A week from Tuesday on February 9, the President will release his budget for the 2017 federal fiscal year. This, of course, will be the final budget proposal of his Adminstration.
The Wall Street Journal offered an interesting financial insight yesterday -- that health savings accounts (HSA) offer better tax savings than its retirement plan cousin, the 401(k) plan. The Thrift Savings Plan is federal employment analog to 401(k) plans. Contributions to HSAs and 401(k) plans typically are not subject to federal income taxation. If you pull money out of a 401(k) plan to cover medical costs in retirement, the withdrawal is subject to federal income taxation. However, if you pull that money out of an HSA, the withdrawal is exempt from federal income taxation. Of course, medical costs are a major expense for retirees. The catch is that you have to build up the HSA account balance before you turn 65 because you can't contribute to an HSA when you have Medicare. All federal employees or annuitants receive Medicare Part A when they turn 65. A few years ago, a group of federal employees sued the federal government for permission to opt out of Medicare Part A in order to continue to contribute to their HSAs offered by their FEHB plans (without also losing teir Social Security benefits). They lost.
A friend pointed out to the FEHBlog this New England Journal of Medicine blog called Catalyst. A recent Catalyst blog post captioned "My Patients Won't Do What They are Supposed to Do" caught my eye
The spotlight has shifted from provider reliability to patient outcomes — the improvement of which is, after all, the real goal of health care. This means the goal of performance analysis is not to judge providers, but instead to assess what is happening to the health of their patients. And if the answer to that question is “Not much,” clinicians have some explaining to do.Whatever happened to personal responsibility?