HSAs or Taxes to pay for Healthcare?

[The Whiskey Priest]

Bush wants us to put $1000 to $2,700 per year into a HAS…plus pay for a high deductible health plan. Why not put all of that money, really it would be less, into taxes and pay for a universal health care plan? Either way we pay.

[SlipperySlope]

1. The difference is

The difference is that at the end of the year, if you weren't sick, all the money you put into your HSA is still yours.

On the other hand, at the end of the year, if you weren't sick, I don't think you are going to get your taxes back.

[Yollam]

3. Exactly why the single-payer universal plan is better.

Of course it should not be a flat amount, it should be about $50K per year on wealthy folks income taxes, nothing for the really poor. Point is to make good, affordable health care available to everyone LIKE EVERY OTHER CIVILIZED DEMOCRACY HAS. Anything else is NOT democratic or liberal.


We spend about 8 times as much per capita on health care than any of the other industrialized democracies (pretend for a moment that we live in a democracy) and yet we only cover about 60% of the population, most of whom get inferior care through HMO's which use redundant bureaucracy and paperwork as an excuse to gouge consumers like in no other nation.


Medicare has only about 10% of the overhead that private insurers have...

[SlipperySlope]

4. That is just outright wealth transfer!

You want the rich to pay for the poor? Who are you, Robin Hood?

What's wrong with a flat rate? Why does it have to be a wealth redistribution scheme as well?

To me, the real devil is in this question: Would you be allowed to seek additional care if you choose to pay for it?

[Yollam]

5. Of course it is. That's what the democratic party is SUPPOSED to be about

Let me guess, you signed on post-Clinton.

I've lived under universal plans abroad. I can tell you from experience that they are WAY cheaper, with better care, and YES, if you need something unnecessary like a nose job, you are free to pay for it yourself.

[SlipperySlope]

6. I don't think so...

I don't support a party that uses a progressive or targeted tax to redistribute wealth.

I support a party that uses a flat tax to provide equal opportunity and protection to everyone.

Extending that to health care: universal payer does not require a progressive rate.

And my question isn't really answered. Can you choose to pay for BETTER care, not voluntary procedures.

Ah foo, it ain't gonna happen anyway.

[Yollam]

7. Then your values are more in line with the GOP.

Haven't you ever heard of the New Deal, Progressive taxation and labor protections? All DEMOCRAT ideas that created America's middle class and made us the most prosperous country on earth, even though the top income tax rate was 90% in 1960.


This is not negotiable with me. I would NEVER, EVER vote for a democrat that was for a flat tax or any other regressive taxation. EVER.

[SlipperySlope]

9. The GOP doesn't care about equal opportunity

The GOP doesn't care about helping anybody. I do.

I support giving a hand out and a hand up. I support protecting civil rights. I support the right for labor to organize.

I just don't support progressive taxation to do it. Scrap our whole bloody tax code and slap a flat 20% on everybody. No deductions, no allowances, no exemptions, no crap.

If we're all in the same boat, we should all pay the same rate.

[Yollam]

29. We are not all in the same boat.

Income inequity is the worst it's been in at least 80 years. I believe we should address that. More progressive taxation and single-payer health care is a good start.

Your proposal would be a completely inhumane burden on the lowest third of income earners, who already work their asses off, but can barely afford crummy housing and food.

I don't mean this as an insult, but this is a fundamental point where your values match the GOP's. Why not join them and try to push them in the direction of supporting equality, etc. (although they supposedly already do)

[The Whiskey Priest]

8. A couple years back I looked at Australia’s Plan

They cover Basic and Catastrophic under a national health plan. If you want anything more you have to pay, or you have to purchase another health policy. So if you want your pre-teen daughter to have liposuction….you pay.

That would be one way for it to work, there are many more, the main thing is that we could get better care for less coverage, plus, you can moderate the cost through a prospective fee schedule...that is everyone knows up front what the cost is on a procedure or service.

Then we could start to look at outcomes....reward providers that produced the best outcomes....health care is the only service that still rewards for suboptimal workmanship.

[SlipperySlope]

11. That sounds like something I could really support

Basic and Catastrophic with Universal coverage, all the rest is pay-as-you go. Sounds good to me!

[sandnsea]

33. Oh for pete's sake

That's single payer health insurance anywhere in the world. Gads. Get a friggin' clue.

[BigYawn]

38. Yes, free healthcare, throw in a good car, why not a livable

house also? All three are basic necessities for
everyone. Why should Tiger Woods have a $40 MILLION
house when most can't afford a $100,000 shack?

[Yollam]

40. Wow, I heard Limbaugh spout similar stuff a time or two.

BTW, Single Payer healthcare is not "Free". Everybody who makes a decent living pays, on a sliding scale, and it's much cheaper for almost everyone then the present disaster of a system.


