Comments on: The worst of both worlds

By: ssumner

ssumner — Sun, 27 Dec 2009 00:41:22 +0000

David, Yes, I think a $6000 deductible can be considered catastrophic. I hope you are right, as you say it depends how many benefits get mandated.

Greg, I notice you often post comments on different posts–I responded in the other post, although I am not certain I got your point.

By: Greg Ransom

Greg Ransom — Sat, 26 Dec 2009 00:11:00 +0000

So have you figured out yet that classic liberalism is neither left or right, and that this language is pathological and unhelpful?

“I can see how a right-winger like Gibson might enjoy glorifying the pure tribal culture as compared to the decadent, cosmopolitan city. But the P.C. left also romanticizes tribal cultures ..”

By: Round Up – December 24, 2009 « Restrained Radical

Round Up – December 24, 2009 « Restrained Radical — Thu, 24 Dec 2009 22:10:06 +0000

[...] Without a public option or Medicare buy-in, I thought this bill was acceptable. But I don’ t know how it affects Health Savings Accounts, which I favor and which I hope will one day replace insurance. According to one source, the bill makes HSA’s so unattractive that the bill will effectively kill HSA’s. That alone would render the bill bad enough for me to oppose. The worst of both worlds [...]

By: David

David — Thu, 24 Dec 2009 20:56:50 +0000

What I meant was that, at least in my HSA plan, some things are not subject to the deductible, like annual “well child” visits and some OB/GYN stuff. In other words, like a first-dollar plan, there’s no out-of-pocket cost for those procedures. I think this is a NY mandate (my insurance is NY, not NJ. I mis-typed earlier.)

I’m not sure if you can classify what I’ve got as “catastrophic” insurance. It’s basically a normal NY insurance policy (mental health, etc. is covered) with a very high deductible, $6,000 for a family. The premium is $600 a month. Compare that to the HMO I left at $1900 a month and you can see the attraction.

So what I was saying is, there’s already a successful growing HSA plan market in heavy mandate states. Adding mandated coverage would drive up premiums in other states, but not by as much as they would drive up first-dollar premiums.

However, if they start mandating more and more services to be not subject to deductible, then HSAs are dead. Another dangerous thing I read a few months ago–but I can’t find this language in my brief scan of the text–is that the bill might lower the maximum deductible. That could kill HSAs.

By: scott sumner

scott sumner — Thu, 24 Dec 2009 03:54:28 +0000

David, I don’t follow your comment. The deductible for HSAs is up in the $1000s. Most of those tests cited in the LA Times story wouldn’t even reach the deductible. Are you saying that HSA catastrophic insurance policies would not be required to cover those procedures?

I keep reading articles that the Dems hate catastrophic insurance plans. I hope they allow them, but if they mandate all sorts of coverage, to me it seems to defeat the entire purpose of the plans. For instance, what about mental health coverage, therapy, that sort of thing? Will it be mandated? And what about states that already have lots of mandates? Will those simply be repealed?

By: David

David — Wed, 23 Dec 2009 17:48:10 +0000

I think the HSA fears are overblown. The article is very vague about the threat to HSAs. I haven’t read the Senate bill but the tax change might be the same as the House version; the elimination of non-prescription drugs being a qualified expense. That sucks but it’s not a dealbreaker.

I have an HSA/HDHP in NJ, which has got to be one of the top states for mandates. There’s nothing the Feds can really add that isn’t already covered. The only thing they can do that would kill HSAs is mandate more services to be not subject to the deductible, beyond well child visits and annual checkups. Mandates that are subject to the deductible will just drive the premium up, but not by as much as for first-dollar plans.

By: Doc Merlin

Doc Merlin — Wed, 23 Dec 2009 16:51:27 +0000

Darnit, I meant indefinite patents.

By: Doc Merlin

Doc Merlin — Wed, 23 Dec 2009 16:51:02 +0000

jm, I’d be more than surprised. Everyone realizes that innovation would grind to a halt with indefinite copyrights.

By: ssumner

ssumner — Wed, 23 Dec 2009 14:18:07 +0000

jm, I’d be very surprised.

By: jm

jm — Wed, 23 Dec 2009 14:11:01 +0000

“…eventually the patents will expire and they’ll become generics.”

Not necessarily. It won’t be at all surprising to see the law changed to extend patent rights indefinitely, as was done (and will probably continue to be done, forever) for the Disney copyrights. After all, the drug companies have much deeper pockets than Disney.