Wednesday, April 05, 2006

Options in Health Care: An Expensive Horizon

Two news stories today take on the issue of paying for health care.

President Bush talked about Health Savings Accounts (HSA) today in Bridgeport, Connecticut, so you can expect to keep hearing more about this option:

"I urge the Congress to look at ways to strengthen health savings accounts," Bush said in a state with 400,000 residents who have no health insurance. "I'm looking forward to continuing to have a consumer-driven system to be the heart of American health care," he said.

HSA are useful by allowing pre-tax dollars to meet your deductible before your insurance coverage kicks in. Even cough drops and over-the-counter pain medications may qualify for reimbursement. However, I take some exception with the idea that a "consumer-driven system" of health care will somehow solve the problems of insuring more Americans and keeping costs down. Health care is not equivalent to buying a winter coat, shopping around until you find the best fit and cost.

Last week we were in urgent care three times for Bo's serious ankle infection. On the first visit, the doctor wanted an x-ray to determine whether there was a fracture. I confess: I didn't ask how much the x-ray would cost, if there was a discount coupon, or whether the emergency room across town might have a lower price. By price comparison, would we have driven around town on a Sunday looking for low-cost x-rays? I don't think so. Consumer-driven health care might work for more elective or optional treatment, not for the reasons that drive you to Urgent Care on weekends or evenings.

Contrast with today's story about the State of Massachusetts: Lawmakers have approved a sweeping health care reform package that dramatically expands coverage for the state's uninsured, a bill that backers hope will become a model for the rest of the nation. The plan would use a combination of financial incentives and penalties to expand access to health care over the next three years and extend coverage to the state's estimated 500,000 uninsured.

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