But thanks for the ignorant dittohead talking point, just the same.

[BigYawn]

43. You listen to Limpballs? Shame on you...

But really what is wrong with the minimum basics,
a house, a car, healthcare and food being available
to everyone who can't afford them?

Are'nt we the richest country? Screw the rich and make
them pay. They are a minority.

[Yollam]

44. Sounds like you're being facetious - pushing RW talking points.

I'm in favor of a living wage for anyone who works, as well as single payer health care funded through progressive taxation.

But it's not about "screwing the rich". Taxation should not be an onerous burden (and the ultra-rich have never been taxed at lower rates than today). The fact is, everybody, including the rich, benefits from a more equal distribution of wealth in society via lower crime, better morale among the work force, healthier workers, less absenteeism due to less illness due to preventive care, etc. etc.

Forgive me if I'm wrong, but you sound like a believer in the right's cynical "universal health care = Stalinism" philosophy.

[BigYawn]

47. Those who can afford, should pay more taxes...

Bill Gates has 60 BILLION dollars. That is 60,000
MILLION dollars !!! If he lives another 50 years,
he can spend 3.3 MILLION dollars every freaking day of
his remaining life and won't run out of money.

Why can't he be made to pay 6 Billion in taxes every year?
He does not need to hoard that much money for himself.

Why are you picking on healthcare as the only thing the
federal government should be involved in? A decent house,
a decent car and decent food are even more important for
every day life.

Yes, I agree with you if they make the minimum wage high
enough so that every one can live decently, I am all for
that.

[Yollam]

48. All right cool - you're just being strident.

I'm cool with that.

Easily mistaken for sarcasm, though.

[sandnsea]

32. No, the difference is

At the end of the year, you have had all your medical needs treated with universal health care. You might get money back with an HSA, but likely because the $5,000 deductible discouraged you from seeing the doctor because it was too much to be able to afford real care if you were sick anyway.

I just got a quote on an HSA for me and my husband, $300 a month, $5000 deductible, and then whatever you put in your HSA aside from that. It's complete bullshit. I can't afford it. Don't qualify for it anyway, my husband has a hernia and I need an ear surgery.

[Vinca]

2. In order to have a health savings account

you have to a) be able to afford an insurance policy and b) have money to save. Assuming the problem is that a) people cannot afford a policy and b) haven't got money to save, what the hell is the point of even proposing this steaming pile of doodoo? This is going to amount to nothing. More Republican spin, more campaign-style rallies, more lots of nothing getting done. We need universal health care and no less. We have 2 models operating already: the VA and Medicare. It shouldn't be that difficult.

[Name removed]

10. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Lydia Leftcoast]

13. YOU get real on health care

Wait till you're over fifty and self-employed. Then try to find affordable coverage that doesn't have a high deductible and doesn't go up every year even if you never use up your deductible.

The analogy to car insurance or homeowner's insurance shows that you're off in some affluent, sheltered world. Some people don't need car insurance because they can't or won't drive. Some people don't need homeowner's insurance because they don't own a home. Everyone needs health insurance, because everyone has a body that can break down or get injured, no matter how careful they are.

In my case, "responsibility" consists of postponing needed tests because they cost hundreds of dollars each and I can't afford them.

Thanks for your concern.

[Name removed]

16. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Lydia Leftcoast]

23. I HAVE a high-deductible account already, and it's

$272 a month, with 20% copays after I meet the deductible, which means that I have so far gotten no benefits from the policy.

Furthermore, HSA policies for my age range and geographical area are only $20 per month less expensive than my current policy for even a higher deductible.

HSAs are a great deal for the affluent who have lots of disposable income to shelter from taxes.

They're a rotten deal for anyone else.

Try this article on for size.

http://www.nytimes.com/2006/01/26/business/26accounts.html?_r=1&oref=slogin

They're about the feasibility of HSA's for people who are in the real world.

[Name removed]

25. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Lydia Leftcoast]

41. Affluent people rarely admit that they're affluent

especially when they're complaining about taxes or social benefits.

[Yollam]

45. "But I only make $180K/year, which doesn't go far on the Upper East Side!"

Try to explain to them that a household with a $100K income is already in the top 10% of income earners and watch their eyes glaze over...

[Lydia Leftcoast]

53. And it doesn't go far on the Upper East Side because they

have two kids in private schools and a summer house on Fire Island and eat out three nights a week. :eyes:

I've seen LTTE's in which the writers say things like,

"I pay $100,000 of income taxes per year, and I'm not rich." (Clue: That's at least $300,000 of adjusted gross income if not more, and that's with a non-clever tax accountant.)

"I pay $47,000 of income taxes a year, which is more than I make in my business." (Clue: That means the business is not his primary source of income. He's gets major dividends from investments.)

