Philadelphia Reflections

The musings of a physician who has served the community for over six decades

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A New Currency? Equity Savings Accounts.

Once More, Why Drag Healthcare Into This Mess?

Most people have little background in currencies and their squabbles. But everyone wants healthcare to cost less, Health Savings Accounts seem to offer promise, providing a useful introduction to much the same idea. Learning about one helps people understand the other. Although currency reform amounts to much more money, 18% of the gross domestic product is very large, and both reforms affect everyone with a common approach.

Add to that the walloping unfunded retirement cost of prolonging longevity with improved health, and the combined result might require more time than its simplicity initially suggests. The governing party seems to be putting its chips on Health Savings Accounts, big business is experimenting cautiously with it, and millions of people already have started small accounts. So kicking out illegal immigrants might help unemployment, lowering corporate taxes might bring overseas corporations back home, removing red tape might help small business, and passive investing might finance part of healthcare cost. Working backward, extracting a couple of percent from international trade might reasonably trigger an economic recovery. The public is getting strident, and it's time to take some chances.

There's safety in diversification. Four programs which might each add 2% to the economy are far less chance than one big gamble to pay off 15%. There's room in this program for three of the proposals to fail, and still have the survivor keep us from sinking. Reducing the goals of each will reduce the urgency for results. Slowing the pace will improve the designs. All of these four programs are more likely to fail because of implementation delays than because of faulty design. On the other hand, a single concept behind two or three of them will lead to success in one breeding success in the others. Foreign countries adopting one of the ideas will strengthen all of them, and only currency reform is based on a technology advance seemingly confronting the nation with foreign chaos if it fails.

We sometimes forget it is possible to succeed too well. The Bretton Woods Conference was necessary because America essentially had all the gold in the world. Therefore, nobody could buy anything we had to sell.


Change to something more affordable seems inevitable, no one really believes something so expensive can be given free to everyone. But perhaps in a democracy, it can be given free to a majority of the population. Since two-thirds of the world population is poor while we seem rich, perhaps the unfairness can be extended a few percents to include all Americans. Meanwhile, America seems to have an unspoken agreement to buy its way out of healthcare costs with research, so perhaps in a century, we can recover the indebtedness by spending too much. That's bunk, of course, but it makes a good slogan.

Originally published: Tuesday, January 10, 2017; most-recently modified: Wednesday, May 29, 2019