MSAs return medical choice to people

To read Sen. Sharon Treat’s take on it (BDN op-ed, March 6), you might be fooled into thinking that the Democrats in the Legislature are the only people in Augusta fighting for better, more affordable health care while the Republicans are nowhere to be found.

Is this the truth? Far from it.

The reforms she speaks of amount to little more than the latest in the Democrats’ uninspired and ultimately failed approach to health care reform. For years now, the state has been the victim of a Democrat health care policy that has followed two basic tactics.

Tactic No. 1 is to go after the dreaded “profit motive” by adding more and more regulations and mandates for coverage by private insurance. Years of this, of course, have added millions to our insurance premiums, thus making insurance unaffordable for individuals and small businesses.

Do you think there is a big profit to be made selling health insurance in Maine? Ask the dozens of private insurers who have fled the state, leaving us with zero choices and some of the most expensive health insurance in the nation. But the Democrats aren’t done there. Tactic No. 2 always involves some expansion of one of the myriad of failed government programs. Medicare, for instance, is a mess of a health care program. Its regulatory burden is such that nurses now spend nearly as much time on paperwork as they do caring for patients. It has done nothing to contain costs and its chronic underpayment to providers is having the twin effect of driving physicians out of the state and small hospitals into bankruptcy while forcing those that remain to shift costs to the privately insured.

It should be clear that years of following these failed tactics has done nothing to improve quality, expand choice or contain costs. Luckily there are other ideas out there besides more burdens on business and more big government.

One of the ideas my colleagues and I in the other party are working on would give patients the power of choice, make insurance affordable for employers and reintroduce competition to drive down prices. The idea is medical savings accounts. Imagine rather than paying for a stunningly expensive insurance policy that covers you for unneeded services and limits your choices, you would simply receive from your employer a lump sum to be deposited in a tax-free medical savings account to be spent on the medical services you choose.

Second, imagine that your MSA (medical savings account) was paired with a high deductible health insurance policy that kicks in when your yearly health care expenditures exceed the balance in your MSA (medical savings accounts) fund. MSAs would be used to cover most expenses, with insurance available as a backup. The combined cost to employers of providing both might be as much as half what full insurance plans cost now.

It gets better. Imagine that at the end of each year you could shift unspent MSA dollars into other accounts, to pay for college tuition, retirement or care for an elderly relative. In such a way, we would introduce an incentive for people to adopt healthy lifestyles and introduce competition by encouraging people to shop around for the most cost-effective care.

There’s more. The primary way MSAs contain costs is in how they are used. Since most care would be paid for directly out of MSAs, insurance companies would be removed from the majority of medical transactions. No more medical secretaries and claims analysts to be paid to process every $25 claim. Plus, since these high deductible policies would be profitable for insurers because everyone would buy them and few would make claims against them, insurance companies would be lured back to Maine, increasing competition and further driving down prices.

What about the poor? A state program like MaineCare would simply take the place of an employer, making deposits in MSAs for those in need and purchasing low-cost high deductible plans to go with them. The poor would have complete coverage, be returned the dignity of making their own health care choices and have an incentive, as we all would, to live healthy lives.

What about the most sick? They too would be fully covered. And because everyone would have to buy high deductible insurance plans that few would use, those insurance dollars could be focused on those with the highest medical expenses. MSAs would, in effect, create a high-risk pool that everyone pays into, but only those with high yearly costs would draw from. And since an MSA-high- deductible plan would be much less expensive than today’s insurance, those who now choose to remain uninsured, the young and healthy, would be more inclined to buy in. This would spread the insured pool even farther, providing additional revenue for those most in need.

MSAs give back to the people the power of making their own medical decisions, encourage cost-effective care and competition and could reverse the trend of climbing health care costs and a shrinking pool of insured. But you are unlikely to see them if we continue the business-hostile, big government march to that Holy Grail of Democrat health plans: single payer.

That’s right, for many in the other party, the best of all worlds in health care policy is to turn over the management of the state’s entire health care system to that paragon of effectiveness and efficiency, the Department of Human Services. Believe it or not, there are bills in the Legislature right now to make it happen.

The time is now to make your voice heard. Tell the majority party you are tired of the same old tactics. Speak up for new ideas, for innovative solutions and for putting the power of choice back in the hands that matter most – yours.

Stephen Bowen is a Republican from Rockport who represents House District 63 in the Maine Legislature.