Friday, February 03, 2006

An incomplete discussion of HSA's

Who benefits from HSA's? TPM Cafe has a discussion that covers some parts of it.

One problem I don't see discussed is how we get our health care. I have a single physician who I go to first for all illnesses and health issues. He has my records and my healthy history, something no other physician will have. My memory isn't perfect, and in some cases I flat don't know what problems I had. For example, there is one medication my records tell me I am allergic to. I don't recall ever taking it and don't know what it was for.

I also get almost all my medications from a single pharmacist. He has the records of what I am taking, and a program that watches for drug interactions. I recently changed to a stronger version of one medication, and was warned by the pharmacist that it would be dangerous to continue taking the older prescription along with the newer one.

So What?

So I don't shop for price. The risk involved in getting medical services from a different provider with less information is higher than any price savings justifies. An HSA can only save money if I shop for price. I rank my priorities as health first, safety second and a long, long way further down is price.

Frankly, HSA's seem to me to be an effort to prove that all production and distribution of goods and services can be optimized by manipulating the money incentives. That implicitly assumes that I would prefer to be wealthier than I would to be healthier.

Unfortunately for those assumptions, health care is more of a human problem than an economic one. Efforts to apply nothing but economic incentives to the production and delivery of health care will fail some serious tests. Economics are a restriction on health care, but they to not optimize its production and delivery. Health care is too important to basic humanity to treat as nothing more than a simple set of commercial exchanges.


Post a Comment

<< Home