Public health insurance-essential for system lifeguard-American health

There are a lot of discussion on the types of insurance proposals which will be required in the new health care system, which are currently being negotiated in Congress. President Obama has only come out in the framework of public health, which is opposed by private insurers, who say that they cannot compete with the plan, public health, which didn't have to generate a profit. Supporters claim public plan correctly say that it will have more choices and create more competition. Opponents argue that private health plans would go out of business, leaving only the system of health care completely Government.

Of course, all parties are exaggerating and taking up extreme positions. They are all at the time of the compromise and hopefully reach some form of agreement. Sad part is that at the moment they do not seem to be thinking of the person in the Centre of all this-the patient. Widely considered that the costs of health care, too many in this country, at the same time Americans at least 47 million are uninsured. So, from the perspective of patients, if you have health insurance, you pay way too much and getting a low value, and if you do not have it, and then simply continue to have problems. What dreadful choice. The noting of America.

The objectives of the capital health system are to lower costs and extend care to the uninsured. Obama wants a bill on his desk in October at the latest. Where can I start the Congress to compromise and why is it that Republicans in particular believe that the plans for public health are likely to be so dreadful. What is proof of this belief beyond their own philosophical ideas. Regularly make up alleged ogre "socialized medicine" whenever discusses plans for the public, but there is no evidence that countries with Federal systems with greater control over their health care, particularly in Europe, have worse health outcomes, the UNITED STATES. In fact, the contrary is TRUE, the results are much better overall health and costs much less money per capita of the population.

As a physician who has lived and worked in the USA, Australia and the United Kingdom, and who has an interest in the Organization of health services, I think that America can move forward in a way that is relatively simple, as long as we always keep the patient at the center of each system of health care plan. It is important that we do not design a system of health care primarily to protect the level of profit for some or all of the various components, whether they are vendors, insurers, health or pharmaceutical companies. We have the ability to pick the best parts of other health systems around the world, including those in the possible reform of American health care, and we should learn from other countries.

What can we do?

Firstly we should philosophy private partnerships. Australia is a good example where this works great. This means that public and private, not just private. The activities of the core American and social philosophy are based on the entities so that each new capitalist approach to health care must combine the need for profits in certain sectors of the health system, with the need to develop a number of basic public health services, which may be less likely to ever make a profit. The financing of care to include selection and should be implemented in many cases, through payments for annual or episodic whole person care, and not on a piece of individual rates as at present. These payment systems capitated works well for Kaiser Permanente, and in the UK. The primary benefit of this approach is rather to force more resources to the prevention of diseases and wellness promotion, and not for the treatment of diseases, which have begun already.

The public health care system, seemingly strongly supported by President Obama includes universal basic health insurance, as well as insurance of catastrophic care. We know that this type of system is also in America and is generally accepted and popular, because we have a very successful example of Medicare for seniors. Effectively widening the basis for Medicare for other populations could prevent many of the bankruptcy caused by the cost of health care and could include many of the current uninsured. Public insurance then you will probably pay for many services, emergency health and isolation, as well as the public health service, outstanding and postnatal care, and early, as well as some special care population, who cannot afford private health insurance, such as unemployment benefits, and some depletion or geographically isolated groups. Of course they would still be Medicare for seniors. These are areas where it will be less competition with private insurers, who are usually kept from them, but, of course, any private health insurers will be able to enter these markets and to compete if they wish to.

The private component might be funded with assistance from the wider tax incentives financial or similar tools to encourage most of the people (or businesses) to purchase private insurance. The aim should be that at least 80-90% of the population should have private insurance or comprehensive insurance or insurance payment to support the core Government provided insurance. It is important to achieve this level of insurance to ensure that everyone is financially responsible for at least a reasonable proportion of our health care costs. Here the Republicans are right as it is important that we do not care as something, which is supplied free of charge. The private sector should offer the full range of services from birth to death, but the industry should be more precisely regulated, so that they, for example, should be prevented from excluding patients due to the existing conditions. They should also have the possibility of additional charges for some services, "low", such as plastic.

