The high cost of health care and how to lower that cost has always been of great concern in the United States.  In 1971, the RAND Corporation began a decade-long study to see what effect health care cost-sharing would have on consumer behavior.  It found that people did indeed use health care services less when they had to share significantly in the cost.  See: http://www.rand.org/pubs/research_briefs/RB9174/index1.html

Years ago when I was a young mother, my husband worked for a company that had amazing health care insurance for its employees.  I never hesitated to take my children to the doctor for anything that looked suspicious.  Everything was paid for.  When our situation changed and I had to deal with deductibles and co-pays or no coverage at all for certain health problems, I was shocked into realizing that most people were not as privileged as I had been and was no more.  I was a perfect example of the findings of the RAND study.  I began to use physician services less.

The Health Savings Account (HSA) is one of the methods being used to get the insured to take responsibility for their own health, and one that we need to understand as more than half of all employers offer this plan as a choice.  Here are some of its provisions:

1. The HSA has a high deductible with lower premiums.  Generally healthy people are opting for the high deductible plans so that monthly premiums take less out of their paycheck.  We’ll take the chance that no catastrophic illness or injury ever occurs.

2. When an employee leaves his job, he can take it with him.  That is not true of all consumer driven plans.

3. Unused benefits can carry forward into the next year.  The Flexible Spending Plan that preceded the HSA required that benefits be used in the year in which they were funded or be lost to the Federal government.

4. The HSA can be funded by either or both employee and employer.

5. With some limitations, up to 100% of the deductible can be contributed to the plan.
This is just a very brief view of  HSA plans to give you an idea of what is involved.  Wikipedia has an excellent description of HSAs: http://en.wikipedia.org/wiki/Health_savings_account, and I urge you to read it.

We have a long way to go before we as individuals take responsibility for our own good health and for preventing health problems from occurring.  Look at the way we eat.  Consider the abuse of our health through illegal drugs and alcohol.   Harming ourselves through the use of fossil fuels and on and on.  We’re on a journey here, and solutions are coming little by little as we work through our political differences on how best to move forward.

It’s complicated,
but not so complicated that we all can’t understand it if we try.

Coming next: Managed Care.