[Prudence]

First of all -- I've watched the definition of "catastrophic" shift over time. Ooops, that's not covered because we don't know what it is. Ooops, that's now a chronic condition and we don't cover that. Ooops, that now affects so many people that it's considered routine, not catastrophic. I don't want what little coverage I have taken away for ill-defined speculation. I want to know what "catastrophic" covers. I don't want to lose what I have now, see that replaced with high-deductible "catastrophic" coverage, and then watch that whittled away until it's all pay-as-you-go.

And maybe we're weird up here. Our HSA type accounts expire every year. Whatever you put in you have to spend or you lose it. Which is frustrating. Is this the year I need $10,000 in emergency dental work like last year? Or is this the year everything's fine? $10,000 is a lot of aspirin to be buying on 12/31.

I suppose rollover HSAs are beneficial to a point, but it still leaves me with significantly less coverage than a year ago which was less than the year before that, and so forth.

An example: I broke my arm in a car accident 2 years ago. The bone wasn't knitting together very quickly so they wanted to send me to surgery and install pins and put me through another 10 weeks in the cast (after already doing 6). The other option? Put me in a removeable splint because increased activity -- as long as the bone is stabilized -- has been shown to increase bone healing. Traditional insurance covers the former, and I had to fight like hell to get the latter. Which worked wonderfully AND I was able to take showers. Another one of my many fears (it's one of those days) is that in the health care future people will be faced with similar decisions, only with much higher stakes. Do I take the covered, "catastrophic" treatment that's covered but is more painful/takes longer/leaves me out of work/less successful? Or the non-covered and objectively superior treatment that I can't afford? Actually, the system's already like that.

I'm really incoherent today. I should table this until I've had sleep. I'm trying to say that I'm not against the plan in theory. In the past I have advocated for a national system of catastrophic care, and HSAs sound better for other coverage than nothing, but I'm skeptical of how this would actually be put into place. I don't think that "they" actually have my best interests at heart. If I thought for a second that this would open the door to more universal coverage and that lower overhead would lead to lower costs I'd be all over it. But I don't. My gut tells me that it's a way for employers to dump the costs of employee healthcare and shift the burden to employees, who will see neither increased wages (to reflect that "responsible individual" spending) nor decreased health care costs.

But then again, I think people suck. I really need a nap.