These ideas are taken from and recognize the best parts of America, Australia and British healthcare systems. No country has a system of excellent health, and no country will ever. America can afford to choose the best from other countries as debates how to improve its health care system. Lets hope that Congress may be creative, look outwardly, and do not get the time down in political dogma.

Peter Yellowlees MD has recently published "health in the age of information-how can you and your doctor may use the Internet to work with". available in the http://www.InformationAgeHealth.com and most shops. E-Book download from RTM API, Blackberry, PDA and other mobile devices called "4 simple steps to better health-the appearance of the Interior" is available at Smashwords http://www.smashwords.com/books/view/1271in

Insured vs. uninsured-American health care template

Everyone, at some time in his or her life, will have to seek medical care. American health care system is the industry Dollar billion, and rejects people who cannot afford their services. The current system of health care is divided into two groups--care for insured and do not care or limited care for the uninsured. The nature of the medical and personal care that the person is under the current American system of health care depends on the status of insurance of the person. In the land of equal opportunities, segregation continues to be practised.

It is well known fact that people have health insurance receive better medical treatment and personal care providers than persons who do not have health insurance. The insured are treated with dignity and respect. Unfortunately, the uninsured are treated with indifference and disdain. For those uninsured receive care can be very demoralizing and frustrating experience.

When a person calls a doctor appointment, the first question of the medical staff of the office is, if the person has health insurance. If the person does not have health insurance, the attitude of the staff of the Office varies considerably. Many times the person is asked questions abrasive financial and invasive. Cash payment is in advance of the visit will be scheduled, or at the time of the visit before the services are provided. Some medical authorities refuse to provide medical care, if there is no health insurance and the person is not able to pay cash in advance. Uninsured persons seeking medical care face embarrassment because they do not pay the full medical services without the benefit of the plan of the monthly payments. They are made to feel like their health is irrelevant, because they are uninsured.

In some hospitals and physician offices, a much different kind of medical care, which is rendered uninsured patients with medical care, delivered to the insured patients. During the interview with Carolyn Hagan, uninsured residents of Oregon, as it was discovered that uninsured patients are shoddily treated. In accordance with because it has no Hagan health insurance, she's unable to obtain necessary medical care for her heart. Hagan stated, "I have so much trouble getting medical care, because I'm uninsured and cannot afford the cost of health insurance. Cannot afford the high cost of medical research, that it should be. None of the doctors will treat me, except for occasional brief checkups because I'm not profitable to them. We at health insurance and contact to See if you can get insurance refused to insure me because I have trouble with the heart. I had to cancel medical tests because of funding and requests assistance with the cost has become unavailable. Care that is needed is expensive, and it is so frustrating, because nobody can help me. I feel like no one cares. "

Hagan is production American citizenship, which works and pays taxes, and she's among the middle class, which is being carried out by the American health care system. Due to the health insurance company exemption is not insurance and not created, it is able to pay cash in advance for the care you need. At the current health care system in America is Ana is that even if it is a national American hard work, she doesn't matter because it may not help to increase the bottom line of the healthcare industry.

Many lawyers refuse to work with people not insured and will be able to pay for medical care on the agenda of the monthly payments. Disable this additional prevents thousands of Americans to obtain the necessary health care. American health care system has become so convoluted and costly that American citizens are forced to seek care outside the United States. Places such as Argentina, Singapore, Manila, Bangalore, and Costa Rica to ensure high-quality, low-cost health care us citizens that America should be providing to its own nationals.

American society for the insurance of the poor--people are not able to obtain health insurance. Private insurance is too expensive for most people to afford, and rules, which are affordable for the people of the middle class and lower are frequently insufficient in medical services, which include. American insurance companies have exclusions, which prevents many people eligible for health insurance, even having insurance would prevent further illness and allow for current disease, therefore reducing medical costs.

America has some of the best trained medical professionals, and the cost of their education is enormous. Nobody can expect them not to make a good life for their profession; However, the migration of medical treatment to countries outside the UNITED STATES is essential to indicate that the American health care system must be revamped and made affordable for all.

Many attempts to reform health care in America; until finally, it may not be sufficiently many people seeking medical care reform in the United States to any differences. America will continue to be poor health care in other countries will be getting in the rich by providing Americans the health care that places outside America.

