Etalkinghead

Tonight’s debate centers on domestic policy, including how to keep our fractured and hyper-expensive health care system from going even further out of control.

The centerpiece of the Bush plan, which he is certain to trot out this evening, is “medical savings accounts”

The plans let workers create tax-free savings accounts to use for medical costs, combined with lower-cost, high-deductible insurance to cover major medical care.

If you’re young and healthy, this may not sound like such a bad idea. But if you’re planning on getting older, I can guarantee you there is a chronic illness with your name on it.

From the NY Times, here’s the money quote

Uwe E. Reinhardt, a Princeton University economist and health policy expert, said the new plans were “a bum deal” for people with chronic illnesses. But “for chronically healthy people,” he said, “it’s another 401(k) savings account, and Wall Street is licking its chops at the prospect of managing the money.”

If Bush spends any time at all touting his medical savings accounts in tonight’s debate, that quote is a “two-fer” for Kerry.

A chronic illness is one lasting 3 months or more, by the definition of the U.S. National Center for Health Statistics

Examples of chronic illnesses include asthma, diabetes (I & II), sickle cell anemia, cancer of all kinds, congestive heart failure, high blood pressure, high cholesterol, renal failure, osteoarthritis, Alzheimer’s disease, Parkinson’s disease, stroke, rheumatoid arthritis, fibromyalgia, chronic fatique syndrome, Gulf War syndrome, anxiety disorders, cystic fibrosis, AIDS – and a mass of other illnesses and disorders.

Each and every one of those chronic conditions can land you in the hospital or a nursing home, where costs reach the catastrophic level within minutes.

But what about the “maintenance”, the every day costs which medical savings accounts require you to pay out of your own pocket, or would have to be covered by an additional policy?

If you have high cholesterol, you know you have to show up at the lab on a regular basis for a little blood-letting. There goes a quick $150 or more.

The CDC estimates that 101 million Americans have cholesterol levels over 200mg dL. That’s one hundred and one million Americans who have good reason to be suspicious of medical savings accounts.

High blood pressure? Blood pressure clinics are often free, but when your medication needs to be adjusted you win a visit with the doctor himself – lotsa money, especially if the medication levels are tricky (they usually are) and require multiple office visits within a short period of time.

Chronic illnesses mean a lot of smaller bills; small change to the wealthy, but even one lab bill can be catastrophic to middle class budgets.

As to the second part of the above quote – “it’s another 401(k) savings account, and Wall Street is licking its chops at the prospect of managing the money.”

Knock that one out of the park, Mr. Kerry.