The American Spectator

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The trouble with the current conservative answer is that it would likely drive down costs for most people but drive them up for the most vulnerable Americans — the poor and the old, who would be stuck in ever more costly traditional plans while the young and the healthy flooded into HSAs.

br> The point behind HSAs is that higher deductibles result in enormous savings in health insurance costs, and that savings can be used to fund the HSA with cash to pay for expenses below the deductible. In my own case, I save with my $5,000 deductible far more than $5,000 compared to what I am told standard family coverage costs. With cash in the account to cover the deductible, the HSA is far better for the sick than standard coverage, because they have cash on hand to finance what they choose for their own care at least up until the deductible. It is also far better for the poor, who have cash to finance routine preventive care that health insurers generally do not pay for, and they can make a net profit out of the deal besides.

Would it be too much to ask for the authors to call the acknowledged national expert on HSAs, John Goodman at the National Center for Policy Analysis, who does have a telephone, and ask him about the false criticisms of HSAs that they embrace? This failure to acknowledge and recognize what has come before is a general problem for the conservative movement, and reduces our effectiveness sharply.

Douthat and Salam do have some good ideas. While their health care section is confused, their discussion of education is tremendous, with a focus on school choice among public schools for elementary and secondary education, and a transformation of higher education focused on true benefits for the working class. Conservatives should also embrace their call for government policy to get out of the way and even promote suburban development that would produce highly attractive, affordable housing for the working class. Their ideas for expanding highway, road, airport, and Internet infrastructure throughout flyover America are also valuable to the extent the private sector is not already doing that.

But Big Government is not going to work any better for conservatives than it did for liberals, in terms of achieving public good, rather than just short-term political power.