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Carson, who may be in Trump administration, likes HSAs, which most benefit the affluent

Ben Carson, M.D., who ran against Donald Trump in the Republican primaries before endorsing him, may play a major role in setting the soon-to-be President Trump’s healthcare agenda.

Politico reported that Dr. Carson may become secretary of the Department of Health and Human Services in a Trump administration. In an interview with the news outlet, Dr. Carson said “of course” he intends to help create an Affordable Care Act replacement.

“The replacement must come first” before dismantling the current healthcare-reform law, he  said.

FierceHealthcare said that Dr. Carson’s influence could mean a greater emphasis on health savings accounts  (HSAs).  Dr. Carson, a retired neurosurgeon, campaigned on replacing the ACA with a plan that includes what he dubs “Health Empowerment Accounts.”  These are tax-free savings accounts to help cover out-of-pocket expenses and premiums for the insurance plans of  consumers’ choice.

Paul Ginsberg, Ph.D., director of the Brookings Institution health policy center,  said that the accounts are most useful for high-income individuals with high-deductible health plans because they can serve as both transactional and investment vehicles. But they won’t be of much use to low- and middle-income people.

To read a FierceHealthcare overview of this, please hit this link.

To read the Politico piece on this, please hit this link.

 


Dr. Carson’s ‘insurance death spiral’

circle

Vicious Circle by Jacek Malczewski,  in the National Museum, Poznań, Poland.

Modern Healthcare’s Harris Meyer looks at Dr. Ben Carson’s healthcare-reform proposals and finds it shows that the retired pediatric surgeon doesn’t understand the economics of health insurance.

The core of Dr. Carson’s proposal is make heath savings accounts available to everyone, with the idea, he says, of weaning people off the government “dependency” involved in the Medicaid and Medicare programs.

He  does say that people could stick with those programs if they wanted.

But the trouble is, says Mr. Meyer, imaking Medicare and Medicaid voluntary  could “unravel the insurance risk pool in the same way that proposals to make Social Security voluntary would unravel the retirement safety net. ”

“Younger, healthier and more affluent Americans could take Carson’s government-provided HSA money and combine it with their own funds to buy comprehensive health insurance plans or pay for their own care out of pocket. But older, sicker and poorer Americans who wanted to stay in a government health insurance program would have to pay much higher premiums and likely accept less-comprehensive benefits because the safer insurance risks had exited the program.

“Actuaries call that an insurance death spiral. That apparently lies outside Dr. Carson’s medical expertise.”


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