© Copyright 2007 Patti McMann. All rights reserved.

Patti McMann is a journalist. Writes on various subjects for print and electronic publication. Has a diverse background in many areas and specialized technology, marketing, and information. She is the eBook "Diabetes: a guide for beginners to the base" http://www.pattimcmann.comavailable at

Health Savings Accounts - An American Innovation in Health Insurance

INTRODUCTON - The term "health insurance" is commonly used in the United States to describe any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance or a non-insurance social welfare program funded by the government. Synonyms for this usage include "health coverage," "health care coverage" and "health benefits" and "medical insurance." In a more technical sense, the term is used to describe any form of insurance that provides protection against injury or illness.

In America, the health insurance industry has changed rapidly during the last few decades. In the 1970's most people who had health insurance had indemnity insurance. Indemnity insurance is often called fee-forservice. It is the traditional health insurance in which the medical provider (usually a doctor or hospital) is paid a fee for each service provided to the patient covered under the policy. An important category associated with the indemnity plans is that of consumer driven health care (CDHC). Consumer-directed health plans allow individuals and families to have greater control over their health care, including when and how they access care, what types of care they receive and how much they spend on health care services.

These plans are however associated with higher deductibles that the insured have to pay from their pocket before they can claim insurance money. Consumer driven health care plans include Health Reimbursement Plans (HRAs), Flexible Spending Accounts (FSAs), high deductible health plans (HDHps), Archer Medical Savings Accounts (MSAs) and Health Savings Accounts (HSAs). Of these, the Health Savings Accounts are the most recent and they have witnessed rapid growth during the last decade.

WHAT IS A HEALTH SAVINGS ACCOUNT?

A Health Savings Account (HSA) is a tax-advantaged medical savings account available to taxpayers in the United States. The funds contributed to the account are not subject to federal income tax at the time of deposit. These may be used to pay for qualified medical expenses at any time without federal tax liability.

Another feature is that the funds contributed to Health Savings Account roll over and accumulate year over year if not spent. These can be withdrawn by the employees at the time of retirement without any tax liabilities. Withdrawals for qualified expenses and interest earned are also not subject to federal income taxes. According to the U.S. Treasury Office, 'A Health Savings Account is an alternative to traditional health insurance; it is a savings product that offers a different way for consumers to pay for their health care.

HSA's enable you to pay for current health expenses and save for future qualified medical and retiree health expenses on a tax-free basis.' Thus the Health Savings Account is an effort to increase the efficiency of the American health care system and to encourage people to be more responsible and prudent towards their health care needs. It falls in the category of consumer driven health care plans.

Origin of Health Savings Account

The Health Savings Account was established under the Medicare Prescription Drug, Improvement, and Modernization Act passed by the U.S. Congress in June 2003, by the Senate in July 2003 and signed by President Bush on December 8, 2003.

Eligibility -

The following individuals are eligible to open a Health Savings Account -

- Those who are covered by a High Deductible Health Plan (HDHP).

- Those not covered by other health insurance plans.

- Those not enrolled in Medicare4.

Also there are no income limits on who may contribute to an HAS and there is no requirement of having earned income to contribute to an HAS. However HAS's can't be set up by those who are dependent on someone else's tax return. Also HSA's cannot be set up independently by children.

What is a High Deductible Health plan (HDHP)?

Enrollment in a High Deductible Health Plan (HDHP) is a necessary qualification for anyone wishing to open a Health Savings Account. In fact the HDHPs got a boost by the Medicare Modernization Act which introduced the HSAs. A High Deductible Health Plan is a health insurance plan which has a certain deductible threshold. This limit must be crossed before the insured person can claim insurance money. It does not cover first dollar medical expenses. So an individual has to himself pay the initial expenses that are called out-of-pocket costs.

