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> Sorry, are you seriously trying to claim an HSA is better than universal healthcare? I think it can be. Depends on the details but an HSA comes with a high-d

> Sorry, are you seriously trying to claim an HSA is better than universal healthcare? I think it can be. Depends on the details but an HSA comes with a high-deductible plan. This is normally ideal for young people, who are generally healthy and only need insurance for rare catastrophic illness or serious accidents. Normal, routine care (checkups, immunizations, etc.) can be budgeted and paid out of the HSA tax-free. I don't see why that stuff should be "free" for most people, any more than groceries or utilities or housing should be.

binaryblitz 6y ago
There are actually tons of studies that show preventive healthcare reduces spend later on. For instance, if you pay for someone's routine checkup you might catch a heart issue or cancer early. Both insurance companies and the government (Medicaid/Medicare) would save money by paying for preventative care. Study by the NIH: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296930/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296930/
- zip1234 6y ago
  An HSA doesn't mean that you don't have preventative care. I have a high deductible plan plus HSA and there are things like annual checkups covered without going into deductible.
  - bsanr2 6y ago
    So about those. I started with a new doctor after finally getting insurance a few years back. I told them I needed to come in for my annual check-up, and came in with a list of the things that had been bothering me and that I hadn't been able to get looked at (this is common for people who have not had healthcare access). The doctor spent 15 minutes with me, doing the bare minimum of setting up outside testing/imaging - as in, basically no guidance that day - and then coded it as a 45-minute, in-depth consultation ("because of the number of issues addressed"). $250. Before any tests or treatment. For reference, that was about 1% of my annual take-home. For a lot of you, that's like paying a grand or more just for your doctor to direct you elsewhere. So, yeah, certain things are "covered." But the structure of our healthcare system forces our clinics and hospitals to operate like many other American businesses, which is "in a predatorial manner."
    - refurb 6y ago
      You went for a preventative check, and asked for a bunch of issues to be addressed and you’re surprised it cost you money?
      - ShroudedNight 6y ago
        What, exactly, is a preventative check, if not a discussion with your GP about your current physiological status? Given the time described (15 minutes), and the lack of immediate diagnostics, it sounds exactly like what I would expect from a check-in with my doctor here in Canada. The only other option I could see counting as a preventative check is a physical, which would be more involved than what was described.
        refurb 6y ago
        It’s a matter of billing. A preventive visit does a set of screening and evaluation of results. If you say “my knee hurts lately”, then that’s separate as the physician will do an evaluation that is separate from a routine physical. And it’s not just the US. I have family in Canada and they were told maximum of 2 complaints can be addressed as they can only bill for a certain amount of time. Beyond that the doctor is working for free. Another separate appointment is needed.
        bsanr2 6y ago
        So, yes, this is the problem. Healthcare should not be a business. It should be obvious that people who have been denied access before will come in to their first visit with multiple concerns, and the system should be accommodating to that without a massive "onboarding" fee. After all, it's not their fault that previous incarnations of said system did not supply care adequately. If you view a person and their health in a holistic manner, you can't just say, "Well, I've got you set up to check for diabetes and Crohn's, but if you want me to consider that mole then you'll have to pay me another $300 and/or wait a few weeks until I'm not so booked." My point was that "free preventative care" is not a panacea. Any time a doctor is incentivized to turn that visit into a money-maker, they'll gladly attempt to. And that's wrong.
emayljames 6y ago
Universal Healthcare systems can and do provide a significantly better coverage and vastly more cost efficient system. What you just said is selfish healthcare provision, look out for yourself and to heck with everyone else. You have no empathy for people who can never afford ridiculous health care systems in private systems. This optimises the failed "rugged individual" philosophy that has only lead to ruin.
lostlogin 6y ago
> I don't see why that stuff should be "free" for most people I do. Having a healthy population benefits me. Having people immunised, cared for and well keeps me healthier and safer. Having people lose homes and jobs and potentially their lives because they can’t afford healthcare is not something I support.

binaryblitz 6y ago

There are actually tons of studies that show preventive healthcare reduces spend later on. For instance, if you pay for someone's routine checkup you might catch a heart issue or cancer early. Both insurance companies and the government (Medicaid/Medicare) would save money by paying for preventative care. Study by the NIH: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296930/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296930/

zip1234 6y ago
An HSA doesn't mean that you don't have preventative care. I have a high deductible plan plus HSA and there are things like annual checkups covered without going into deductible.
- bsanr2 6y ago
  So about those. I started with a new doctor after finally getting insurance a few years back. I told them I needed to come in for my annual check-up, and came in with a list of the things that had been bothering me and that I hadn't been able to get looked at (this is common for people who have not had healthcare access). The doctor spent 15 minutes with me, doing the bare minimum of setting up outside testing/imaging - as in, basically no guidance that day - and then coded it as a 45-minute, in-depth consultation ("because of the number of issues addressed"). $250. Before any tests or treatment. For reference, that was about 1% of my annual take-home. For a lot of you, that's like paying a grand or more just for your doctor to direct you elsewhere. So, yeah, certain things are "covered." But the structure of our healthcare system forces our clinics and hospitals to operate like many other American businesses, which is "in a predatorial manner."
  - refurb 6y ago
    You went for a preventative check, and asked for a bunch of issues to be addressed and you’re surprised it cost you money?
    - ShroudedNight 6y ago
      What, exactly, is a preventative check, if not a discussion with your GP about your current physiological status? Given the time described (15 minutes), and the lack of immediate diagnostics, it sounds exactly like what I would expect from a check-in with my doctor here in Canada. The only other option I could see counting as a preventative check is a physical, which would be more involved than what was described.
      - refurb 6y ago
        It’s a matter of billing. A preventive visit does a set of screening and evaluation of results. If you say “my knee hurts lately”, then that’s separate as the physician will do an evaluation that is separate from a routine physical. And it’s not just the US. I have family in Canada and they were told maximum of 2 complaints can be addressed as they can only bill for a certain amount of time. Beyond that the doctor is working for free. Another separate appointment is needed.
        bsanr2 6y ago
        So, yes, this is the problem. Healthcare should not be a business. It should be obvious that people who have been denied access before will come in to their first visit with multiple concerns, and the system should be accommodating to that without a massive "onboarding" fee. After all, it's not their fault that previous incarnations of said system did not supply care adequately. If you view a person and their health in a holistic manner, you can't just say, "Well, I've got you set up to check for diabetes and Crohn's, but if you want me to consider that mole then you'll have to pay me another $300 and/or wait a few weeks until I'm not so booked." My point was that "free preventative care" is not a panacea. Any time a doctor is incentivized to turn that visit into a money-maker, they'll gladly attempt to. And that's wrong.

emayljames 6y ago

Universal Healthcare systems can and do provide a significantly better coverage and vastly more cost efficient system. What you just said is selfish healthcare provision, look out for yourself and to heck with everyone else. You have no empathy for people who can never afford ridiculous health care systems in private systems. This optimises the failed "rugged individual" philosophy that has only lead to ruin.

lostlogin 6y ago

> I don't see why that stuff should be "free" for most people I do. Having a healthy population benefits me. Having people immunised, cared for and well keeps me healthier and safer. Having people lose homes and jobs and potentially their lives because they can’t afford healthcare is not something I support.