One insanely important feature of the various Republican-based health care reform packages is Health Savings Accounts. Why?
The idea behind HSAs is sort of like 401(k)s. You get a tax free account in which employers/and or employees can put money, only in the case of HSA, you don’t necessarily save it for retirement, but to pay for medical expenses. The less you spend, the more you can (eventually) keep, and that gives you incentive to shop around and be miserly with health care costs.
Of course, that requires you to have an employer who will contribute or enough income that you not only can pay your bills and save extra money in a conventional savings account for a rainy day but also money for an account you hope never to need or use. In fact, some studies suggest people will neglect necessary health care because they don’t want to deplete the funds.
If you are someone who doesn’t have any money to put in a conventional savings account – such as a person with a substance use disorder or mental health illness, maybe both (dual diagnosis or co-occurring disorder) – how much good do you think having the right to a health savings account (HSA) would do for you?
The obvious answer seems to be very little. Wendell Potter, a former Cigna insurance agent who is a healthcare analyst, said “HSAs are great tax shelters for the well to do, but most Americans simply don’t have the extra cash to put into such an account.”
So why don’t Republican politicians seem to realize that? HSAs are the backbone of their health care reform plans, like investing in the stock market is their answer for the poor to get out of poverty or the middle class to become rich.
Yes, if you have the money, a HSA is probably a good idea, but it’s not a panacea. The people who are mostly likely to benefit are those who are both rich and healthy, which is not the usual situation for those requiring mental health illness or substance use disorder treatment.
Even so, savings accounts are by their nature small unless they’ve built up for a number of years untouched. The need for health insurance coverage is unpredictable and sometimes overwhelmingly large. No one sets out to get cancer or become addicted to prescription opioids or other drugs.
We need fewer health care schemes and better health care results.