In a number of HDHPs costs of immunization and preventive health care are excluded from the deductible which means that the individual is reimbursed for them. HDHPs can be taken both by individuals (self employed as well as employed) and employers. In 2008, HDHPs are being offered by insurance companies in America with deductibles ranging from a minimum of $1,100 for Self and $2,200 for Self and Family coverage. The maximum amount out-of-pocket limits for HDHPs is $5,600 for self and $11,200 for Self and Family enrollment. These deductible limits are called IRS limits as they are set by the Internal Revenue Service (IRS). In HDHPs the relation between the deductibles and the premium paid by the insured is inversely propotional i.e. higher the deductible, lower the premium and vice versa. The major purported advantages of HDHPs are that they will a) lower health care costs by causing patients to be more cost-conscious, and b) make insurance premiums more affordable for the uninsured. The logic is that when the patients are fully covered (i.e. have health plans with low deductibles), they tend to be less health conscious and also less cost conscious when going for treatment.

Opening a Health Savings Account

An individual can sign up for HSAs with banks, credit unions, insurance companies and other approved companies. However not all insurance companies offer HSAqualified health insurance plans so it is important to use an insurance company that offers this type of qualified insurance plan. The employer may also set up a plan for the employees. However, the account is always owned by the individual. Direct online enrollment in HSA-qualified health insurance is available in all states except Hawaii, Massachusetts, Minnesota, New Jersey, New York, Rhode Island, Vermont and Washington.

Contributions to the Health Savings Account

Contributions to HSAs can be made by an individual who owns the account, by an employer or by any other person. When made by the employer, the contribution is not included in the income of the employee. When made by an employee, it is treated as exempted from federal tax. For 2008, the maximum amount that can be contributed (and deducted) to an HSA from all sources is:

$2,900 (self-only coverage)

$5,800 (family coverage)

These limits are set by the U.S. Congress through statutes and they are indexed annually for inflation. For individuals above 55 years of age, there is a special catch up provision that allows them to deposit additional $800 for 2008 and $900 for 2009. The actual maximum amount an individual can contribute also depends on the number of months he is covered by an HDHP (pro-rated basis) as of the first day of a month. For eg If you have family HDHP coverage from January 1,2008 until June 30, 2008, then cease having HDHP coverage, you are allowed an HSA contribution of 6/12 of $5,800, or $2,900 for 2008. If you have family HDHP coverage from January 1,2008 until June 30, 2008, and have self-only HDHP coverage from July 1, 2008 to December 31, 2008, you are allowed an HSA contribution of 6/12 x $5,800 plus 6/12 of $2,900, or $4,350 for 2008. If an individual opens an HDHP on the first day of a month, then he can contribute to HSA on the first day itself. However, if he/she opens an account on any other day than the first, then he can contribute to the HSA from the next month onwards. Contributions can be made as late as April 15 of the following year. Contributions to the HSA in excess of the contribution limits must be withdrawn by the individual or be subject to an excise tax. The individual must pay income tax on the excess withdrawn amount.

Contributions by the Employer

The employer can make contributions to the employee's HAS account under a salary reduction plan known as Section 125 plan. It is also called a cafeteria plan. The contributions made under the cafeteria plan are made on a pre-tax basis i.e. they are excluded from the employee's income. The employer must make the contribution on a comparable basis. Comparable contributions are contributions to all HSAs of an employer which are 1) the same amount or 2) the same percentage of the annual deductible. However, part time employees who work for less than 30 hours a week can be treated separately. The employer can also categorize employees into those who opt for self coverage only and those who opt for a family coverage. The employer can automatically make contributions to the HSAs on the behalf of the employee unless the employee specifically chooses not to have such contributions by the employer.

Withdrawals from the HSAs

The HSA is owned by the employee and he/she can make qualified expenses from it whenever required. He/She also decides how much to contribute to it, how much to withdraw for qualified expenses, which company will hold the account and what type of investments will be made to grow the account. Another feature is that the funds remain in the account and role over from year to year. There are no use it or lose it rules. The HSA participants do not have to obtain advance approval from their HSA trustee or their medical insurer to withdraw funds, and the funds are not subject to income taxation if made for 'qualified medical expenses'. Qualified medical expenses include costs for services and items covered by the health plan but subject to cost sharing such as a deductible and coinsurance, or co-payments, as well as many other expenses not covered under medical plans, such as dental, vision and chiropractic care; durable medical equipment such as eyeglasses and hearing aids; and transportation expenses related to medical care. Nonprescription, over-the-counter medications are also eligible. However, qualified medical expense must be incurred on or after the HSA was established.

