Yakoob on 20/3/2012 at 18:40
So I fall into the unfortunate self-employed/part time category of "no reasonable healthcare for you" so I've been looking at private insurance and my options. I've just read about the Health Savings Account and when I first heard it, I thought "holy crap awesome" but as I keep reading all the 'buts' I'm slowly starting to wonder who the intended audience of it is: those who can't afford health insurance wont benefit, and those who can probably dont need it. In the end, it's just a carrot-on-the-stick that only really benefits the insurance company.
See the idea is you make a savings account specifically for medical expenses and what you put into it is tax deductible. Free healthcare, right? Well, no.
1) The money is tax DEDUCTIBLE, not a tax CREDIT. So the amount you actually "save" is only equal to year's tax % of how much you spend.
2) There is a limit of 3,000 dollars a year you can deposit. With a tax bracket of ~10% this means you only save up to $300 a year, (at the "cost" of setting $3000 aside for potential medical expenses)
This would actually be a really smart scheme to incentivise people to save for their own health instead of passing it on as cost to society, if it wasn't for this one last gem:
3) You are required to have a High-Deductible medical insurance to set up this account.
So basically, I am required to purchase a $100-200/dollars a month plan that has twice the normal deductible in order to save UP TO $300 a month while making $3000 of my income unusable for anything else. Wtf? How is that an incentive at all??? If I could afford 200/month insurance + $3000/year, I wouldn't need a goddamn specialized health savings account.
Whats worse, a lot of insurance companies will provide a copay-only, no deductible plans for regular visits to the doctor, but if you choose to use the HSA, they will actually revert back to using deductible for basic doctor visit. So you pay 100 bucks to see a doctor, "save" $10 off of it thanks to HSA, effectively paying $90/visit with your 100/year insurance plan. Yea I'd rather go for a non-HSA plan that has no deductible, $45 copay on a simple doctor visit, and overall smaller deductible as well.
Now I can see this making more sense for people who have pre-exisitng conditiong and spend thousands of dollars on medical expenses each year, except...
1) If you have a preexisitng condition you probably wont qualify for insurance, so you cant get HSA
2) If you are spending thousands of dollars on medical expenses a year, the $300 dollar saving will be LESS than what you end up actually paying, as doctor visits are now subject to deductible AND the deductible is much higher than non-HSA plans. So you end up spending more in the end.
Correct me if I am wrong, but the whole thing just looks like a really nice-on-paper scheme that effectively only encourages people to enroll in more expensive insurance plans. So people get screwed, while insurance companies increase their already gigantic profit margin. GG Health Industry...
Schwaa2 on 20/3/2012 at 18:53
Quote Posted by Yakoob
So I fall into the unfortunate self-employed/part time category of "no reasonable healthcare for you" so I've been looking at private insurance and my options. I've just read about the Health Savings Account and when I first heard it, I thought "holy crap awesome" but as I keep reading all the 'buts' I'm slowly starting to wonder who the intended audience of it is: those who can't afford health insurance wont benefit, and those who can probably dont need it. In the end, it's just a carrot-on-the-stick that only really benefits the insurance company.
See the idea is you make a savings account specifically for medical expenses and what you put into it is tax deductible. Free healthcare, right? Well, no.
1) The money is tax DEDUCTIBLE, not a tax CREDIT. So the amount you actually "save" is only equal to year's tax % of how much you spend.
2) There is a limit of 3,000 dollars a year you can deposit. With a tax bracket of ~10% this means you only save up to $300 a year, (at the "cost" of setting $3000 aside for potential medical expenses)
This would actually be a really smart scheme to incentivise people to save for their own health instead of passing it on as cost to society, if it wasn't for this one last gem:
3)
You are required to have a High-Deductible medical insurance to set up this account.So basically, I am required to purchase a $100-200/dollars a month plan in order to save UP TO $300 a month while making $3000 of my income unusable for anything else. Wtf? How is that an incentive at all??? If I could afford 200/month insurance + $3000/year, I wouldn't need a goddamn specialized health savings account.
