Re: Another Reason To Hate HSAs

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I dunno, Becks. I'm not a fan of HSA's in general, but this isn't the strongest reason. Health care for women costs more than health care for men. Somebody's got to pay for that - it can be the women (as with HSA's), it can be split down the middle (as with employer-provided coverage), it could be something else we could pull out of thin air. But if you're going to argue that somebody other than the recipient of routine care should pay for it (as I generally do), you ought to argue that, not simply assert it.

Heck, a pretty simple shift in women's plans to have the first grand or two covered, then a donut-hole deductible would fix this.


Posted by: ptm | Link to this comment | 04- 6-07 9:34 AM
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if you're going to argue that somebody other than the recipient of routine care should pay for it (as I generally do), you ought to argue that, not simply assert it.

She is. This is one more reason why medical care should be a collectively borne cost.


Posted by: Matt F | Link to this comment | 04- 6-07 9:42 AM
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I'm generally kind of sympathetic to the idea that the costs people face going through life should be sort of equalized between each other.

But thats not really how things ever get done; its way too ambitious. WE just make corrections where there costs are too big, like slapping some insurance on health care, since it is $$$$$$$, but not giving big people a few extra $$ for the extra cost of buying big&tall.


Posted by: yoyo | Link to this comment | 04- 6-07 10:16 AM
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Yes, but women get to bare their legs and arms at work. I have to wear a suit on hot summer days.


Posted by: will | Link to this comment | 04- 6-07 10:32 AM
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It sounds like a lot of the extra costs for women are for services relating to sexuality. I would argue that this benefits men as well as women, which is another reason for them to be borne collectively, through something like universal health care. Men get a benefit from women paying for birth control. Society gets a benefit from women having kids.


Posted by: Becks | Link to this comment | 04- 6-07 10:58 AM
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5: Does this all apply even if I'm not getting any?


Posted by: ptm | Link to this comment | 04- 6-07 11:03 AM
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Becks:

There should be a check-off box on our taxes:

___ Yes, I am willing to have $20.00 subtracted from my return to promote healthy vaginas and breasts!


___ I would like to join the Friends of Breasts and Vaginas with my $150.00 contribution.


___ I would like to join the President Clinton Society Supporting Breasts and Vaginas with my $1000.00 contribution.


___ No, I do not support healthy vaginias and breasts.


Posted by: will | Link to this comment | 04- 6-07 11:10 AM
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6: It's a tricky question. If women hadn't using birth control, there would be more potential sex partners from which to choose.


Posted by: apostropher | Link to this comment | 04- 6-07 11:11 AM
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6: I believe that under Becks' plan, there would be an "Ogged Tax Credit" (or "OTC") available to you.


Posted by: SomeCallMeTim | Link to this comment | 04- 6-07 11:18 AM
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There was a Daily Show interview a while back with a guy who didn't feel like his insurance money should have to be used to provide coverage for women's health care services and you all are SO LUCKY that Viacom is all about the takedown orders because it would make you all look like fools. Fools!


Posted by: Becks | Link to this comment | 04- 6-07 11:22 AM
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it would make you all look like fools

Like we need Viacom for that.


Posted by: apostropher | Link to this comment | 04- 6-07 11:26 AM
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For instance, apo just made himself look like a fool by misreading Becks' comment.


Posted by: ben w-lfs-n | Link to this comment | 04- 6-07 11:28 AM
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My comment doesn't rely on any particular reading of Becks' comment, ben.


Posted by: apostropher | Link to this comment | 04- 6-07 11:32 AM
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Ahhh. Fool me twice, shame on me.


Posted by: apostropher | Link to this comment | 04- 6-07 11:33 AM
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Agreed that healthy breasts and vaginas (and babies, whatever) are worth the extra investment. Also: "Dr. Steffie Woolhandler"? Awesome.


Posted by: Jesus McQueen | Link to this comment | 04- 6-07 11:40 AM
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For most kinds of insurance, it's straight-up risk management. Getting the extra insurance on the gift your mailing, getting replacement coverage on your car, etc. But health insurance is different because we think everybody ought to have health coverage (for various definitions of "everybody" and "coverage"), and health insurance is how we provide that in the US right now.

What's bugging me is exactly how we choose when to pool risk and when not to. I'm fine with charging smokers more for their health insurance. Probably drinkers, too. But I'm sure we could come up with other criteria that do affect expected healthcare costs that we think should be pooled - maybe genetic testing results. Or, you know, employment status. What I don't understand is how to tell the difference.

Sex has attributes of both. It's a relatively low-cost difference that is well known but isn't a freely chosen behavior.


