Bipartisan legislation aims to get more Americans into high-deductible insurance, but perils would remain.

For thrifty consumers, there’s a lot to like in high-deductible health insurance. The plans offer low monthly premiums and those fees fully cover preventive care, including annual physicals, vaccinations, mammograms and colonoscopies, with no co-payments.

The downside is that plan participants must pay the insurers’ negotiated rate for sick visits, medicines, surgeries and other treatments up to a minimum deductible of $1,500 for individuals and $3,000 for families. Sometimes deductibles are much higher.

Let’s keep it civil.

Yeah, that’s rough buddy.

I didn’t realize Max OOP limits were so high. I’d say it’s bullshit that HSA contribution limit isn’t tied to the max annual OOP.

My family OOP is lower than family contribution limit. Hadn’t realized that it could be any other way.

It’s not a hardship, though. I’m healthy with no chronic conditions, and I’ve made the specific choice to go with a HDHP to get the HSA, which I treat like a pre-tax Roth IRA. If some catastrophe happens, it’ll be easier to pay for surgery out of the HSA than a real Roth, but I don’t expect to see doctors until Medicare. I don’t even pay for glasses out of the HSA, because its future value is too great.

This is a perfectly rational individual choice to maximize my personal benefit, but it is terrible policy at the population level. It means there are less resources available for the small minority of people who do have expensive health issues, because I’m diverting my insurance premiums into a retirement fund. This is a recurring theme in right wing policy - it’s fine for people whose lives have no major complications, and people with special circumstances are too few to consider. You have to look out for yourself, and a few people will fall through the cracks, which is a borderline sociopathic attitude.

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