Bet­ter than Oba­macare Health sav­ings ac­counts would be free from govern­ment con­trol

The Washington Times Weekly - - Commentary - By Ben S. Carson

It’s for­tu­nate the Supreme Court of the United States saw fit last week to rule that cor­po­ra­tions could not be co­erced into cov­er­ing re­li­giously ob­jec­tion­able forms of birth con­trol for their em­ploy­ees. This was a crit­i­cal rul­ing be­cause it in­di­cates that the ma­jor­ity of the court still thinks that re­li­gious be­liefs and per­sonal choice have a valid place in Amer­i­can so­ci­ety. The mar­gin of the split de­ci­sion, how­ever, is alarm­ing be­cause it re­minds us of how close we are to hav­ing a govern­ment that will sub­ject moral con­vic­tions to its bu­reau­crat­i­cally di­rected con­trol.

People have le­git­i­mate dif­fer­ences of opin­ion about the ap­pro­pri­ate­ness of var­i­ous forms of birth con­trol, which is some­thing that most rea­son­able people on both sides of the po­lit­i­cal ledger un­der­stand. How­ever, legally re­quir­ing the side op­posed to a form of birth con­trol to be fi­nan­cially re­spon­si­ble for its dis­tri­bu­tion to any em­ployee who wants it is dis­tinctly un-Amer­i­can and abu­sive to the con­cept of free­dom of re­li­gion.

A ma­jor prob­lem is that many people in our en­ti­tle­ment so­ci­ety see noth­ing wrong with forc­ing oth­ers to pro­vide for their de­sires. In a free and open so­ci­ety, any­one should be able to pur­chase any­thing they want that is le­gal. It re­ally should be no one else’s busi­ness. Com­mon sense dic­tates, how­ever, that it im­me­di­ately be­comes my busi­ness if I’m be­ing forced to pay for it. Wouldn’t it be fairer and make more sense for people want­ing some form of birth con­trol to pay for it them­selves? This is ex­actly what would hap­pen if ev­ery­one had ac­cess to their own health sav­ings ac­count. A woman and her health care provider would de­cide on a birth-con­trol method, and the cost would be de­ducted from her ac­count with no in­volve­ment of any­one else in any way. It’s so sim­ple, and up­holds pri­vacy and free­dom.

Health sav­ings ac­counts can be funded in a va­ri­ety of dif­fer­ent ways and give people to­tal con­trol of where, how and with whom they wish to spend their health care dol­lars. Most people will want to get the big­gest bang for the buck and will in­de­pen­dently seek out both value and qual­ity. That, in turn, will bring all as­pects of medicine into the free-mar­ket eco­nomic model, thus au­to­mat­i­cally hav­ing an ame­lio­rat­ing ef­fect on pric­ing trans­parency and qual­ity of out­comes.

Many cor­po­ra­tions and com­mu­ni­ties al­ready have very pos­i­tive ex­pe­ri­ences with health sav­ings ac­counts. Those ex­pe­ri­ences could be fur­ther en­hanced by al­low­ing fam­ily mem­bers to shift the money in their ac­counts among them­selves. For in­stance, if a fam­ily mem­ber was $500 short for a pro­ce­dure or test, an­other fam­ily mem­ber could pro­vide the money by autho­riz­ing its de­duc­tion from his ac­count. This pro­vides a whole other level of flex­i­bil­ity to the con­cept of health sav­ings. The overwhelming ma­jor­ity of en­coun­ters with the med­i­cal world could be han­dled through this type of sys­tem, elim­i­nat­ing bu­reau­cratic de­lays and frus­tra­tion.

Un­der the mul­ti­tudi­nous rules of Oba­macare, the amount of money al­lowed to be man­aged through health sav­ings ac­counts is se­verely re­stricted. Per­haps that is be­cause the crafters of this gi­gan­tic, bu­reau­cratic mon­stros­ity re­al­ized that a well­func­tion­ing sav­ings sys­tem would be easy to un­der­stand, much less ex­pen­sive and give people con­trol of their own health care. It would also elim­i­nate two-tiered sys­tems of health care, mak­ing ev­ery pa­tient equally de­sir­able from a busi­ness per­spec­tive. There should be no limit to the amount of money that can be con­trib­uted to and man­aged in an ac­count. Money un­spent at the end of the year should sim­ply con­tinue to ac­cu­mu­late with­out penalty.

If ac­counts are es­tab­lished at the time of birth, they will be even more po­tent be­cause the vast ma­jor­ity of people will not ex­pe­ri­ence cat­a­strophic or even ma­jor med­i­cal events un­til well into adult­hood. By that time, a great deal of money will have ac­cu­mu­lated. Since bridge or cat­a­strophic in­sur­ance will not be drawn upon for rou­tine med­i­cal ex­penses, its costs will plum­met, very much like home­own­ers in­sur­ance, which costs vastly less when there is a high de­ductible. Some­how over the past few decades, we as a so­ci­ety have wan­dered away from the con­cept of us­ing health in­sur­ance only for ma­jor med­i­cal is­sues and pay­ing for rou­tine ser­vices our­selves. This is largely re­spon­si­ble for the tremen­dous spike in med­i­cal costs, and by us­ing the health sav­ings ac­count sys­tem, we can re­turn to a sem­blance of ra­tio­nal think­ing.

The 5 per­cent of pa­tients with com­plex pre-ex­ist­ing or ac­quired mal­adies would need to be taken care of through a dif­fer­ent sys­tem, sim­i­lar to Medi­care and Med­i­caid, but in­formed by the many mis­takes in those pro­grams from which we can learn. Even this kind of sys­tem should have el­e­ments of per­sonal re­spon­si­bil­ity wo­ven into it.

The bot­tom line: Health care for all of our cit­i­zens is the re­spon­si­bil­ity of a com­pas­sion­ate so­ci­ety and is well within our grasp if we don’t make it into a po­lit­i­cal foot­ball. The ma­jor­ity of Amer­i­cans are un­happy with Oba­macare and would pre­fer some­thing that is sim­ple, ef­fec­tive and un­der their own con­trol. We do not have to set­tle for some­thing im­posed upon us for rea­sons other than good health care. Ben S. Carson is pro­fes­sor emer­i­tus of neu­ro­surgery at Johns Hop­kins Univer­sity and au­thor of the new book “One Na­tion: What We Can All Do To Save Amer­ica’s Fu­ture” (Sen­tinel).


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