[high density]

15. So I take it you don't have health insurance?

Good luck with that HSA of yours if you have one of those annoying "disasters."

[Name removed]

18. Deleted message

Message removed by moderator. Click here to review the message board rules.

[high density]

20. So you do have health insurance?

That's what I thought.

Most people in this country can't afford to throw money at a high deductible plan plus put funds in an HSA. It's one or the other.

[Name removed]

21. Deleted message

Message removed by moderator. Click here to review the message board rules.

[high density]

27. But then we get back to the disaster risk mitigation

The idea of an HSA would be great for me too, until I factor in the "disaster" part of it all. I haven't visited a doctor in about three years, but tomorrow something horrible could happen and I would be owned by the hospital for the rest of my life if I didn't have health insurance.

Bush wants to put all the risk on us, and I don't like that.

[Name removed]

30. Deleted message

Message removed by moderator. Click here to review the message board rules.

[scorpiogirl]

22. You are assuming that people are not responsible enough.

How about those of us who have young children who often need to go to the doctor? So if I don't have the cash to do this and it's not considered an "emergency," then either my children won't get care, or I spend $150 each appointment. Doctors should be in the business of helping people just like social workers, etc. If they want to rake it in, then they should be in an elective surgery specialty.

[Name removed]

28. Deleted message

Message removed by moderator. Click here to review the message board rules.

[scorpiogirl]

35. We do pay in the hundreds. My husband's company contributes

$500/mo. My point is I think if a doctor is dedicating his/her life to helping people, how much money they're making shouldn't be based on what money they put into their career choice. Does someone who gets an MBA have some right to make a certain amount of money in their career just because they put a lot into their education? I'm not saying that doctors should be making what social workers make, but where's the line going to be drawn? I don't believe I would benefit from a high deductible plan. My husband has three medications he must take daily. One of them costs almost $300/mo, with insurance it is $30/mo. I have an HMO and am grateful for it. I'm going to stay right where I am with my insurance for as long as possible.

[sandnsea]

34. Disasters are MORE expensive

That's what is driving the cost of health care UP, people who can't see the doctor until disaster strikes. HSA's are the exact OPPOSITE of what we need for everyone to have health care AND bring the costs down. Do you have $500,000 to go into an HSA to pay for a heart transplant if you need one? Or several thousand a month to pay for prescription drugs? Didn't think so.

[hopeisaplace]

12. Question: what about the jobless? what about the poor?

[high density]

14. HSAs are great for the wealthy and the banks

Plus the high deductible insurance plan helps keep the money flowing to the insurance companies. Everybody wins... well, uhh, except for those of us being "insured."

The argument Bush is going to be using here makes no sense. I guess he's going to be saying that people use too much health care because of health insurance and I don't think there's any evidence of that. I only use health care when I need it, and I'm sure 95% of Americans are the same way. If anything most of us probably don't go to the doctor enough.

[Name removed]

19. Deleted message

Message removed by moderator. Click here to review the message board rules.

[hopeisaplace]

24. which is why corporations selling and promoting health destructive

products need to be held accountable for their "marketing to the masses"..because
ultimately these corporations are costing the health care system some serious coin.

How should they be held accountable? Well there's an interesting discussion. Stop
giving them massive tax breaks - increase corporate taxes for companies that contribute
to the national health care disaster in the US..
(I live in Canada - I have health coverage - and guess what I don't abuse the system,
I parent my kids to eat healthy <---that's a job and half with all the advertising out there -
my hubby and I both exercise regularly - So there is personal responsibility involved, but
there's also national and corporate responsibility to the public good.


edit: typo

[Lydia Leftcoast]

26. I don't smoke, I eat nutritiously, and I exercise

Yet I still pay through the nose for an insurance policy that leaves me unable to get preventive and early diagnostic checkups. However, I'd have 80% of my costs paid if I needed cancer surgery or something.

Anybody with half a brain knows that it costs less to treat a condition that is detected early or to prevent it from occurring in the first place than to treat it when it's advanced.

Bush's HSAs go completely against this basic principle and penalizes preventive care.

[Name removed]

31. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Lydia Leftcoast]

37. Reading comprehension

What part of "I don't have the money" don't you understand?

Just ten years ago, I could pay $110 a month for a Kaiser-Permanente plan with no deductible and $20 copays for each office visit or test. THAT was affordable.

$253 a month+$200 to cover the deductible on an HSA account is NOT.

Read the NY Times article. People are NOT able to save the money they should be putting aside for their HSAs, not because they're spending it on cigarettes but because they're living from paycheck to paycheck.

Since I work free-lance, my income varies tremendously from month to month.

You really need to get out more.

