America’s health-care system, already on life support after a
decade of Republican neglect, faces cardiac arrest if a new prescription by
the president is administered to America’s middle class.
President Bush and Republicans say they have found the cure to America’s
health-care crisis, and it’s called a Health Savings Account, or HSA.
A fundamental premise of this social re-engineering is that Americans would
shop for health-care bargains, as if they were shopping for pans.
In many newspapers, Wednesday is grocery coupon day. Under the president’s
plan, Thursday might become medical coupon day.
HSA follows the same tortured logic as the president’s proposals
to privatize Social Security, Medicare and pension programs. Simply, HSA is
another attempt to cut the social safety net underneath the American middle
class and use it as gift wrap for another tax holiday for the wealthy. HSA really
should be called GIA — Go It Alone.
Republicans say their plan will allow people to set money aside tax-free to use
for their health-care expenses, if they purchase high-deductible insurance policies.
It sounds too good to be true — and it is.
Here’s what they don’t say. Of the 46 million Americans without any
health insurance, many don’t earn enough to derive much benefit from a tax-free
plan. As for America’s middle class, HSAs are a false promise. Who but the
wealthiest could afford to save enough money to pay the expenses resulting from
a serious medical illness or injury before a high-deductible policy even kicked
Would saving fifty bucks a month protect you financially from the cost of your
deductible for a heart transplant, hip replacement or even a broken arm?
Do you forgo car insurance and set aside a hundred bucks a month in case you’re
in an accident? The idea is so far-fetched that it’s illegal throughout
the United States.
A bedrock principle of this nation is to pool our resources and share the risk,
because it benefits us all. That’s why we collectively support police and
fire departments, national defense and a host of other essential services. The
alternative would turn back the clock to the early 20th century, when people were
wiped out by one moment of misfortune.
Is HSA any different? No. HSAs would accelerate a trend that has seen the percentage
of employers offering health insurance drop 15 percent during the Bush administration.
An HSA would be an incentive for employers to transfer more of the burden to the
individual. The outcome is inevitable, even for forward-thinking, employee-focused,
responsible corporate citizens. How long can they last when the competition abandons
providing health insurance?
More than 160 million Americans rely on their employer for health insurance today.
How many workers will have employer-sponsored health insurance five years from
now if the president gets his way?
The answer can be seen by looking at what Republican policies have done for defined
benefit pensions. By the millions, workers are being forced to go it alone —
promises broken, contracts broken, lives broken — as more companies cancel
or deny pension programs. That’s the model for the HSA.
In the end, HSAs are about reward, not health care. They are a great tax shelter
for the rich and will produce higher profits for the health-care industry. For
the rest of us, HSAs are lost revenue for the government and missed opportunity
for the nation.
America’s health-care crisis isn’t going to be solved until we create
a national program, covering everyone, and sharing the risks as one nation.
Everyone knows what can happen