21 April 2008

rigged for silent run

http://online.wsj.com/article/SB120856003868627785.html?mod=djemEditorialPage

Since I have one of these things, I was much disturbed to see it being assailed, even indirectly. I am not by any means one of the 'evil rich', at least not right now. In fact I'm basically one of those people who wouldn't have health insurance at all but for this nifty new idea. There are two things I like about HSAs. They are run by the individual, and they're a savings device. They're awesome for young healthy people and entrepreneurs (the future of America). They're not as great for families and sick old people. That doesn't mean there shouldn't be a place in the market for them.

Fortunately the Senate will probably kill this one, maybe. That old 60-40 filibuster comes in handy when people are stupid. What does this bill actually accomplish? Nothing. The IRS already audits transactions from HSA accounts. They could very easily buy the company's software that is pushing for this bill if it was truly necessary and efficient or helpful.

I'd have to wonder, based on all this rhetoric that government (at least THIS government) is terrible at doing things why we're supposed to accept government operating and running a complex operation like health care, even just the provision of insurance. I can accept that 'health care' is considered a 'right', because I certainly would like to be treated if I break my leg sometime. But most of 'health care' is actually voluntary treatments for minute or at least non-life threatening issues. Some of this is preventive care and I certainly applaud it. Some of it is unnecessary because the spending for health care not only isn't made by the actual consumer, but lacks any transparency. We don't know how much it really costs (and thus can't 'shop' around), and we don't pay the bill anyway so we don't care. This is a recipe for disaster. So to resolve this, somehow or other government is going to determine what sort of care is mandatory and necessary (like the article mentioning chiropractors, etc) and then pay the bill. I don't see how this proposed solution resolves the actual problem.

The reason and problem is the rising cost of health care which is driven by the improper marketing of health care, the insane obsession with marginal health gains by American consumers, and the generally decreasing healthy lifestyles of those consumers. Those lifestyles can be readily adjusted because there are medications or procedures that help, which is fine, but it's rather lazy to use the fall-back position as the first line of health defense for an individual. We can't keep marketing drugs that nobody knows what they're for. And people really need to consider what they're paying for (whether or not it is them or their employer, or their taxes, doing the paying) and whether that payment is granting gain in health and lifestyle of appropriate value. It may not be, but we don't know. Having our taxes pay for health care doesn't make it free, doesn't reduce cost, and doesn't make it clear how we're consuming health care in this country. I don't see how it could possibly help right now. So if Congress could quit screwing with something that is actually helping, thanks.

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