Michael F. Cannon, Director of Health Policy Studies at Cato Institute, Discusses Health Savings Accounts

I am Michael Cannon. I will be talking about replacing Obamacare, particularly one idea that has been introduced as legislation and will be the topic of this Cato Institute Hill briefing tomorrow. We will be talking about the bill to expand health savings accounts (HSAs) that Flake and Brat have introduced based on my Large HSAs proposal.

You can follow me on Twitter at @MFCannon, and on Facebook at Darwin's Fool. I blog at www.Cato.org/blog and at www.darwinsfool.com.

@jr.hebert: Hi @michaelfcannon I understand economic arguments for replacing Obamacare, but I don't think they are politically realistic. I also believe Obamacare despite its issues fixed many serious problems with our system. Why not focus on improving Obamacare instead of hopelessly trying to replace it?  Hi, @jr.hebert. The problem is that Obamacare cannot be fixed. As long as it exists, it will continually erode coverage for the sick.

We can see that erosion happening right now. At the same time Obamacare plans are getting more expensive, coverage is getting thinner. Obamacare literally punishes insurers for offering coverage attractive to the sick.

@career.killer: How do health savings accounts work?  You definitely have the best alias yet, @career.killer. HSAs are a tax preferred savings vehicle that attempt to reduce government control over your health care decisions. "Large" HSAs would allow a typical worker to control $13,000 of their income that their employer currently controls. 

If you have a qualified, high deductible health plan, then you or your employer can make limited tax-free contributions to an HSA. You can then use that money to pay for your medical care tax-free, or save it and let it grow tax-free.

HSAs are actually the basis of the legislation we will be discussing tomorrow at a Cato Institute Hill briefing. Sen. Jeff Flake and Rep. Dave Brat have introduced a bill based on my idea to create "large" HSAs. Each will speak at tomorrow's event.

@career.killer: @michaelfcannon Thank you. I try. Can I use the money for non-medical or "alternative medical" expenses too?  If those expenses make the IRS list of "qualified medical expenses," then yes. 

For more on what a market system in health care would look like, see here. To learn how to get there, come to tomorrow's Cato briefing.

@career.killer: Whoa whoa whoa, so the IRS will be the final arbiter of what is and isn't a medically necessary expense? Have we learned nothing from their handling on non profit exempt statuses? @michaelfcannon: Please, @career.killer. *Congress* will be the final arbiter. Which is why you don't want any special tax preferences or subsidies for health care at all. They all give politicians (and bureaucrats) control over your health care decisions.

@horsey.wofford: @career.killer I agree. That sounds like a terrible idea.  It is, @horsey.wofford, and it is happening right now! If you come to tomorrow's briefing, however, I will explain how Large HSAs minimize government's ability to use this tax preference to manipulate your health decisions.

@chief.russell: How does your plan protect healthcare consumers from the price gouging prevalent  in the industry? You can choose your emergency room in an emergency, and if you live in a rural area you may not have access to multiple providers. Good question, @chief.russell. Price-gouging in health care is almost always and everywhere the result of government intervention. 

Government diminishes price competition by insulating consumers from the cost of their care. It also allows gouging by protecting doctors, hospitals, and pharmaceutical companies from competition.

Letting consumers control their healthcare dollars, rather than letting government or employers control that money, will go along way toward eliminating gouging. 

Beyond that, we need to eliminate regulatory barriers to competition among providers. And important example is restrictions on telemedicine, which limit access to care for people in rural areas.

@horsey.wofford: @michaelfcannon Will your plan fix what's wrong with Hillary? And why do we need a national healthcare program at all? Shouldn't this be up to the states?  Hi, @horsey.wofford, if that is your real name. We would get better health care if we devolved control to individuals, rather than to the states.

@america.strange: Can they be used to pay for abortions?  Not sure about that.

@hillarwho: Has the CBO scored the bill yet? What are the estimated savings compared to Obamacare? Where are the costs shifted to? What are the bill numbers? No scores yet. And while I have read the bill, I will be darned if I can remember the bill number. I guess you'll have to come to tomorrow's briefing!

@prince.allee: Government run healthcare sucks. Insurance companies playing doctor sucks too. Do these accounts cut the middlemen out at all? Prince Ali, Wonderful He: We will probably never be able to get rid of middlemen in health care. In a market system, even the middlemen would have to compete to justify their existence.

@michaelfcannon: OK, gang. You all have been great. I look forward to meeting you all tomorrow.