Whats worse, a lot of insurance companies will provide a copay-only, no deductible plans for regular visits to the doctor, but if you choose to use the HSA, they will actually revert back to using deductible for basic doctor visit. So you pay 100 bucks to see a doctor, "save" $10 off of it thanks to HSA, effectively paying $90/visit with your 100/year insurance plan. Yea I'd rather go for a non-HSA plan that has a no deductible, $45 copay on a simple doctor visit.
Now I can see this making more sense for people who have pre-exisitng conditiong and spend thousands of dollars on medical expenses each year, except...
1) If you have a preexisitng condition you probably wont qualify for insurance, so you cant get HSA
2) If you are spending thousands of dollars on medical expenses a year, the $300 dollar saving you get from it isn't that big and it will probably get offset by the fact doctor visits are now subject to deductible, which is much higher than non-HSA plans due to federal requirements
Tell me if I am missing something here, but the whole thing just looks like a really nice-on-paper scheme that effectively encourages people to enroll in insurance plans, while STILL paying more in the end. So people get screwed, while insurance companies increase their already gigantic profit margin. GG Health Industry...
The health care insurance system in this country is the biggest scam ever perpetuated on society.
It is soley a money making endeavor. Doctors prescribe stuff you don't need, because they get paid by pharma companies to push product.
The insurance companies only want to insure people who are healthy (no payoffs) and can dump people and refuse service when someone gets sick.
But like everything else in America, it is for profit only.
the govt is bought and paid for by lobbyists. And if you are a politician and aren't bought out they make it impossible for you to do anything.
Health Care (Big Pharma) pumps more money into our govt 'representatives' than any other industry outside of big Oil.
faetal on 20/3/2012 at 21:02
The UK is following suit too. The NHS reform which just got passed is about to drive an axe into the system splitting it into a choice between increasingly beleaguered free healthcare or increasingly expensive private healthcare.
Sg3 on 21/3/2012 at 01:16
So should I move, then? Norway? Guess it's time to brush up on my conversational Norwegian.
Pyrian on 21/3/2012 at 16:21
HSA's are primarily for people who get their insurance through their employer, when it comes down to it.
faetal on 21/3/2012 at 16:33
France still has the world's best health system. Good thing I am probably moving there when I graduate.
SubJeff on 21/3/2012 at 17:05
Quote Posted by faetal
The UK is following suit too. The NHS reform which just got passed is about to drive an axe into the system splitting it into a choice between increasingly beleaguered free healthcare or increasingly expensive private healthcare.
Yeah, it's potentially terrible but we'll have to wait and see.
faetal on 21/3/2012 at 17:15
It was penned largely by private health consultants.
An internal press release by the General Healthcare Group said:
"We are entering a new, exciting era, driven by the forthcoming healthcare reform that will ultimately change, to our benefit, the landscape in which we operate."
Lansley himself said that 2020 Health, a largely private consortium had a large part in drafting the bill, plus the bill was given its first airing at a 2020 Health conference. Everyone with 2 brain cells to rub together who has read the bill (myself included) agrees that it can only lead to a two tier system and increased privatisation. Waiting and seeing is all well and good, but I think the only realistic outcome is going to be an increasingly monetised system which puts share value before patient health.
Vis the US.
HSAconsumer on 22/3/2012 at 23:40
An HSA is a better plan if you're focused on your out of pocket maximum. If so, an HSA cannot be beat. The reason is because you have a defined out of pocket maximum. With your typical PPO Copay plan, you'll have a deductible, coinsurance 80/20, plus doctor copays, Rx deductible and Rx copays. COPAYS are forever. Imagine a broken back, surgery, pain meds and 3 X a week physical therapy for 6 months. Copays will rack up over $400/mo or more, they rarely go towards the deductible. With the HSA plan, you pay your deductible, everything else is covered 100%.
The system is broken because people got addicted to copays for doctors. I can't name one other professional I can hire for $30, but for some reason, everyone expects it. Everyone also expects to have "insurance" pay for all the small things, but that's not the definition of insurance (to remove biggest risks for smallest cost). I would hate to think what my car insurance would be if I expected $5 oil changes, tire rotations, and door ding fixing.
demagogue on 23/3/2012 at 02:56
Ho.ly.sh.it. at this rate they're going to gain sentience by the end of the decade.
