Reform Proposal 1

By Kaylin Holthaus

Congress should pass and enforce a legislation that promotes access to quality primary care for all United States citizens. In doing so, Congress will pass legislation on the production of tax deductible outpatient and primary care, and also mandate that all individuals who are employed have the option, and are encouraged, to create a Health Savings Account (HSA). With these new legislations, a new door will open to provide greater access to primary care without the burden of a deductible or co-pay for using such services. Also, Congress will mandate that outpatient and primary care medical facilities are accessible or in close proximity to the community in which individuals live. The Comprehensive Health Care Act states the following about the creation of tax deductions and Health Savings Accounts.

“Specifically, the Comprehensive Health Care Act:

1. Provides all Americans with a tax credit for 100% of health care expenses. The tax credit is fully refundable against both income and payroll taxes.
2. Allows individuals to roll over unused amounts in cafeteria plans and Flexible Savings Accounts (FSA).
3. Makes every American eligible for a Health Savings Account (HSA), removes the requirement that individuals must obtain a high-deductible insurance policy to open an HSA; allows individuals to use their HSA to make premiums payments for high-deductible policy; and allows senior citizens to use their HSA to purchase Medigap policies.
4. Repeals the 7.5% threshold for the deduction of medical expenses, thus making all medical expenses tax deductible.” ¹

“A Health Savings Account (HSA) is a special account owned by an individual used to pay for current and future medical expenses.”² Health Savings Accounts are already in use today, but with our reform, Congress would allow all individuals who are currently employed to develop a HSA. The Health Savings Accounts can be used to pay for any type of medical expense an individual may obtain, either past, present, or future. An individual may pay into their account at any time and can contribute any amount of money from their own paycheck. The money set aside in a HSA then accumulates interest just like a checking account or savings account people have at their banks that allows for means of paying for unexpected or necessary medical expenses. The accumulated money, if not used in a year, can roll over. The Health Savings Accounts are structured as long-term accounts that individuals will have access to without penalties or fees charged towards accumulated funds. “A health savings account (HSA) is an account into which you can deposit tax-free money to be used for future medical expenses. Health savings accounts were established in 2003 and are becoming more common. Health savings accounts are part of a larger trend known as consumer-directed or consumer-driven health care. HSAs and consumer-driven health care plans have been promoted by companies and the government as one way to help control health care costs. The goal of an HSA is to reduce the money spent on health care by placing more of the responsibility on you to shop for health care.”³

Congress will mandate that medical expenses will be tax deductible without consideration of gross income. With medical expenses being tax deductible, there will be less tax dollars retained by the government. This will put a constraint on the government and help with the reduction of unnecessary spending which limits the Government to spend what they can afford. This in return will slowly reduce our national debt. “A deduction is allowed only for expenses primarily paid for the prevention or alleviation of a physical or mental defect or illness. Medical care expenses include payments for the diagnosis, cure, mitigation, treatment, or prevention of disease, or treatment affecting any structure or function of the body. The cost of drugs is deductible only for drugs that require a prescription, except for insulin.” ⁴

According to Shi and Singh, “One of the goals of primary care is to bring health care as close as possible to where people live and work. In other words, true primary care is community based. It represents convenience and easy accessibility.”⁵ With the pass of this reform, communities will receive federally funded satellite clinics. Members of communities should be allowed primary and outpatient care in close proximity. With the close proximity of outpatient and primary care, patients are able to have access to medical care without having the expense of travel to an outpatient and primary care facilities. This will also include close proximity for free clinics for those who do or do not have health insurance or directly for the poor. “Free clinics have three main characteristics: (1) services are provided at no charge or at a very nominal charge [based on one’s ability to pay], (2) they are not directly supported or operated by a government agency or health department, and (3) services are delivered mainly by trained volunteer staff.”⁵ These clinics also include women’s health medical care facilities. The cost of adding these addition clinics based on need may be an added expense, but with this added cost, the access is improved and the quality of outpatient and primary care for individuals and the facilities will increase.

Based on this proposal citizens will have access to their primary care practitioners to provide screenings for medical disorders or diseases. This access will allow practitioners to manage care in an outpatient setting and reduce the need for inpatient services. The focus should remain on maintaining wellness at a tax-deductible benefit. Overall health care relies on all levels of access and quality of medical care.

References:

1 Ron Paul, http://www.lewrockwell.com/paul/paul407.html

2 http://www.ustreas.gov/offices/public-affairs/hsa/pdf/all-about-HSAs_072208.pdf

3 Mayo Clinic Staff, . (2008, May). Health savings accounts: Is an HSA right for you? . Retrieved March 1, 2010, from http://www.mayoclinic.com/health/health-savings-accounts/ga00053

4 http://www.irs.gov/taxtopics/tc502.html

5 Shi, L., & Singh, D. A. (2008). Delivering Health Care in America A Systems Approach (Fourth ed. , pp. 243-287). Jones and Bartlett Publishers.