Philadelphia Reflections

The musings of a physician who has served the community for over six decades

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Health (and Retirement) Savings Accounts: Steps To Lifelong Health Insurance
If you are a fast reader, we will begin with a ten-minute summary of Health Savings Accounts. At first, it covers future revenue, then spending projections follow. No matter how medical care changes, cost and revenue must remain in balance.

Unfinished Business

Two things remain to be addressed: the cost of the catastrophic insurance, and the sort of agency which should sell the HSA service. Because both of these issues contain a strong political flavor, and because of the uncertain cost of the Affordable Care Act without subpoena power which the incoming administration will possess if it needs it, it is not possible to integrate these two features just yet. The power to delay action, inherent in the federalized system of governance, makes it difficult even to predict when these obstacles will be cleared away. Presumably, the Scalia vacancy on the Supreme Court will clarify much of this, but a time table is difficult to predict. Nevertheless, it is possible to outline the shape of what is needed.

Catastrophic healthcare insurance is "term" insurance, both in the sense its premium can be changed yearly, and in the sense that individual policies can negotiate their premiums to the degree, the agent is allowed to discount part of his sales commission in order to lower the premium. Thus to be fair, it must be admitted a general premium is difficult to state for a lifetime. The closest I have been able to find for a national insurance company is an offer of a $2000 yearly deductible, for $55 a month premium. But is it automatically renewable? The agent didn't know. What is covered? The agent didn't know.

Originally published: Tuesday, January 03, 2017; most-recently modified: Monday, June 03, 2019