Debating Health Savings Accounts

Why create another complicated system for employees and insurance companies to keep up with (“Savings No Salvation for Healthcare,” James Flanigan, Jan. 16)? Why not just allow the first, say, $2,000 of healthcare costs each year as a state and federal tax deduction.

I think the insurance companies would start selling, and employers would start offering, a plan that wouldn’t kick in till the deductible was met. Doctors would be paid directly and avoid paperwork, many employees would never exceed the deductible, and all insurance costs would go down.

Employees also would be a bit more careful as to how they spend their first $2,000.

Bert Argo

Rancho Palos Verdes

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No matter how healthcare bills are paid, someone has to pay. Whether we do it through payroll deductions to an insurance company, savings accounts or payroll taxes, someone has to foot the bill.

The U.S. spends more than 15% of GDP on healthcare, while France and Germany spend about 10%. More than 40 million Americans are not covered by insurance, and many do not get all the care they reasonably need.

In Europe, governments regulate prices and ration service; here, insurance companies set prices and ration service but don’t do either very well.

I would suggest that Medicare looks a lot like the European systems, and with a proper drug benefit (not the one President Bush pushed through), it could do nicely for everyone.

Medicare is trying to service a large share of the demand with a smaller share of the healthcare dollar.

Peter Morici

Professor

Robert H. Smith

School of Business

University of Maryland

College Park, Md.

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I have yet to see an article written about health savings accounts that accurately depicts the true benefits of these accounts.

Just look at the numbers. My family medical insurance with a $1,000 deductible costs about $800 per month, or $9,600 per year. I now have a comparable HSA with a $5,000 deductible costing only $300 per month or $3,600 per year.

Even if I spent every penny of the difference in deductibles, I would still save $2,000 per year.

Dr. Bryan S. Jick

Pasadena

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There was no mention of whether there were any pricing controls placed upon the initial self-insured part of each individual’s plan.

If there are to be no controls, as there are with Medicare and other HMO and PPO plans, one visit to an emergency room would eat off most of the savings.

One only needs to examine a hospital bill to discover the vast differential between what is billed and what is eventually collected by the institution.

Dr. Leslie M. Eber

Brentwood

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One thing that I have yet to see explained is just where are the increases in medical costs coming from. The insurance companies say it is not them, the doctors and other practitioners say their pay is not increasing that fast, etc., etc.

So what really gives?

Henry M. Feilen

Chino