Flexible Spending Accounts
I think that if anything typifies the American approach to health care reform, it's flexible spending accounts (FSA). These accounts are clearly the devil's handiwork. They work as follows: You are allowed to set aside X pre-tax dollars per pay period that gets placed into a "savings account". The benefit is that you don't have to pay tax on that money and you can use that money for medical purchases. But here's the rub, if you don't spend the money by the end of the year or some designated date early the following year, you lose the money. So, you can play it conservative and only set aside a few dollars for medication, etc. but if you anticipate a lot of expenses, it may be a good idea to set aside more. But don't forget that you're in the US, so it's a bit of a crap shoot as to what your insurance will cover. Two years ago we anticipated a largish expense but were pleasantly surprised that it was covered. As a result we had to frantically find ways to spend the money before the plan ran out. Last year, we put aside far less, and, you guessed it, we hit a lot more expenses. As I noted in a FB comment, trying to budget for an FSA is like trying to budget for a trip to Vegas with the condition that gambling will be required.
A far less draconian approach would be to allow users to roll money over from previous years but not allow them to contribute more to the plan once it has reached a designated cap. For example, if I contributed $200/month last year, I can't contribute more the following year until the account contained less than $2400. That would actually encourage people to use these things for the purposes they were designed, i.e., give consumers a reasonable way to cover medical costs while also making more costs the patient responsibility. (In fact, it's not clear to me why it would be so terrible to just let people accumulate arbitrarily large amounts in these accounts with the requirement that it get used for medical expenses, I guess they wanted to make a compromise between encouraging savings for health care expenses and making medical expenses tax deductible across the board)
A far less draconian approach would be to allow users to roll money over from previous years but not allow them to contribute more to the plan once it has reached a designated cap. For example, if I contributed $200/month last year, I can't contribute more the following year until the account contained less than $2400. That would actually encourage people to use these things for the purposes they were designed, i.e., give consumers a reasonable way to cover medical costs while also making more costs the patient responsibility. (In fact, it's not clear to me why it would be so terrible to just let people accumulate arbitrarily large amounts in these accounts with the requirement that it get used for medical expenses, I guess they wanted to make a compromise between encouraging savings for health care expenses and making medical expenses tax deductible across the board)