Health Savings Account Blog

In an article entitled “Health Care in the 21st Century”, published in the New England Journal of Medicine on January 20, 2005, Senate Majority Leader Bill Frist, M.D., made several suggestions on ways to provide all Americans with lifelong, affordable access to high-quality health care. Senator Frist graduated from Harvard Medical School in 1978, and was a surgeon before entering politics. One of the key aspects of his vision is a system that is responsive primarily to individual consumers, rather than to third-party payers. This concept is known as consumer-driven health care.

Today most health care is paid for and controlled by third parties such as the government, insurers, and employers. Consumers rarely compare prices or quality of service when shopping for health care – partly because this comparison is usually very difficult or even impossible, and partly because the price often just doesn’t matter to the consumer, who is only responsible for a moderate co-payment. Frist notes “a consumer-driven system will empower all people – if they so choose – to make decisions that will directly affect the most fundamental and intimate aspects of their life – their own health. This empowerment gives people a greater stake in and more responsibility for, their own health care. Health care will not improve in a sustained and substantial way until consumers drive it.”

A key aspect to enabling consumer-driven health care was the creation of tax-free Health Savings Accounts (HSAs). This legislation was part of the Medicare Modernization Act (Public Law 108-173). “HSAs, coupled with affordable high deductible insurance policies, give individual consumers more control over their health care choices and hard earned dollars. HSAs give people a greater stake in their own health care. The accounts can move with employees from job to job and can be rolled over year to year. HSAs should increase demand for greater information and transparency.”

What Senator Frist is suggesting is that people with high deductible health insurance plans and HSAs have incentive to keep their health costs low, since any money they save on health care expenses stays in their Health Savings Account, and grows tax-deferred, like an IRA. Thus there is also incentive for the consumer to demand information about health care pricing. No system has yet been devised in the history of mankind that does more to increase quality and lower prices than a competitive market system. As more and more consumers begin to own health savings accounts, health care providers will be forced to compete for their business by providing better quality service and better prices.

The other factor in play is the financial motivation the individual will have to stay healthy. The vast majority of health care spending today is due to degenerative diseases such as high blood pressure, diabetes, metabolic syndrome, cardiovascular disease, and other modern ailments that are primarily the result of lifestyle choices. The consumer who wisely spends his HSA dollars on preventative care (which can be done tax-free) and pays attention to diet and exercise could be rewarded with a substantial amount of money in their Health Savings Account by age 65.

Consumer-driven health care has the potential to be a powerful force of change in the health care system. By instituting competitive pressures, encouraging greater price transparency, and rewarding consumers who are proactive about their health, the growing adoption of Health Savings Accounts will help make health care more affordable for everyone.