Alright, second interesting health study of the day. Health savings accounts are misogynistic. Here's the deal: Non-elderly men and women tend to use the health care system in very different ways. Men rely on it for events-based care, physical traumas and serious illnesses and the like. Women tend to deal with it much more routinely, requiring mammograms and pap smears and reproductive health care on a fairly regular schedule. So when you put men and women into high-deductible plans, where the first X amount of health spending comes out-of-pocket, you end up seriously disadvantaging women.
A new study by a group of Harvard Medical Researchers actually ran the numbers. They found the median expense for men under $45 in HSAs was around $500, while the women racked up costs nearer to $1,200. The upward distribution ranged more widely for women as well. About a third of men spent over $1,050, while 55 percent of women broke the same barrier. Dr. Steffie Woolhandler, the lead author of the study, summed up the findings this way: "When an employer switches all his employees into a consumer-driven health plan, it's the same as giving all the women a $1,000 pay cut, on average, because women on average have $1,000 more in health costs than men."
That's pretty significant. Add in that women are already paid less than men, and the move towards high-deductible health plans begins to look grievously unfair, particularly because what accounts for the differing routine costs are health expenses that we tend to consider meritorious: mammograms, cervical cancer screenings, etc. Which all goes back to what I was arguing in the previous post: There may be a role for cost-sharing in health plans, but it needs to be very thoughtful about which procedures and treatments are included. Widespread adoption of standard HSAs would, among other things, amount to a serious penalty on being born female.
