Can someone explain these "health savings accounts" that Bush is touting?

[jjmalonejr]

I hate to admit it, but I'm unaware of how they are supposed to work.

[SoCalDem]

1. It's like an IRA..It's YOUR money

You know.. it's all that money you have "left over", when your bills are paid??

That money goes into a special medical savings account, and the interest is TAX FREE..Yaaaay..yippee.. (We all know HOW much interest a couple of hundred bucks a week/month accumulates:eyes:..)..And when you get sick, you use THAT money.. Whoooo Hoooo !!!!

The rub is this.. Let's say that you only have $1k in your MSA, and uh-oh, you need a 20K operation...hmmmmm that could be a problem..:(..

and at the end of the "term"..what you have not used for medical purposes is all YOURS... Yaaaaaay...

Isn't it a grand Idea???

It always reminds me of the "tax experts" who always "remind" us in December, to be sure and give all our family members $10K, since there's no tax on that amount.. "Suuuuure!.."

[bluestateguy]

2. It should reduce the percentage of uninsured

by about .0000000001%.

[blondeatlast]

14. No, it won't reduce the numbers at all. It also won't increase

the amount of health care available to the working class one iota.

[notbush]

3. At the risk of being called a Freeper or worse...

My understanding of MSA's is that you can set aside a portion of your gross income before taxes(like a 401K) for medical expenses.
The real goal is to get average people to buy high deductible, catastrophic policies to cover cancer...heartattacks...aids...etc.
It kind of assumes a participant would either pay for their own day to day care(office visits)out of the fund but be covered for the really big bills by an insurance policy.
Problem???Not many company's offer those catastrophic policies.

[bluestateguy]

5. There is nothing inherently bad about MSA's

If people want to start one, go ahead. I won't get in the way, but the notion that that should be America's health care policy, or that it will cover the 45 million uninsured is a pure fantasy.

[blondeatlast]

15. And they are absolutely worthless for people with chronic

illnesses. Like me.

[trogdor]

20. The way they currently work is....

...you try to guess how much you'll spend in copays, non-covered items, etc, divide by the number of paychecks you get in a year (usually 24), and put that amount aside in your MSA. That money comes out of your paycheck before taxes. The catch is, you have until the end of the year to spend all of the money, or you lose whatever is left on Dec. 31st.

Needless to say, places like LensCrafters just LOVE this system, since many people have significant sums left over in December, and eyeglasses is one of the no-brainer items bought with the surplus funds. No-one at the company administering the benefits, or at the IRS is going to ask you for the old busted glasses, so there you go.

[Morning Dew]

4. It's ownership, see

and when you own something, you have ownership. That means you own it.
people who have ownership have a vital stake in our country, see?


;)

[blondeatlast]

16. That's the most compelling argument I've heard yet! nt

[notbush]

6. I think it has appeal to the middle class

It's just like your homeowners insurance or your car insurance.
It doesn't have any appeal to the unemployed.
I have raised my deductible on both my auto and home insurance over the years, thinking I could "eat" that $1000 if a tornado blew my roof off. I can pay for that fender bender on my $20,000 car, but I need help if my house is blown away or my car is "totaled".
The "pre-tax" issue is important, as your contribution to a MSA isn't felt "in your pocket" to the extent am after-tax program would be.
My wife is an HR manager for a small manufacturing plant and she tells me that pre-tax 401K's can actually bring some low paying jobs down to the 0 percent tax bracket, while the employee is actually accumulating assets for retirement. Could this work the same way??

[SoCalDem]

8. The real problem here is the "creep"

as in.. affordability..

It was not all that long ago, that a $50 deductible auto policy was a very affordable policy and was the NORM...

A regular mainstream family could afford to take their kids to the doctor and dentist with or WITHOUT insurance.. MOST people did not even HAVE medical insurance...

The same for dentists and eye doctors..

A prescription for the top-of-the-line medicine was $10-15 ...people could afford it..

All that stuff has morphed into BIG TICKET items that we must now have "insurance" , so naturally the insurance goes up as the costs go up and we are stuck in a spiral that our incomes have not kept pace with...

We were "talked into" the HMO stuff and of course the employers saw it as a cheap way to give us "raises" and of course he can deduct the "benefits" he "gives" us...but the monster got too hungry for him too, and now we are all stuck..

