Can HSAs restore the doctor patient relationship?

by Charles W. Patterson, MD

Is it possible that some do not understand that to promote Healthcare Savings Accounts is the most effective thing we could do to preserve traditional medical practice? In a true doctor-patient relationship only doctors and patients discuss the options agree to the treatments and handle the money. No third party touches any of these.

If everyone had a HSA it would be just like the good old days, only better. Everyone would write a check when they went to the doctor, and the checks would be good.

The HSA law of 2008 was a big step toward establishing a rational and effective system that treats HSAs similarly to IRAs. The new law reduced the tax deferred contribution a little, under insurance company pressure, no doubt. But it is not necessary to have a tax deferral to start your own HSA. Just put money in the bank, in the tradition of having “something for a rainy day.” This kind of rainy day account has the advantage that you can use it for any kind of bad luck; auto repair or earthquake. The most expensive bad luck is often bad health so try to hold back a little unless you also have a tax advantaged HSA.

Some despair of people learning to save again. But the Great Depression taught our grandparents, the Great Recession may teach us.

Until you have saved a lot you also need catastrophic insurance. But the more you have saved, the higher your deductable can be, and the more you save.

If everyone saved the amount the average person spends on healthcare, half the population would die with a surplus in their accounts. An inheritance tax on that could cover the costs of those with greater than average needs, and no one would need catastrophic insurance any longer. If everyone saved the amount they now spend on health insurance premiums that point would be reached much sooner.

To promote HSAs you don’t need to get involved in politics. You can ignore what the politicians and insurance companies are doing. Just talk to you patients and friends. If everyone wanted one, the politicians would provide them. Henry Ford didn’t become a politician, He just built cars. Then the politicians build roads for him.

Another nice thing, you may be swimming with the tide. The use of HSAs continues to rise since the 2008 law, and if insurance premiums continue to increase, as some predict, HSAs may soon become the only viable alternative. And you can say, “I told you so.”

If “Obamacare” will cause insurance premiums to rise, as some say it will, then to repeal it now, as some would like, might be the worst thing we could do.

Charles W. Patterson is a psychiatrist.

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