go under the scenario mentioned, I'm not sure we're both on the same page as to what the doctor was getting at. Currently to have a HSA you also have to carry a high deductible insurance plan, so that you're limited each year in what your OOP expenses will be. My impression of what the doctor was proposing is that you make everyone eligible for the tax free savings account without requiring the high deductible plan. So if you had your health savings account to go along with your co-pay plan, be it a PPO or HMO, you could pay all of your co-pays and other expenses out of your health savings account. So the family putting back $2k a year would be out of pocket for $100 on a trip to the ER (going by my co-pay in this example, so obviously this number will vary a bit) plus whatever co-pays come up for any follow up prescriptions.
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Old Feb 9, 2013, 08:37 AM   #24
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There's no reason to reinvent the wheel, other first world countries have already figured this one out.
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Old Feb 9, 2013, 09:10 AM   #25
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I disagree with the first statement. Healthcare should be a top priority for all families. Putting money aside for that should rank right up there with putting money aside for the mortgage, food, water, and keeping the lights on.

Of course healthcare should be a top priority but when you're making $40,000 to support a family, your priorities are paying rent and probably worrying how you're going to feed your family until your next check. Healthcare is a luxury at that income level and that is ****ed up.

Under Obamacare, they'll have subsidized insurance and could get proper preventative care and not use the emergency room as their doctor's office. That will save us big money.
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