Wednesday, April 20, 2005

Republican Health Care Proposals Worsen the Problem

Health Savings Accounts have become the major Republican proposal for changing health care as they attempt to eliminate the system of employer-paid health coverage while being unwilling to consider increased governmental involvement as occurs in most of the developed world. Their real goal is to relieve supporters in business of their current health care expenses.

John Kerry was actually sympathetic to the problems faced by businesses, and aware of how this reduces American competitiveness. While Kerry's health care plan sought to reduce the burdens faced by businesses while expanding health care coverage, Republican proposals are directed purely at saving money for businessmen.

Previously Republicans attempted to reduce health care costs for business by encouraging movement towards HMO's, which were changed from a method of providing health care to a scheme to allow businesses to pay less on health care. As this HMO model has been found to be both economical inefficient and to be a poor method of delivering quality care (especially in the Medicare population, where Republicans continue to push for HMO's), Republicans were forced to go back to the drawing board and develop the HSA idea.

The Commonwealth Fund has published a review of the Republican proposal for Health Savings Accounts, finding that they provide little benefit for the uninsured, who will not receive sufficient tax benefits to make health care affordable, and are likely to exacerbate current problems as they "undermine the entire structure of job-based coverage among small firms."

We looked at earlier studies of problems with HSA's in January, showing the likelihood that this will lead to people avoiding payment for routine and preventative care out of reluctance towards paying out of their own funds. This results in long term increases in health care expenses. It is far less expensive to treat diabetes, hypertension, and hyperlipidemia early than to pay for bypass surgery, dialysis, and long term care following strokes. Similarly it is preferable, and less expensive, to screen for cancer than to pay for expensive treatments.


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