Healthcare Savings Accounts
Last week, Mark Milke provided an opinion in the Calgary Herald entitled “A small reform that would work”. Basically he suggested that Alberta’s health care premiums be put into government “owned” health savings accounts instead of into general revenues, and that patients could access them as a deductible for a range of health services (not just ministry designated services). Am I missing something here? Since this money is now going into the government’s coffers and would be the government’s “owned” health savings account with his proposal, expanding the services covered would only increase the cost of health care to the government (i.e. the taxpayer). Isn’t the present problem one of unsustainability? How does increased spending on “new” services address that issue?
The only way this could work is if the government actually de-insured many of the services that are now provided e.g. visits to the family doctor, chiropractor, ophthalmologist, the first $100.oo of a specialist visit, the first $100.oo of diagnostic imaging, laboratory investigations, etc. Can you imagine the uproar by Joe Public over something like that? The bottom line is that the government “bean counters” would have to de-insure more than 900,000,000 dollars of annual healthcare spending in order to come close to making Mr. Milke’s proposal cost effective, and still not address the unsustainability of our healthcare system.
Now don’t misunderstand me; health savings accounts, as done by some companies can have merit; but it does not do so by increasing the coverage of a variety of health services funded by the Canadian taxpayer.
The area that still needs intensive scrutiny in a health savings account system is the area of preventive medicine. Since most of these systems still carry “insurance” (either private or government) for major health expenditures, the participants may decide to spend their “annual allotted moneys” on eye laser corrective surgery instead of medication for their hypertension and not have to be concerned about the cost of their choice. As a taxpayer and a physician, I believe there needs to be justification for, and a shown benefit to, any tax funded health service. Ideally, the system should have significant “built in” incentives for disease prevention. Mark Milke had best get back to the drawing board on this one.
The only way this could work is if the government actually de-insured many of the services that are now provided e.g. visits to the family doctor, chiropractor, ophthalmologist, the first $100.oo of a specialist visit, the first $100.oo of diagnostic imaging, laboratory investigations, etc. Can you imagine the uproar by Joe Public over something like that? The bottom line is that the government “bean counters” would have to de-insure more than 900,000,000 dollars of annual healthcare spending in order to come close to making Mr. Milke’s proposal cost effective, and still not address the unsustainability of our healthcare system.
Now don’t misunderstand me; health savings accounts, as done by some companies can have merit; but it does not do so by increasing the coverage of a variety of health services funded by the Canadian taxpayer.
The area that still needs intensive scrutiny in a health savings account system is the area of preventive medicine. Since most of these systems still carry “insurance” (either private or government) for major health expenditures, the participants may decide to spend their “annual allotted moneys” on eye laser corrective surgery instead of medication for their hypertension and not have to be concerned about the cost of their choice. As a taxpayer and a physician, I believe there needs to be justification for, and a shown benefit to, any tax funded health service. Ideally, the system should have significant “built in” incentives for disease prevention. Mark Milke had best get back to the drawing board on this one.
posted by Al | 4:04 PM
|
3 comments
