Health Savings Accounts/High Deductible Plans: Better than nothing?

In an article at the website cited, W. Scott Bailey of the San Antonio Business Journal reports on the surge in Health Savings Accounts in conjunction with High Deductible Insurance policies (W. Scott Bailey - San Antonio Business Journal
http://www.mlive.com/business/ambizdaily/
bizjournals/index.ssf?/base/abd-4/1211179206182550.xml)

Bailey reports that highest enrollment was in California, Florida, Texas and Minnesota.

While the article still points out that health savings accounts are not a great choice for average American health insurance needs, while the article points out that up until now these insurance company creatures have been used by the wealthy because of the ability to sock a way some tax free money, the change has begun....and the US consumer is about to endure the consequences of the next phase of neglecting to stay on top of the health services crisis...worse access, worse affordability, and worse quality of health services with more increases in cost.

Soon we'll be hearing how the American consumer has spoken and we'll be watching interviews of charming families who are ever so satisfied with the High Deductible Plans. We'll hear governmental disconnects as the conclusions drawn are that the US consumer WANTS the high deductible plans rather than any sort of reasonably sufficient, affordable health insurance as part of a governmental partnership or even...heaven forbid single payer...we'll hear about how the free market is "working."

So...For the record...for most US citizens choosing the high deductible health insurance it's because they view it as better than nothing. Not better, not a great opportunity to get some tax free dollars, not because the marketplace has provided them with choice.

Better than nothing consumerism has a long-standing history, but has NEVER been based on the choice of choosing better than nothing over better. The danger of better than nothing purchasing is that it can be used as an excuse not to address a problem. It can be misinterpreted and indeed, those who want to cover their eyes and ears and say everything is great in the US health services system
will rave about increased enrollment, the average tax free savings of members, and the blah blah blah of see, everything's fine. Failure to act will mean that until the "insurance experience" of those who purchase these plans is considered, counted, and tallied over the next several years, nothing will be done to address the health services crisis that includes health insurance as part of the problem. But as the insurance experience of citizens who purchase these products that are sub standard to even some of the worst plans out there because they are those worst plans with the added twist of requiring higher deductibles to get even bad coverage, we will again see the eruption of the health services crisis.

When "better than nothing consumerism" becomes "worse than nothing consumerism": Is the purchase of a cheap TV better than no TV? Sounds reasonable. And when we count how many people have TV's, the numbers increase, right? How 'bout if the cheap TV only works for five hours a day? Then we still count households with TV's, but in reality, many households only have TV's for five hours a day. How 'bout if the cheap TV's only get a single channel? How 'bout if they only work an hour a day? At some point, the MARKET for cheap TV's will dry up because they don't meet even the basic needs of consumers. And then, we as free market gurus assume that the marketplace will provide a cheap TV that is a little better than the CHEAP TV, but of course it won't be quite as cheap. This marketplace solution will not occur until people STOP buying the inadequate TV. And in the area of health services, how many people will go bankrupt? Fail to see doctors because they don't want to drain their thousand bucks worth of tax free savings? Never reach their deductibles? Die? Before consumers notice and speak up and say that this choice is no choice at all?

Our consent to the better than nothing insurance product perpetuates and worsens our current system, but what can we do?
Whether we purchase the better than nothing product or not, always bear in mind that we are settling out of fear, out of powerlessness, and for those who are rich enough not to worry, out of greed. Instead of holding your breath and squeaking through each year saying your risky insurance coverage "worked" because you didn't need health insurance coverage because you stayed well that year, continue shopping for, advocating for and anticipating next year's benefits season when your crummy cheap TV will be the same except with one less channel and at a cost of a few more dollars.

Is the decision easy for you? Why make it easy for health insurers, providers and government to do this? Whether or not you buy the Health Savings Plan/High deductible health insurance, it doesn't ever make sense to blandly accept the conclusions drawn about your purchases that perpetuate a worse consumer environment: Politicians who support HSA's (health savings accounts) based on consumer support interpreted from increased enrollment should be immediately reminded that most elections for this inferior insurance product are motivated by it's better than nothing reasoning.

Health insurance companies that use the increased enrollment numbers to indicate they are providing the consumer with what the consumer wants should be called on the carpet for arguing that anyone in his right mind would choose the better than nothing choice without the combined fear of having nothing and the ability to buy the better than nothing. At least this way maybe the cost
of better than nothing can be kept down.

And consumers should remember that these plans were at one time publicly known as an inferior product not right for most Americans. Consumers should remember the good old days when you didn't have to hold your breath and hope that your trade-off of decent health insurance coverage for cheap coverage was all in the hands of whether you got sick, were injured, or caught some virus or bacterial infection that required actual medical services. And though we may be voting FOR health savings accounts and high deductible health insurance with our dollars and our feet, without remembering that it's mostly because we have no other choice, we let our politicians, our health insurers, our medical services providers, and ourselves off the hook for remembering that we chose cheap because we couldn't afford better, not because we love our choices.