Tax free distributions can be taken from the HSA for the qualified medical expenses of the person covered by the HDHP, the spouse (even if not covered) of the individual and any dependent (even if not covered) of the individual.12 The HSA account can also be used to pay previous year's qualified expenses subject to the condition that those expenses were incurred after the HSA was set up. The individual must preserve the receipts for expenses met from the HSA as they may be needed to prove that the withdrawals from the HSA were made for qualified medical expenses and not otherwise used. Also the individual may have to produce the receipts before the insurance company to prove that the deductible limit was met. If a withdrawal is made for unqualified medical expenses, then the amount withdrawn is considered taxable (it is added to the individuals income) and is also subject to an additional 10 percent penalty. Normally the money also cannot be used for paying medical insurance premiums. However, in certain circumstances, exceptions are allowed.

These are -

1) to pay for any health plan coverage while receiving federal or state unemployment benefits.

2) COBRA continuation coverage after leaving employment with a company that offers health insurance coverage.

3) Qualified long-term care insurance.

4) Medicare premiums and out-of-pocket expenses, including deductibles, co-pays, and coinsurance for: Part A (hospital and inpatient services), Part B (physician and outpatient services), Part C (Medicare HMO and PPO plans) and Part D (prescription drugs).

However, if an individual dies, becomes disabled or reaches the age of 65, then withdrawals from the Health Savings Account are considered exempted from income tax and additional 10 percent penalty irrespective of the purpose for which those withdrawals are made. There are different methods through which funds can be withdrawn from the HSAs. Some HSAs provide account holders with debit cards, some with cheques and some have options for a reimbursement process similar to medical insurance.

Growth of HSAs

Ever since the Health Savings Accounts came into being in January 2004, there has been a phenomenal growth in their numbers. From around 1 million enrollees in March 2005, the number has grown to 6.1 million enrollees in January 2008.14 This represents an increase of 1.6 million since January 2007, 2.9 million since January 2006 and 5.1 million since March 2005. This growth has been visible across all segments. However, the growth in large groups and small groups has been much higher than in the individual category. According to the projections made by the U.S. Treasury Department, the number of HSA policy holders will increase to 14 million by 2010. These 14 million policies will provide cover to 25 to 30 million U.S. citizens.

In the Individual Market, 1.5 million people were covered by HSA/HDHPs purchased as on January 2008. Based on the number of covered lives, 27 percent of newly purchased individual policies (defined as those purchased during the most recent full month or quarter) were enrolled in HSA/HDHP coverage. In the small group market, enrollment stood at 1.8 million as of January 2008. In this group 31 percent of all new enrollments were in the HSA/HDHP category. The large group category had the largest enrollment with 2.8 million enrollees as of January 2008. In this category, six percent of all new enrollments were in the HSA/HDHP category.

Benefits of HSAs

The proponents of HSAs envisage a number of benefits from them. First and foremost it is believed that as they have a high deductible threshold, the insured will be more health conscious. Also they will be more cost conscious. The high deductibles will encourage people to be more careful about their health and health care expenses and will make them shop for bargains and be more vigilant against excesses in the health care industry. This, it is believed, will reduce the growing cost of health care and increase the efficiency of the health care system in the United States. HSA-eligible plans typically provide enrollee decision support tools that include, to some extent, information on the cost of health care services and the quality of health care providers. Experts suggest that reliable information about the cost of particular health care services and the quality of specific health care providers would help enrollees become more actively engaged in making health care purchasing decisions. These tools may be provided by health insurance carriers to all health insurance plan enrollees, but are likely to be more important to enrollees of HSA-eligible plans who have a greater financial incentive to make informed decisions about the quality and costs of health care providers and services.

It is believed that lower premiums associated with HSAs/HDHPs will enable more people to enroll for medical insurance. This will mean that lower income groups who do not have access to medicare will be able to open HSAs. No doubt higher deductibles are associated with HSA eligible HDHPs, but it is estimated that tax savings under HSAs and lower premiums will make them less expensive than other insurance plans. The funds put in the HSA can be rolled over from year to year. There are no use it or lose it rules. This leads to a growth in savings of the account holder. The funds can be accumulated tax free for future medical expenses if the holder so desires. Also the savings in the HSA can be grown through investments.

