Multiple hits meaning more surgeries per period that the savings can be refilled. Like, say, if you get into a major accident requiring multiple surgeries, or get a condition that requires multiple surgeries or extensive treatment. People can get seriously ill, not just "average" sick.
The $5000 deductible is per year. Your typical decent high-deductible plan will have a $5000 deductible and 100% coverage thereafter until year end.
The worst-case scenario with such a plan is that you end up with a chronic condition that requires extensive treatment every year, at which point it will cost you $5000 per year. Oh, and that's typically a per-family deductible, not per-person.
Just to put that in perspective, health care spending in the US as of 4 years ago was about $7400 per person. It's likely higher now. So if we managed to get into a situation where everyone was spending $5000/year on the deductible and $100/month on premiums, that would actually be less spending... and that assumes that everyone is sick all the time.
Now in practice, we won't get there; even high-deductible plans cost have more than $100/month premiums when you take away employer subsidies. But the point is that having high deductibles and HSAs that automatically get money put into them every year for those who can't afford to do so themselves is not a completely unreasonable approach to the situation. Actually getting the politics and details worked out could take some work, of course.
"HSAs that automatically get money put into them every year for those who can't afford to do so "
That's encouraging too, although I bet it doesn't refill at the same rate as topping it up yourself?
I still think it's the wrong thing to do, though. I can appreciate the market pressure idea, but there are other ways to lower prices charged for procedures, and this way still involves people actually worrying about whether they have enough money for health care. Do Americans realize just how much mental angst they cause themselves actually devoting this mental energy to worrying about whether they will have enough money to make themselves not sick, if they get sick? All this pride or whatever at choosing clever HSA solutions or having an awesome work health care policy is simply relief at not having to worry about health care bills. It's not a value add, you're simply avoiding the horror of a double whammy: getting very sick and going bankrupt (or seeing your lifestyle change drastically due to budget concerns). It's the awesome opportunity to get completely fucked.
But if this HSA/whatever is some kind of compromise towards progress... well, hope it works.
That's encouraging too, although I bet it doesn't refill
at the same rate as topping it up yourself?
No one is doing that sort of thing yet, so it's impossible to say how it would work if it were done.
I think we Americans have a pretty good idea of how much the current situation sucks. The issue people worry about has three aspects (in a very oversimplified view):
1) How do we make it not suck for individuals?
2) How do we, as a society, stop spending 16% of GDP (and climbing) on healthcare?
3) How do we avoid some sort of explicit rationing?
People's worries are that a lot of proposed solutions for #1 seem to imply giving up on #2 or #3. I suspect the worries about #3 are overblown, but it's hard to say without doing an experiment of course.
Luckily, perhaps, experimenting on humans is considered acceptable in politics. ;)
The details may change between the policies, but I do think the limit is per period, not per incident (how would you classify that, anyhow? Does several rounds of chemo count as one, or more incidents?).
