Bush Healthcare Plan Creates a Queasy Feeling

The Jan. 31 story, “Healthcare Overhaul Is Quietly Underway,” said the president advocated that employer-paid health plans be replaced with health savings accounts funded by the employee. These would be used to pay for day-to-day medical expenses. Also, the employee would purchase a catastrophic plan to cover medical catastrophes.

One question: How do you define a catastrophe? Is a long hospital stay for an asthmatic child a day-to-day cost or a medical catastrophe? Will the sellers of medical catastrophic insurance be able to deny sales to people who have an existing medical condition? One reason employer-provided insurance works is because it consists of group plans, and all the employees are in the group and thus granted insurance. Will the federal employees -- including members of Congress -- have to give up their present health plans and take on this new plan?

There are yet a lot of unanswered questions about health savings accounts.

Robert C. Mason

Simi Valley

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The Republicans’ plan to shift from employer-supported health plans to individual catastrophic coverage will not result in individuals taking a more active role in reducing their healthcare costs. Have any of these people seen health plans recently? Co-payments and deductibles are already so high that people monitor their healthcare costs closely. And for people with a chronic health problem that doesn’t rise to the level of a catastrophe, the routine costs of their medical care are often hundreds, or even thousands, of dollars a month, more than most people can afford even with tax-sheltered dollars. The medical care and drugs that allow people with illnesses such as diabetes, fibromyalgia, Parkinson’s, narcolepsy and others to be fully functioning members of society would be out of reach.

Employers might save in the short run, but the long-term result would be more workdays lost to illness, more employees on disability and increased costs to local municipalities in emergency room visits and disability payments.

Healthcare spending is out of control, but we need to get to the underlying reasons why medical care is so expensive, rather than turning people with health problems into a disadvantaged class.

Jacqueline Fuchs

Los Angeles

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One important issue was left out of your front-page story on the Bush administration’s quiet push to promote the use of health savings accounts. The current health insurance market discriminates against people with disabilities and other preexisting conditions. Unless companies are required to sell catastrophic coverage to all comers at the same rate, regardless of health status, people with significant health problems will be unable to buy the coverage required to qualify for the tax benefit of the health saving accounts.

Further, high out-of-pocket medical expenses can quickly wipe out such an account. The truth is that under the system, many people will forgo needed care and/or wind up spending themselves into poverty, at which point they will be forced to rely on programs like Medi-Cal, at taxpayer expense.

Health savings accounts may be a great idea for healthy people with average or better incomes. But for the rest of us, they are the wrong way to reform the healthcare system.

Laura Remson Mitchell

Winnetka