Pulaski

If you are regularly using your entire deductible then I would suggest that the cost of your ad hoc GP visits and non-recurring prescriptions are a similarly small proportion of your healthcare costs as brakes and service are of your motoring expenses.

nun

Sure, but the macro-economic cost of $billions is going the be expressed in the pocket of the consumer as a premium or an out of pocket cost.

Right now health care is a cash cow and to reduce costs means to cut into someone's profit and income and that will be resisted right up to the point where the system becomes so expensive that it collapses in on itself.

Giantaxe

How do you feel about the tax deductibility of HSA contributions and the tax-free growth they allow?

Pulaski

You make some very fair points, but I still don't think that there is anyway for the US to get "there" from where it is today.

Pulaski

Well it costs "the government" i.e. you, about 75% less than my taxes funding your healthcare.

But honestly, you seem to hate so much about how the US works that I don't know why you don't go somewhere else. ..... But I certainly wish you and your buddies would quit trying to change the US into something that you think would be an improvement.

scrubbedexpat099

Exactly

Giantaxe

I agree. Which is why I believe the ACA is the most plausible approach for the US, i.e a mandate coupled with insurance available regardless of health status.
We now have the lowest uninsured rate ever recorded, even with many red states having refused the Medicaid expansion.

Giantaxe

You didn't answer the question, nor do you know how my healthcare is funded.

MidAtlantic

Why do you keep making such an issue about this? "Tax free growth" in my case is a piddling bit of interest which makes it irrelevant in the scale of things.

Are you also concerned that (predominantly poor) people in rented accommodation cannot claim mortgage interest as a tax deduction?

Do you use the same argument for 401ks and ROTH accounts?

Giantaxe

I'm hoisting Pulaski by his own petard. No, I don't have significant issues with the tax free contributions and growth of HSAs just as I don't - unlike Pulaski - have an issue with ACA subsidies to buy insurance. That's not to say HSAs don't have some negative effects, however.

I do think the mortgage interest deduction should go, just as that well known socialist Thatcher phased it out in the UK.

Pulaski

My reference to "your healthcare" was a reference not to you personally but to this post you made a few minutes ago, about necessarily funding healthcare by a tax or mandate.

And your question was daft, you know perfectly well I don't have a problem with it. And FWIW, because I believe the stock exchange is currently overvalued and due for a "correction", and because my HSA balance is relatively modest, I have held it all in cash, so to date my HSA has cost the US Treasury precisely $0 in taxes lost on tax-free growth.

petitefrancaise

I'm perplexed by this attitude that "healthcare" is a personal item rather than a national priority like education, defense, police or even roads.

A healthy population benefits us all after all. I'm sure Pulaski would not want his daughter to be at school with a load of sick children/teachers because they can't afford healthcare ( oh wait, that does happen in the USA), or for the teachers to be absent all the time due to ill health. Or to have not enough police due to ill health or soldiers....

Don't forget that the 12 % figure for France provides top-notch care for everyone in France. Not like the 18% in the USA.

Pulaski

Not really, you and I are just arguing opposites, but you some how feel there is some moral justification for taking money out of my pocket.

Everyone has the freedom or potential to avail themselves of the benefits of an HSA, whereas your preference is stacked in one direction taking money from one group of people to give to another.

Giantaxe

How much tax has the Treasury forgone given the tax deductibility of your health insurance and HSA contributions?

MidAtlantic

The stronger argument is that they have a positive effect because they lead to the consumer being more cost conscious about their well being and health costs.