Posted by: ptm | Link to this comment | 04- 6-07 11:48 AM
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Dr. Steffie Woolhandler

How did I miss that on my first reading! Wonderful.


Posted by: mrh | Link to this comment | 04- 6-07 11:50 AM
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I think the big issue here is the disconnect between worker expectations and employer offerings. The nature of healthcare-for-profit is such that it will continually squeeze people for more and more. (This is one of the reasons I quit working for Ma Bell, because the benefits there are now so slapdash and expensive that it wouldn't have been financially feasible for me to be sick whether I had health insurance or not.) Employees expect to be reasonably covered; employers are changing that standard so that more and more cost gets pushed onto the worker.

I don't think the increased burden to women is an intended consequence but it's clearly going to be an impact on their finances and management knows this going into such benefit revisions; after all, pushing more of the cost onto employees is the point of those revisions. A part of me wonders whether there's a case to be made there, legally, in terms of sex discrimination. If an employer covers everyone equally in terms of their maximum out-of-pocket cost, but does so knowing that said theoretical maximum will in practice be greater for women than men, are they discriminating? Frankly, I say yes.


Posted by: Robust McManlyPants | Link to this comment | 04- 6-07 12:03 PM
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5: Does this all apply even if I'm not getting any?

You'd get more if you'd call yourself a feminist.


Posted by: mcmc | Link to this comment | 04- 6-07 12:04 PM
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You'd get [called a tool] more [often] if you'd call yourself a feminist.


Posted by: apostropher | Link to this comment | 04- 6-07 12:07 PM
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18: Yah.


Posted by: ptm | Link to this comment | 04- 6-07 12:15 PM
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You'd get more if you'd call yourself a feminist.

That seems like the sort of claim that Healy, as a sociologist, ought to be investigating. At least to the extent he believes that sociology should contribute to the general well being.


Posted by: SomeCallMeTim | Link to this comment | 04- 6-07 12:23 PM
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15, 17. Given current pubic styling, I would venture to say that Dr. Steffie is handling less wool these days.


Posted by: Tassled Loafered Leech | Link to this comment | 04- 6-07 1:03 PM
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Becks, so you feel it is unfair for women to be charged more for medical insurance even though they incur more medical costs. How do you feel about charging men more for auto and life insurance?


Posted by: James B. Shearer | Link to this comment | 04- 6-07 3:06 PM
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24: See, I don't think that this is true over the life cycle. I'm guessing that women have higher routine costs but that men wind up having big expensive costs in mid-life. The income inequality issue is raised, because women have those costs when they are young and less established. Men are likely to have made their money before they get sick.


Posted by: Bostonaingirl | Link to this comment | 04- 6-07 3:23 PM
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25- not to mention that big expenseive mid-life costs are (mostly) covered by insurance even under HSAs, whereas routine costs are mostly paid for out-of-pocket under HSAs. Which is the entire point, which seems to have eluded James.


Posted by: Brock Landers | Link to this comment | 04- 6-07 3:30 PM
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I would guess that it doesn't even out over the long haul. Women tend to live longer than men, and old age is when the medical bills really start to pile up.


Posted by: apostropher | Link to this comment | 04- 6-07 3:36 PM
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I got this very good book that Ezra Klein recommended:

http://www.amazon.com/Understanding-Health-Policy-Thomas-Bodenheimer/dp/0071423117/ref=pd_bbs_sr_2/102-7040267-9588112?ie=UTF8&s=books&qid=1175895847&sr=1-2

It is very readable. It gives an overview of the details and history of the US healthcare system with comparisons to other country's systems. I bet even James B. Shearer would like it because it brings the economics 101. It is somewhat expensive but there are cheap used copies of earlier editions. I haven't gotten to the HSA part yet.


Posted by: joeo | Link to this comment | 04- 6-07 4:12 PM
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27: I was thinking that too, but I didn't want to admit that at the ouset. I can make the data fit my theory by saying that old-age stuff is going to be covered by medicare, so the expensive private insurance stuff is going to cover the men who have heart attacks in their 50s.


Posted by: Bostonaingirl | Link to this comment | 04- 6-07 4:12 PM
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25

According to this study .

"Per capita lifetime expenditure is $316,600, a third higher for females ($361,200) than males ($268,700). Two-fifths of this difference owes to women's longer life expectancy. ..."


Posted by: James B. Shearer | Link to this comment | 04- 6-07 5:29 PM
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Single men have to spend hundreds of additional dollars per year buying dinner and tickets for single women. Where's my fancy Harvard study?


Posted by: MQ | Link to this comment | 04- 7-07 12:48 AM
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Hangin.'


Posted by: goofyfoot | Link to this comment | 04- 8-07 4:46 AM
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