Wednesday, December 20, 2017

A Real Christmas Surprise: Bring Healthcare Home in Virginia



Speaker-Designee Kirk Cox wants to play Santa Claus with the taxpayers' money to give parental leave for employees to the House of Delegates.  What Grinch could oppose 12 weeks of parental leave?  But, which Hoos are going to pay for it?  How?  A real Christmas surprise worth having would be expanding health savings accounts (HSA) in Virginia – to allow working families affordable paid medical leave.  The gift that would really keep on giving is bringing Medicaid – and all Healthcare eventually back to home to Virginia.

Expanding HSAs isn't really a gift.  It's better.  It's the right thing to do in healthcare.  Bring Medicaid and all healthcare home to Virginia.

Candidates for higher office, from both political parties, should run on this:

Virginia's Senators and Representatives to the U.S. Congress should submit a bill to move healthcare from the Federal Government back home to Virginia. 

  • Move healthcare decisions from the Department of Health and Human Services to your home. The people know what's best for their family, not some Washington politician.
  • Change policy choices from bureaucrats and lobbyists in Washington to your Virginia legislators – who will actually return your calls.
  • Increase medical services available and decrease costs, inefficiency, waste and fraud.
  • Create an economically sound, sustaining Virginia healthcare system that provides for the poor and cares for all.

First, bring Medicaid home to Virginia.  Eleven states already administer Medicaid through their own programs.  Virginia should lead, be first again, to do it rightly.  We should get the Medicaid money taken from Virginians by taxes and put them in individual Virginia Health Savings Accounts.  Health Savings Accounts (HSA) are established already under Virginia law.  The General Assembly needs to expand HSA's in the Code of Virginia to create an HSA for every Virginian.

There are 8.41 million Virginians.  1.01 million are on Medicaid.  $8.56 billion is spent on Medicaid in Virginia annually.  That's an average of $8,476 per person on Medicaid.


Virginians pay over $70 billion in employment taxes and over $12 billion in business taxes to the Federal government.  We pay far more in to Washington than the $4.26 billion we get back for Medicaid.  If a new federal law would return just $5 billion of our own money to Virginia, we could fully pay Medicaid and put seed money into the HSA's of every Virginian. 

Generous tax deductions can be given for families and employers to invest in HSAs.  Gift deductions can be made for church families, friends, work colleagues and neighbors to give to others' HSAs. 

Health Savings Accounts return control of healthcare to the individual.  Not the insurance company.  Not the government.  Not some bureaucrat.  Not some hospital administrator. 

HSA's are:

  • More effective. When patients pay directly for services, more services will compete to provide more, better medical care.
  • More efficient. When Virginia gets to keep its own money, we don't pay the pass through costs of the Federal Government. 
  • If returning Virginia's money for Medicaid comes without strings – any rules or regulations on administration from Federal bureaucrats – Medicaid patients can be provided better care with more choices at lower costs.
  • More freedom. When patients pay for their own care, they choose their own care.
  • More sustainable. The money invested and saved over a lifetime will provide for all but rare catastrophic care – which is fixed by every Virginian contributing into an insurance pool of shared resources.  Even if a large portion of the HSAs are invested in government bonds yielding a flat 6% interest, significant money will be saved over time.
  • Lower costs. Lowering the administrative costs of healthcare makes medical services cheaper.
  • More jobs. The insurance providers, banks or other financial institutions certified to manage HSA's in Virginia will invest billions in Virginia businesses.
  • More flexibility - portability. If a Virginian leaves the Commonwealth – (much to their loss) – their HSA can stay in Virginia and be drawn down like a debit card for their medical needs.
  • For Family and others. When a Virginian dies, the remainder of their HAS should be bequeathed to the HSAs as willed by the deceased person.
  • More Constitutional. Healthcare is among the plenary powers of States, not the limited powers of the Federal Government.  Follows the Constitution.
  • Include parental leave and make other affordable expansions.    


After a few years of success with Medicaid, then add Medicare to Virginia's administration.  Then, add Social Security. 

Let Virginia lead again.  Make Virginia first, again, with the right ideas creating the best governance for the dignity, freedom and power of the individual and for our common good.


James Atticus Bowden


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