The nature of such investments is decided by the insured. The earnings on savings in the HSA are also exempt from income tax. The holder can withdraw his savings in the HSA after turning 65 years old without paying any taxes or penalties. The account holder has complete control over his/her account. He/She is the owner of the account right from its inception. A person can withdraw money as and when required without any gatekeeper. Also the owner decides how much to put in his/her account, how much to spend and how much to save for the future. The HSAs are portable in nature. This means that if the holder changes his/her job, becomes unemployed or moves to another location, he/she can still retain the account.

Also if the account holder so desires he can transfer his Health Saving Account from one managing agency to another. Thus portability is an advantage of HSAs. Another advantage is that most HSA plans provide first-dollar coverage for preventive care. This is true of virtually all HSA plans offered by large employers and over 95% of the plans offered by small employers. It was also true of over half (59%) of the plans which were purchased by individuals.

All of the plans offering first-dollar preventive care benefits included annual physicals, immunizations, well-baby and wellchild care, mammograms and Pap tests; 90% included prostate cancer screenings and 80% included colon cancer screenings. Some analysts believe that HSAs are more beneficial for the young and healthy as they do not have to pay frequent out of pocket costs. On the other hand, they have to pay lower premiums for HDHPs which help them meet unforeseen contingencies.

Health Savings Accounts are also advantageous for the employers. The benefits of choosing a health Savings Account over a traditional health insurance plan can directly affect the bottom line of an employer's benefit budget. For instance Health Savings Accounts are dependent on a high deductible insurance policy, which lowers the premiums of the employee's plan. Also all contributions to the Health Savings Account are pre-tax, thus lowering the gross payroll and reducing the amount of taxes the employer must pay.

Criticism of HSAs

The opponents of Health Savings Accounts contend that they would do more harm than good to America's health insurance system. Some consumer organizations, such as Consumers Union, and many medical organizations, such as the American Public Health Association, have rejected HSAs because, in their opinion, they benefit only healthy, younger people and make the health care system more expensive for everyone else. According to Stanford economist Victor Fuchs, "The main effect of putting more of it on the consumer is to reduce the social redistributive element of insurance.

Some others believe that HSAs remove healthy people from the insurance pool and it makes premiums rise for everyone left. HSAs encourage people to look out for themselves more and spread the risk around less. Another concern is that the money people save in HSAs will be inadequate. Some people believe that HSAs do not allow for enough savings to cover costs. Even the person who contributes the maximum and never takes any money out would not be able to cover health care costs in retirement if inflation continues in the health care industry.

Opponents of HSAs, also include distinguished figures like state Insurance Commissioner John Garamendi, who called them a "dangerous prescription" that will destabilize the health insurance marketplace and make things even worse for the uninsured. Another criticism is that they benefit the rich more than the poor. Those who earn more will be able to get bigger tax breaks than those who earn less. Critics point out that higher deductibles along with insurance premiums will take away a large share of the earnings of the low income groups. Also lower income groups will not benefit substantially from tax breaks as they are already paying little or no taxes. On the other hand tax breaks on savings in HSAs and on further income from those HSA savings will cost billions of dollars of tax money to the exchequer.

The Treasury Department has estimated HSAs would cost the government $156 billion over a decade. Critics say that this could rise substantially. Several surveys have been conducted regarding the efficacy of the HSAs and some have found that the account holders are not particularly satisfied with the HSA scheme and many are even ignorant about the working of the HSAs. One such survey conducted in 2007 of American employees by the human resources consulting firm Towers Perrin showed satisfaction with account based health plans (ABHPs) was low. People were not happy with them in general compared with people with more traditional health care. Respondants said they were not comfortable with the risk and did not understand how it works.

According to the Commonwealth Fund, early experience with HAS eligible high-deductible health plans reveals low satisfaction, high out of- pocket costs, and cost-related access problems. Another survey conducted with the Employee Benefits Research Institute found that people enrolled in HSA-eligible high-deductible health plans were much less satisfied with many aspects of their health care than adults in more comprehensive plans People in these plans allocate substantial amounts of income to their health care, especially those who have poorer health or lower incomes. The survey also found that adults in high-deductible health plans are far more likely to delay or avoid getting needed care, or to skip medications, because of the cost. Problems are particularly pronounced among those with poorer health or lower incomes.

