With this in mind, it's not surprising that the centerpiece of Bush's upcoming State of The Union address is apparently going to be shifting the healthcare system to private healthcare savings accounts. One of the many obvious problems with HSAs is that the system assumes that employees will have surplus income to contribute to them. In the Wal-Mart economy, that's becoming increasingly rare. And health insurance works by spreading the cost of healthcare out among a large group of people, both healthy and sick, ensuring that those most in need are not those least able to pay. Bush's system, by incentivizing healthy people to leave insurance pools, would essentially destroy that balance, making healthcare more expensive for those who can least afford it.
In a sense, this is exactly like Bush's Social Security privatization plan. Why share a burden that can be forced upon the individual? Bush's National Economic Council chairman Al Hubbard sings the praises of "trying to give consumers the opportunity to be engaged in the process." But don't 'consumers' (see also: patients) have enough to worry about without seeking out and then poring over healthcare industry data they don't really understand?
At the end of the day, these are band-aids on a mortal wound. We don't have a very good healthcare system in the United States. The problems that Bush's adviser cites are indeed actual problems. But further privatization of the system is the exact wrong answer. It's too dangerous to leave the health of our nation to a private pay-to-play system like the one Bush is pushing. The only answer that truly makes sense is the one used in every other industrialized nation -- a universal system of public healthcare.
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