[blondeatlast]

17. It is useless for those with chronic illnesses, a fact that needs to

be emphasized.

How the hell am I gonna save when I'm WELL-INSURED and my treatment still costs me approx. $300 a month out of pocket???

[Old and In the Way]

7. This site goes wonkish in detail

http://www.americanprogress.org/site/c.biJRJ8OVF/b.8473/

sign up for the e-mail newsletter....it's all you need to keep up with the daily screwing.

[blondeatlast]

18. Interesting site, duly bookmarked. Thanks. nt

[Tom Kitten]

9. Kinda like explaining a bear shitting in the woods....

You see these bears have organs that make that happen. And we like bears but they have to change that. And we won't accept any more bears shitting in the woods....That is against America, the will of the American people. The will of the American people will no longer tolerate bears shitting in the woods!

Therefore I've adopted a plan...Bears shall be granted a savings account plan to allow them to build access towards shitting in approved facilities that allow them to shit with government approval...

Official bear shitting facilities will not be officially approved until enough culling of finances from willing bear donors to cover the costs of endorsing such a program are reached...

Until then it is it is to be assumed that the act of a bear shitting in the woods is a federal offense not exceedable by prison time and a fine not less than one hundred thousand dollars...

[Skidmore]

10. If they are anything like the flex medical accounts

they've been experimenting with at my job, the work like this. Part of your benefits dollar allotment left after purchasing whatever combination of insurances offered is put into an account to which you can submit a form with the accompanying documentation to claim reimbursement for out of pocket medical expenses not covered by the health insurance plan. Amounts available to you are determined by whether you are single, a couple, or have children as well. Any dollars left at the end of the year revert to the business. This process is a hassle and there's something strange about how it is counted in your total compensation. I got a rare Social Security report in the mail this week and realized that they count the benefit package as part of my taxable income, even though I may not use any or all of the funds available to me any given year. I've come to believe they are a slush fund and the government and business are making out like bandits.

I'd rather they develop a system of routine or preventive care with basic affordable fees set so you could pay out of pocket, and limit the insurance industry to cover catastrophic illnesses only.

[SoCalDem]

11. BINGO...

The government NEVER does anything that does not benefit them.. Some companies are including their cost of your HMO coverage as income too..

So they tell you you get a $10 raise per week, and oh yeh.. your share of the insurance went up $12..and they are including that "extra" money into your taxable income, even though you never see it.. Wow.. aren't you the lucky one :)

and your co-pay went from $5 to $15..

Happy Days are here again

[eridani]

12. They are intended to take money from the risk pool--

--and give it back to those who are lucky enough not to get sick, thus defeating the entire purpose of shared risk.

It would be like getting a break every year on your property taxes if your house didn't catch fire. That way people who had fires would be stuck with much more of the expense and could all file for bankruptcy like so many people with medical bills do now.

Basically a message from the majority of healthy people to the minority of sick ones--FUCK OFF AND DIE!!!

[wolfgirl]

13. This might

be a good idea if you have enough income to set aside $..as for me, I need every penny just to get through each month's worth of food, housing,gas...

[Ghetto_Boy]

19. Medical IRA... Tax exempt savings for medical fees

[Lydia Leftcoast]

21. I'm self-employed and looked into this

Basically the way the Blue Cross MSA worked was that you bought a high-deductible insurance policy--about $200 a month for a $1500 deductible at my age (If you're over 50, as I am, you pay through the nose, even if you're healthy, as I am). That's right. If you didn't have $1500 worth of illness, that $2400 a year would be a gift for Blue Cross.

In any case, if you did get sick, your out-of-pocket expenses would be $3900, counting premiums and deductibles. A little higher math showed me that it was impossible to get below $3900

The deductible was supposed to be paid out of your tax-free MSA account. However, you could not put your whole deductible into your MSA--only 85%. :wtf:

Unlike what a poster above said, the savings account WOULD accumulate tax free from year to year.

The problem for me was that I could neither come up with the savings account amount up front nor risk having periodic withdrawals from my checking account, given the irregular nature of a self-employed person's income. (I can handle my expenses just fine, but I DO need to be able to control which days I pay my bills on.)

On the whole, it seemed like a good deal for a young, healthy self-employed person in an upper income bracket, but a rotten deal for most uninsured people.

I ended up with a high-deductible regular insurance policy that costs $161 a month.