Why else would people join Costco?

The Wall Street Journal just published this story about the Bush Administration’s nascent plans to boost the use of HSAs and high-deductible plans to make insurance more affordable for low-income workers.

Here’s the lead of the story:


With health-care costs emerging as one of voters’ biggest domestic concerns, President Bush is considering promoting a tax-code change making it easier for people to buy health insurance for themselves in the open market, rather than relying on employers.

Bush is expected to announce this plan when he releases his budget and state of the union later this month.

Bush, and proponents of HSAs believe that high-deductible plans will make people more cost conscious. Early evidence does show that costs drop — because people don’t go to the doctor. And when you are “low-income” earning $50,000 with two small mouths to feed, it’s easy to forgo the doctor.

What gets to me, though, is this idea — as the Journal article says, that the idea would “make it easier” for people to buy insurance on their own, rather than relying on their employers.

Why would *anyone,* particularly health policy advisers, think a single person could get a better deal on health coverage than a group?

Society has all kinds of “group” activities that help people pool together to join risk — think office lottery pools or a membership to Costco, where you pool together and amass buying power to get lower prices. Maybe you don’t need two gallons of Pepto Bismol, but the person that pays the membership fee and uses that Pepto Bismol is also helping you buy your lower priced flat-screen TV.

I have to believe, though, that Bush understands the point of pooling risk, as he said in this 2003 speech where he advocated getting rid of state consumer protections (like the HMO Patients’ Bill of Rights) to help small businesses:

Small businesses must be allowed to come together in order to pool risk in order to provide their employees with reasonably priced health care.

So who knows what has spurred this latest Bush boondoggle; maybe it was this cartoon that inspired him.

(PS the Wall Street Journal requires a subscription to read. If you’d like to read the article and you don’t have a subscription, email me at hquach@health-access.org and I’ll send you a copy)

Health Access California promotes quality, affordable health care for all Californians.

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