tag:blogger.com,1999:blog-5090403.post1681775832424033782..comments2023-09-07T04:24:11.648-06:00Comments on y-intercept blog: Saving for Health Carey-intercepthttp://www.blogger.com/profile/03389285761013186443noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-5090403.post-23740858712711609652009-11-10T09:39:41.172-07:002009-11-10T09:39:41.172-07:00The way the system works is that people pay a prem...The way the system works is that people pay a premium to have access to a guaranteed loan. The purpose of the loan is to simply assure that people have the medical resources they need in case of unexpected expenses.<br /><br />For example, the typical pregnancy might cost $3k. A premature birth might cost $50k. You can't expect a couple to have $50 in the bank before having a kid.<br /><br />The trick of the MS&L is that people pay the premium for the loan upfront. You pay to have access to a guaranteed loan. If your medical expenses exceed the amount in the HSA; you still have the money to get the needed care.<br /><br />The other trick of the MSL is that the loans anticipate a high default rate. This allows default of the loan outside of the bankruptcy courts, eliminating all the whining about medical expenses leading to bankruptcy.<br /><br />BTW, the contract allows default on the loan to occur outside the bankruptcy court ... in the case a person declares bankruptcy, the loan would be drawn into the court.<br /><br />The goal of the loan is to assure that people have the buying power to handle a medical crisis and to pay for any preventative medicine recommended by doctors. I do not know how well the system will be able to stand against the followers of Cloward and Piveen who advocated overloading a system to lead to social change.y-intercepthttps://www.blogger.com/profile/03389285761013186443noreply@blogger.comtag:blogger.com,1999:blog-5090403.post-64681994309501210832009-11-10T01:43:18.661-07:002009-11-10T01:43:18.661-07:00(part 2)
The MS&L would have control over thin...(part 2)<br />The MS&L would have control over things. I favor not having other people<br />judge behavior. The HSA method makes people responsible for their own<br />behavior and suffer the consequences of their own behavior.<br /><br />As for the amount that would go in, I'm guessing you're right about this<br />-- it might fluctuate. However, one might go by this rule of thumb:<br />$4600/yr is what Google tells me the average American is paying for HC.<br />Google also tells me that the average American salary is $40,000 -- so<br />11% or so of the gross pay is paid in HC. That doesn't account for<br />people who aren't working and for dependents. The HSA scheme eliminates<br />middle men in the patient doctor relationship. You walk in and pay the<br />doctor before you see him. That is almost guaranteed to lower HC costs.<br />I looked at a web site in Chicago where they made available many of the<br />prices for procedures in hospitals. There was a more than 2 to 1<br />variance between hospitals and more than one hospital gives a 50%<br />reduction in fees if you pay when you go in. Also, when it's your HSA<br />money you'll ask a lot more questions about costs.<br /><br />You say a person who consumes a lot of Health crae should pay more. I'm<br />not sure I agree. More total money, yes, but a heavier burden paying<br />back, I'm not so sure. Eventually, the HSA will go back into the black,<br />except at end of life. Then either he cannot afford an aortic stent or<br />he can. With a loan mechanism, why would a lender lend money he is<br />unlikely to get back? Also what prevents a lender from just not lending<br />the money at all?<br /><br />I'm not enthusiastic about inserting different agencies (different than<br />the current insurance companies) in the doctor patient relationship.<br />That's why I think individually owned HSA's make sense because people<br />are then directly responsible for their own decisions.<br /><br />When I hear "loan" "loan officers" and panels who will judge whether or<br />not I can get a loan and then when I don't I go to another company --<br />all the while, wasting away awaiting my medical procedure.<br /><br />Interesting discussion.egbhttps://www.blogger.com/profile/05789076407102220586noreply@blogger.comtag:blogger.com,1999:blog-5090403.post-580231490710093582009-11-10T01:42:31.303-07:002009-11-10T01:42:31.303-07:00(part 1)
Instead of a lone, I'm thinking the p...(part 1)<br />Instead of a lone, I'm thinking the person just uses his Medical debit<br />card. All people have them just like social security numbers. The whole<br />bit about applying for a loan and having the care giver wait for money<br />seems unnecessary with a Medical Debit Card.<br /><br />Your system isn't much different than an HSA. How to compel someone to<br />pay into without transgressing constitutional liberties is the problem.<br />I would guess the best way is to model it after the original SS law, as<br />a tax. Originally SS was a funded plan -- your money was kept separate.<br />4 years after SS was invented (1939) FDR and congress changed it to pay<br />as you go so they could give more benefits to the very first people who<br />would collect. That was politics for "buying votes" with no fiduciary<br />morality. With an HSA that goes into the red, the person keeps on paying<br />in and it eventually goes back in the black. This scheme conveniently<br />covers unemployment too, because while he can't pay in, he can still use<br />the medical debit card. The HSA could also be used to continue payments<br />on catastrophic insurance premiums which are still run by private<br />enterprises. All money paid into an HSA that is in the red does two<br />things. The dollars go to the government paying them back (at zero<br />interest) and the amount of dollars is added to the red balance making<br />it less red. Eventually, both the government will be paid back and the<br />account will be in the black.<br /><br />The Social Security discussion, of course, is only valid if you accept<br />the concept of the government forcing universal health care.<br />Reluctantly, I do, because if I don't, we will soon have a completely<br />government run health care system. If the Gov does only two things, we<br />can get universal coverage and have almost no gov control. 1) pay the<br />overdrafts of the HSA; 2) tax gross income at 8% and put the money in an<br />account that cannot be take from the individual. #2 is the hard part<br />because next year the congress can just change the law. Something more<br />than what the original SS law did is necessary. It must be the private<br />property of the individual. If that is written into the law, then the<br />only constitutional way it can be taken away is if the government<br />"condemns" it and takes it under eminent domain.<br /><br />About premium payments amounts: Does one take out a loan to have a baby?<br />This is one aspect of today's payment system that seems absurd to me.<br />Insurance for planned medical care is just income redistribution. I<br />don't quite understand the loan scheme you propose. For a person<br />starting out in life in my scheme, he simply pays into his HSA and uses<br />his debit card as needed. How does a young person start out in life with<br />your scheme and won't his credit rating effect his ability to receive<br />health care?<br /><br />As for someone who has a large amount (say $300K) in his HSA, I would<br />suggest he can give some or all of his $300K to someone else's HSA. He<br />can also will it to his wife or kids. Eventually, the 8% I suggest will<br />drop somewhat because individuals will redistribute their own "health<br />care" wealth without any assistance from the government.egbhttps://www.blogger.com/profile/05789076407102220586noreply@blogger.com