Health savings accounts

Here's an interesting article on health savings accounts from the Wall Street Journal.

The Bush administration and the congressional Republican leadership argued that one of the main achievements of the 2003 Medicare prescription drug bill was that it authorized and encouraged health savings accounts—health insurance with high deductibles that allow policyholders to retain sums not spent. The argument is that HSAs encourage policyholders to weight the cost of routine healthcare and at the same time protect them from catastrophic expenses. After all, your auto insurance doesn't pay you for oil changes but does pay if your car is totaled. Why should a health insurance policy pay for routine, predictable medical expenses but not cover the full cost of catastrophic care?

Conservative critics of the Bush administration and the congressional Republican leadership have argued that the HSA provisions are insufficiently favorable and that they are not worth the creation of a whole new entitlement to prescription drug coverage.

Count me as an agnostic in this argument. But I do think it's worth noting that HSAs seem to be making some gains in the private-sector marketplace. We tend to talk about healthcare finance issues as if the federal government is the only important decision maker. But as Hillary Rodham Clinton found out in 1993-94, we don't have one healthcare finance system in this country, we have many. Trying to impose one model on those systems proved to be intellectually very difficult, even for the very smart people who worked on the Clinton healthcare plan, and politically impossible. Our healthcare finance systems keep changing, in large part because of decisions by private firms and individuals, and if HSAs prove increasingly popular—and the WSJ article suggests they are—then that has important national consequences.

Another senator for president?

U.S. senators, and former senators, often run for president. As evidence of this proposition, I transmit, without further comment, the contents of an e-mail message I received.

Former United States Senator Mike Gravel (1969-1980 D-Alaska) is planning to announce his candidacy for President of the United States at the end of January. One of the first, former or current members of Congress, to publicly oppose the United States going to war with Iraq in 2003 (during several appearances on MSNBC in late 2002 and early 2003), the Senator accurately concluded well before the war began that the White House was not delivering to the American people accurate intelligence on Iraqi's weapons of mass destruction. It was the Senator's filibuster ending the draft in 1971 and 73 that now limits President Bush with "boots on the ground" from expanding the war into your Iran and Syria. Senator Gravel will enter the campaign with an agenda that will start with a National Initiative on ending the war and other national issues that affects the lives of the American people, like Social Security, tax reform and a woman's right to choose, etc. His candidacy will advance a new paradigm of human governance by bringing the people into the operation of government as lawmakers. In partnership with their elected officials (see www.NI4D.us) to better address the challenges the United States and the world face in the 21st century. Be assured that the language and the ideas will be new and will change the nature of the debate among the candidates of both parties making the 2008 Presidential campaign a milestone in the American journey.