Individual Choice And Better Health Care
John Stossel continues to counter the propaganda of the people who are trying to bring socialized medicine to the United States. Today, he highlights an approach taken by the Whole Foods supermarket chain - a company generally considered to be very well run, as witnessed by its performance over the past few years. (This is completely aside from Whole Foods CEO John Mackey's recent problem with sockpuppets.)
We'd each be better off if we paid all but the biggest medical bills out of pocket and saved insurance for catastrophic events. Truly needy people would rely on charity, not government, because once government gets involved, unintended bad consequences abound.
If people paid their own bills, they would likely buy high-deductible insurance (roughly $1,000 for individuals, $2,100 for families) because on average, the premium is $1,300 cheaper. But people are so conditioned to expect others to pay their medical bills that they hate high deductibles: They feel ripped off if they must pay a thousand dollars before the insurance company starts paying.
But high deductibles may be the key to lowering costs and putting you in charge of your health care.
Five years ago, the Whole Foods grocery chain switched to a high-deductible plan. If an employee has a sore throat or a sprained ankle, he pays. But if he gets cancer or heart disease, his insurance covers it.
Whole Foods puts around $1,500 a year into an account for each employee. It's not charity but part of the employee's compensation. It's money Whole Foods would have otherwise spent on more-expensive insurance. Here's the good part for employees: If they don't spend the money on medical care this year, they keep it, and the company adds more next year.
It's called a health savings account, or HSA.
CEO John Mackey told me that when he went to the new system, "Our costs went way down."
Yet today, some workers have $8,000 in their accounts.
"That's their money," Mackey said. "It builds up over time because the money is compounding for them."
The money in the HSA belongs to the employee, not the company. Depending on how those accounts are set up, they can pay for a wide range of uninsured expenses. There are people in this country who are pushing for "free" health care. The examples of what free care is worth abound in Canada and Mexico and Cuba. A high deductible private plan gives the individual control, not the government.
Have you ever seen a well run government program? Why in the world would you want them controlling your health care? Stossel (and Mackey) both dismiss the notion that people will make bad choices if they have to make their own decisions. That is a particularly arrogant and elitist view of others. Saying that a bureaucrat will make better decision - for your own good - is simply a way of allowing government to take away your choices and assume control of your life. It is the subjugation of the individual to the will of the state.
That is never a good idea.
By lynndh, Wednesday, 3 October , 2007 @ 9:27 am
$1,500 a high deductible?? I wish! Try $6000 per person. That is what my wife and I have. We are 61 and retired, getting insurance through my wifes retirement. I take the high deductible because the premimums are much lower, only $370 a month verses $800. And those are subsized by the retirement organization. But I DO NOT WANT GOV’T INSURANCE - NO HILLARYCARE!!
By FedUp, Wednesday, 3 October , 2007 @ 10:00 am
It’s always easy to tell everyone else what to do, but until those doing the telling actually live what they preach, they should just SHUT UP! This is nothing more than an election ploy and the next step to a one world government - NO THANK YOU!
By Kathy, Wednesday, 3 October , 2007 @ 7:04 pm
The money in the HSA belongs to the employee, not the company. Depending on how those accounts are set up, they can pay for a wide range of uninsured expenses.
Question: How would this work for Americans who are unemployed, or who work at jobs that don’t provide each employee with $1,500 in a health savings account? For example, how would this work for a single mother working as a waitress in a coffee shop, or for a man or a woman who cleans office buildings at night, or for someone who cannot find full-time work and so has to work part-time?
What if cancer or heart disease are covered by the employee’s insurance but diagnostic tests are not? Some diagnostic tests, like routine mammograms, are relatively inexpensive, but others, like an MRI or a CT scan cost hundreds or even thousands of dollars. An MRI, for example, costs anywhere from $400 to over $2,000; the typical cost is about $800. If such tests were not covered by the employer’s insurance, or if the deductible was higher than the cost of the test, how would the employee pay out of pocket for the test?
I think questions like these have to be thought through and answered before we jump at “solutions” to health care coverage issues that are offered by wealthy celebrity journalists. I doubt John Stossel has to worry about the uninsured cost of an MRI, but most other Americans would have to, including everyone that I know.
By Gaius, Wednesday, 3 October , 2007 @ 7:25 pm
Those issues could be worked out - without socializing medicine. A sliding-scale tax credit for the purchase of health insurance is one idea. All doable without the government taking over the system.