[hopeisaplace]

17. and do you know why else this just won't work

what if a disaster occurs? OMG that can never happen - lets see
1. job loss
2. hurricane
3. prices so high can't pay mortgage - losing home

etc...

are people then going to withdraw from this "fund" to get them by? cause if they can
withdraw from it, then I can pretty much guarantee that it will be gone in another unexpected
emergency -

also, what if one or all of these terrible things happen to your family...
and you have this "health reserve built up" - would that disqualify you from any type of
assistance programs, that gawd-forbid you may be forced to "need"


edit: spelling

[BigYawn]

42. What's wrong with the rich paying for healthcare, a car,

a livable house in good neighborhood...for EVERYONE!

Everybody needs a house, a car and healthcare. It should
be written into the constitution that those who can't
afford these basics, the rich should be made to pay for
it.

[hopeisaplace]

52. the rich can lose everything too?

then they too would dip into their health care accounts as well to survive..and the education funds..
then if their kids get sick and they don't have family to pay their
health care they would simply go without health care. That's wrong too.

No thanks. I'll keep our Canadian Health Care system.
If I'm ill, I go to the doctor. Invoice $0.
I've been employed and self-employed - thank you, I'll keep our health care system.
And if were "rich" I would insist that everyone have coverage. Compassionate Liberalism.

[Bridget Burke]

54. You've said this several times....

We GET the joke!

[ATHENAofMAINE]

36. HSA's are great for young singles in good health...Vermont is a leader

HSA's are great for young, healthy singles who don't have health care expenses that come close to the cost of health insurance and want to build up a nest egg for the day when they need the wealth they've accumulated.

YOu can't force healthy people to join socialized health care....that's the lesson of DIRIGO health care, Maine's single payer experiment.

Vermonts HSA's are popular and successful since they both build wealth and enable someone to also have a high deductible insurance policy.

Forced socialism has never been popular, as Harry Truman and Hillary Clinton found out the hard way. Canada just went conservative because they couldn't see how their policies destroyed human nature.

Democrats must embrace individual freedom and learn from Canada's move into privatization and Tony Blair's policy of consumer satisfaction with privatization.

...time to move-on, that's what progress is all about; not reliving the Sixties!

[Lydia Leftcoast]

39. What fantasy planet are you on?

:shrug:

Youj said it all in your first paragraph. HSAs are great for young healthy singles. They are lousy for middle-aged people who are beginning to need more medical attention, no matter how healthy their lifestyle has been.

All that stuff about "forced socialism" is probably true for the young and healthy. Young people in Japan gripe about having to pay into their national health care system.

But they sure change their tune when they start having children and/or grow older and/or need serious medical treatment.

By the way, your "facts" about Canada and the UK sound as if they're straight from The National Review, which means that they are unlikely to be facts.

[Yollam]

46. That's why it's called INSURANCE.

The whole idea is to spread the cost among everyone to make it less of a burden. Having those with more ability to pay contribute more makes it even more progressive, as it should be.

By the way, when I lived in Japan, I never heard anyone gripe about paying into the health care system. The premiums are dirt cheap compared to here and you get EXCELLENT care. You can choose your primary physician, you can go without an appointment. Wait times are MUCH SHORTER. There is less paperwork and hurdles to see a specialist. There is LESS Bureaucracy, too.

The US has the ABSOLUTE WORST health care system in the Western world. Everyone in Japan and Europe knows it and is grateful not to have to live under it. (Except for the scummiest of the rich, for whom health care expenses are a trifling expense, but who just hate spending a dime that might go to some one else)

[Telly Savalas]

49. Canada's conservatives won 36% of the popular vote

with the remaining electorate voting for candidates to the left. Furthermore the Conservative Party's stance on health care is far more "socialist" than the Democratic Party.

Go back under your bridge.

[Yollam]

51. It slunk under it's bridge all right.

Tombstoned - good riddance.

Hillarycare was socialism? LMFAO. More like a giveaway to the health care corps. And still they killed it.

[gulliver]

50. I have one. I like it. But I won't as I get older.

The problem is that they put you in groups by age. Your insurance is portable, but that gets you nothing. They just raise the rates for your "group" year by year. Also, you have no power over the insurance company in an HSA. If they screw you, all you can do is switch companies. If you have insurance through a major corporation, the corporation can get volume discounts and have a strong voice with the insurance provider.

I would not have an HSA except I am self-employed. For me, it is better than anything else out there. It covers me for a catastrophic problem. The return on HSA money is a pittance though. It's not like you are really building wealth like you can with an IRA, 401(k) or SEP.

As usual, with the GOP, it's all about helping the insurance industry and HMO's, not the people. Someone who was unemployed could not afford my HSA, for example, so the uninsured will continue to be uninsured under HSA's. And they will have divided us and conquered us so that each of us ends up paying a lot more on average for a lot less. That is the GOP way.