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I'm one of the so-called "wealthy" people with an HSA. My employer put a bunch of money in it for me, and I put a few bucks in out of each paycheck. I went to the doctor today, in fact, and I pay my co-pay or out-of-pocket with a VISA debit card linked to my HSA account, which is simply a checking account. Regular checks, regular debit card.
But there is nothing to stop me from using that debit card or those checks anywhere I want. There is no difference. It's just a checking account. Point being, how is a struggling family who probably doesn't even have any money in their real checking account -- provided they even have one, which many don't -- supposed to maintain one of these accounts? Burger King doesn't provide them for line cooks. Poor people aren't going to carry around a debit card with cash in the account while their kids are hungry. It's just stupid.
For people like me, with an income and resources, sure, the HSA is a pretty good system. But it's ridiculous to call it any sort of solution to the health care crisis.
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