Class warfare is a nasty, self-demeaning debating tactic, incidentally. Just because Stossel has money does not mean he is stupid, hateful or wrong. Bill Gates (Disclaimer: I hate Microsoft products) is giving away more than $30 billion, plus another $30 billion from Warren Buffet to health and education issues. But he’s rich, so that means he’s scum and not to be listened to? Is that your point?
By Kathy, Wednesday, 3 October , 2007 @ 8:45 pm
I just typed the code wrong and lost everything I had typed in response to you.
I’ll try again.
I am not saying that John Stossel is stupid, hateful, or wrong because he is rich. I am saying he is stupid, hateful, and wrong (actually, I didn’t say that, but he is) because he arrogantly advocates a health care policy that would be no problem for him, being financially secure, but would be a huge problem for the vast majority of Americans who are not financially secure, or anywhere close to it.
“We’d each be better off if we paid all but the biggest medical bills out of pocket and saved insurance for catastrophic events.” — which is what John Stossel said in that passage you quoted — is arrogant and insensitive beyond belief. I mean, that statement just boggles my mind. I can’t wrap my brain around it; that’s how clueless it is. Obviously, to Stossel, paying all medical expenses out of pocket except for “catastrophic events” that cost thousands and thousands or tens of thousands of dollars is something he does not have to think twice about. And he assumes that *everyone* would be able to do this. I mean, it’s clearly a given to him. No other possibility enters his mind. Calling him on this is not “class warfare,” it’s common sense.
On the other hand, when Bill Gates and Warren Buffet spend millions or billions of their own dollars on projects that reduce or alleviate human suffering, or address the needs of less economically fortunate people, they are recognizing that most people are not as blessed with financial resources as they are. Instead of viewing everyone through the lens of their own economic condition, Gates and Buffett are seeing through the eyes of people who are living in circumstances they (Gates and Buffett) cannot even imagine having to live in. So why would I “hate” them for using a portion of their money in such a positive way?
By Gaius, Wednesday, 3 October , 2007 @ 9:04 pm
Go read this:
http://www.cato-unbound.org/2007/01/08/arnold-kling/insulation-vs-insurance/
Which came from here:
http://www.qando.net/details.aspx?Entry=7001
Maybe that can give you some perspective. Miracles can happen.
By quilly mammoth, Thursday, 4 October , 2007 @ 8:35 am
Kathy,
I suppose we’d just have to stumble along as we do here in America (and in fact in Germany as well forex) and rely on charity to to provide for those poor folk you so emotionally evoke.
Just like we do today. In fact, Germany gives grants to the Lutheran and Catholic medical organizations because they deliver the care to those that the government would have to support _anyway_. Very practical those Germans.
Unless you can provide proof that there is a single payer system that delivers quality care regardless of ability to pay I think that old saying about rubber and glue and what you claim about Stossel is apropo. Because what you want to do is have the government more firmly plant a boot on my neck and steal from me.
By Kathy, Thursday, 4 October , 2007 @ 12:07 pm
Gaius,
I read the QandO post before I read yours, and it and the Cato post are the same exact ideas that you wrote about here. There’s nothing different or new in either of them from what you have already written. So why would giving me the same arguments change anything?
Quilly Mammoth,
In Germany, everyone is covered by health insurance. People who can afford to do so are required to pay into private or state-regulated plans; the government picks up the contribution costs for those who are unemployed or low income. There are over 400 different plans, private and state-regulated, and people can choose to be privately insured, or pay into a state-regulated plan. If they choose a state-regulated plan, the government regulates the pay-into cost.
Furthermore, all Germans continue to be fully covered by their health insurance plan after they retire, and until they die, but they no longer have to pay into the plans — the government takes over the contribution fees.
No one in Germany is left uninsured or financially unable to pay medical expenses.
Does that sound like the U.S. system to you, or like the “Health Savings Accounts” you propose?
As for charity care, you have to be destitute or close to destitute to qualify for those programs, and they are provided by hospitals, not individual providers. Most large hospitals have such programs, but not necessarily all, and they are not required to. So charity care is completely irrelevant and unhelpful to Americans who are not destitute but do not make or have enough money to pay for necessary medical expenses and also pay the rent, buy food, keep children clothed, etc.