Political leaders have also been vocal about their criticism of the HSAs. Congressman John Conyers, Jr. issued the following statement criticizing the HSAs "The President's health care plan is not about covering the uninsured, making health insurance affordable, or even driving down the cost of health care. Its real purpose is to make it easier for businesses to dump their health insurance burden onto workers, give tax breaks to the wealthy, and boost the profits of banks and financial brokers. The health care policies concocted at the behest of special interests do nothing to help the average American. In many cases, they can make health care even more inaccessible." In fact a report of the U.S. governments Accountability office, published on April 1, 2008 says that the rate of enrollment in the HSAs is greater for higher income individuals than for lower income ones.

A study titled "Health Savings Accounts and High Deductible Health Plans: Are They an Option for Low-Income Families? By Catherine Hoffman and Jennifer Tolbert which was sponsored by the Kaiser Family Foundation reported the following key findings regarding the HSAs:

a) Premiums for HSA-qualified health plans may be lower than for traditional insurance, but these plans shift more of the financial risk to individuals and families through higher deductibles.

b) Premiums and out-of-pocket costs for HSA-qualified health plans would consume a substantial portion of a low-income family's budget.

c) Most low-income individuals and families do not face high enough tax liability to benefit in a significant way from tax deductions associated with HSAs.

d) People with chronic conditions, disabilities, and others with high cost medical needs may face even greater out-of-pocket costs under HSA-qualified health plans.

e) Cost-sharing reduces the use of health care, especially primary and preventive services, and low-income individuals and those who are sicker are particularly sensitive to cost-sharing increases.

f) Health savings accounts and high deductible plans are unlikely to substantially increase health insurance coverage among the uninsured.

Choosing a Health Plan

Despite the advantages offered by the HSA, it may not be suitable for everyone. While choosing an insurance plan, an individual must consider the following factors:

1. The premiums to be paid.

2. Coverage/benefits available under the scheme.

3. Various exclusions and limitations.

4. Portability.

5. Out-of-pocket costs like coinsurance, co-pays, and deductibles.

6. Access to doctors, hospitals, and other providers.

7. How much and sometimes how one pays for care.

8. Any existing health issue or physical disability.

9. Type of tax savings available.

The plan you choose should according to your requirements and financial ability.

BIBLIOGRAPHY

1 Questions and Answers about Health Insurance- A Consumer Guide' published jointly by the Agency for Healthcare Research and Quality (AHRQ)and America's Health Insurance Plans (AHIP)

2 http://www.en.wikipedia.org/wiki/Health_savings_account

3 2002 AHIP Survey of Health Insurance Plans

4 "How High Is Too High? Implications of High-Deductible Health Plans" Davis, Karen; Michelle Doty and Alice Ho. The Commonwealth Fund, April 2005

5 http://www.fdhc.state.fl.us/schs/pdf/hsa_tri-fold_brochure.pdf

6 HSA/HDHP CENSUS 2008 by Hannah Yoo, Center for Policy and Research, America's Health Insurance Plans

7"HEALTH SAVINGS ACCOUNTS Early Enrollee Experiences with Accounts and Eligible Health Plans" John E. Dicken Director, Health Care.

8 Thomas Wilder and Hannah Yoo, "A Survey of Preventive Benefits in Health Savings Account (HSA)Plans, July 2007," America's Health Insurance Plans, November 2007

9 Gladwell, Malcolm, "The Moral Hazard Myth", The New Yorker (29-08-2005)

10 2008 Benchmark Survey HAS Bank

11. Employer Health Benefits 2007 Annual Survey, Kaiser Family Foundation

12. Health Savings Accounts and High Deductible Health Plans: Are They An Option for Low-Income Families?Catherine Hoffman and Jennifer Tolbert for Kaiser Family Foundation, October 2006

13. Medicare Prescription Drug, Improvement, and Modernization Act of 2003

I am an ardent reader who also loves to write as well. I am an MBA with specialization in finance.