Should employers offer health savings accounts?

issue prior to revisions:

Brianr: 

fine

Let's go with the simplest option (a research note: As legally defined in the US, you MUST be enrolled in a  high-deductible plan to open an HSA, so it's not really necessary to specify this). Proposed revision:

Should employers offer health savings accounts?
Yes
No

I agree with Marina and Esperanto here.  I think we're limiting ourselves by looking at government only.  It's something employers now look to when deciding on benefit packages.  There are plenty of pros and cons to instituting HSAs.

Can we just ask whether employers should offer health savings accounts? And leave the research (as to what this entails) to the voter?

i'm out of my realm on this one ... i'll leave it to you all to come up with sample evidence to nail down the wording for this issue ...

The problem is that HSA's don't exactly replace insurance. You still have insurance, but you would have a plan with a lower premium and higher deductible and use the HSA to make up the difference.

We can attack this a couple of ways:

1. Ask which model is better: high-premium, low deductible or high-deductible with HSA
2. Ask whether employers should offer HSAs as part of their health plans, with the tacit understanding that this will almost certainly mean higher deductibles.

can we say:

Should employers replace health insurance benefit packages with health savings accounts?

We're not there yet with this one. The government doesn't "set up" these accounts, but offers tax and other incentives to encourage or allow companies to set them up for their employees. 

The real issue, as I see it emerging, is:

"Should companies be allowed to replace health insurance plans with health savings accounts?"

[See my prior discussion.]

"should the US government..." is the clearest expression of this issue and i support this change.

Should the U.S. government etc.? In this case we are talking about a specific government.

Sure.

issue prior to revisions:

I agree jacki, i think we should preface government with "the" in this issue. "the government" in my mind means the US government, whereas just saying "should government" broadens it up, of course. since this issue is about a domestic policy decision, i think adding "the" before government makes sense here.

do we need "the" preceding government?

The Progressive Policy Institute has often argued the president's proposals for health savings accounts (HSAs) will do little to wring the waste and poor service out of heath care.

They're always out there. 

i don't like "a good alternative".  it's too casual.  i suppose we'll never find anyone that will say:

HSA should replace health insurance ... can someone look to see what bush says or someone like him.  they are bold enough to make a statement like that ...

Vizinertia is totally right. So, how about this:

Are health savings accounts a good alternative to health insurance?
-Yes
-No

I heard an economist on NPR the other day talking about how HSAs should replace insurance for things that don't logically make sense to be insured, like regular doctor visits (i.e., that's not a risk, it's a certainty). I think there's something to this.

Also, the replace/supplement thing I was hung up on before is really just me being duped by an attempt to frame the issue. HSA's really are designed to *replace* at least part of your health insurance, possibly in combination with a high-deductible plan for major medical expenses.

However, I think Viz rightly points out that for many public figures, especially politicians, such a position sounds way too nefarious for them to ever allow themselves to be pinned down to it. Maybe this suggestion will help us identify those who publicly support them, without committing them to an insurance-replacement policy, allowing wiggle room for those who support them but see them as a supplement to, not a replacement for, insurance.

What the government does is give tax incentives, and set up the conditions by which plans qualify for the tax benefits. Nothing necessarily nefarious here. Some companies have taken up the government's invitation, and are giving their employees the alternative of health savings accounts, not only as a supplement to health insurance (as they've already been at many companies for years) but as a replacement. I gather that many companies are reeling under health care costs, and will jump at the opportunity first to "offer" health savings accounts as a supplement - then as an option one picks instead of health insurance - and then, down the road, I suspect, the only option. 

There's certainly an issue lurking here, and one that will eventually work its way into the public consciousness. But I don't hear the public clamoring about it yet, and I don't hear them calling up their congresspeople.

I don't care for this issue.  Should health savings accounts supplement health insurance coverage? doesn't make any sense unless you're asking if the government should mandate the availability of such accounts, and as Esperanto pointed out, they're already available via the Medicare bill. 

I like "Should health savings accounts supplement health insurance coverage."

esperanto's suggestion is framed.

what about:

Should health savings accounts SUPPLEMENT health insurance coverage?

Take your medicine and like it! 

Seriously, I didn't know any of that either until I googled it for five minutes or so. I like how the Internet can make anyone an instant expert on the subject of their choosing. That said, in my expert opinion, I like Jacki's idea, but I wonder if "replace" is too strong a word... I think that at this point, they mostly help people deal with gaps in coverage, so that that government and insurance companies don't have to. 

Maybe we need to be more specific, something like, 

Are health savings accounts a good solution to rising healthcare costs?

Only, less crappy.

brian cracks me up.  don't feel so bad ... i did not know either.  how about:

Should health savings accounts replace health insurance coverage?

Thanks for revealing how little I actually know about Medicaid and the health insurance industry in general. 

-Are health savings accounts a good option for seniors?  Is "seniors" mean?

Few things. First of all, the government doesn't set up the accounts - people set them up at banks and whatnot. The government created the legal framework for them to exist in the Medicare bill.

Since these accounts already exist, it doesn't sound right to ask if they should be created. I think a better question would be, are they a good alternative to comprehensive health insurance, or whatever people are supposed to have.