Diagnosing effects of health savings accounts

According to the trade group America’s Health Insurance Plans, approximately 3 million Americans are enrolled in HSA-eligible plans. More people will continue to be steered to these high-deductible plans by their employers, said John Nelson, formerly president of the National Association of Health Underwriters and a principal of Warner Pacific Insurance which sells health insurance plans to small businesses. “Companies can’t continue to sustain these rate increases, so employees will have to bear out the risk.”

A survey by Mercer Human Resource Consulting found that 73 percent of employers were more likely to consider offering HSAs to their employees this year.

Ironically, HMO plans, which were shunned just a few years ago, are becoming more popular — albeit reluctantly. Kathleen Stoll, director of Families US, a healthcare consumer advocacy group, is seeing a rising trend of consumers moving to the tighter managed-care plans that put a limit on patients’ visits to specialists and treatment costs. “People are saying, ‘I can live with some of that if costs come down and I can lower my premiums.’”

So can the healthcare industry be reformed to bring down costs for everyone? Gleib and Remler’s thoughts are to add more “bite” to HSA, either by increasing cost-sharing or adding more coinsurance. However, that would put consumers at more financial risk.

"It’s a trade-off between more cost-sharing and less insurance protection," said Remler. The more you move away from insurance funding, the more vulnerable people are because they’ll be spending more out-of-pocket costs. That means less protection for people who get unlucky and end up having serious illnesses.”

Even though HSAs may just be the current flavor of the month, they and other reform vehicles attempting to lower costs will have the long-term effect of making the healthcare industry more transparent, said Nelson.  "As people spend more of their own money on procedures, they’ll be asking more questions, and doctors and hospitals will have to learn how to answer them. It’s amazing that $1.7 trillion is spent on healthcare every year, but few people know how much it will cost to see a doctor and get their flu taken care of. So high-deductible plans and HSAs will ultimately revolutionize this business."

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