Health Savings Account Blog

Not surprisingly, he's a fan of high-deductible health plans and mandate-light insurance policies that give consumers greater flexibility to shop for the benefits and services they want.

Rivera talked with the Rocky Mountain News about what he's been up to in the past 15 months.

What have you spent most of the past year working on?

Big picture, I've been really focused on this movement in many aspects of insurance in moving from a paternalistic system where the employer or government makes a lot of decisions to a system where consumers have a lot more decision-making power.

What are the potential downsides of this movement?

Anytime you give consumers the ability to make a decision that's best for their individual circumstances, that's preferable to having government make that decision for them. But you always run the risk of a consumer making the wrong decision.

And as people become busier and have less time on their hands, it is a challenge to manage all this information. That's why one of our focuses has been on meaningful disclosure. The trick is making sure consumers have information but that it is meaningful and not too much so they don't understand it or won't use it.

Give us an update on title insurance.

It's been a big project that's ongoing. But it fits into something I feel strongly about: You can have a lot of competition and choice, but if you don't have a level playing field, the consumer doesn't benefit.

We believe title insurers set up shell reinsurance companies to provide kickbacks to the referring home builders and lenders. If the title insurer was able to divert a portion of the premiums, aren't these premiums overpriced?

Have you made enemies in the title insurance industry?

I wouldn't say we've made enemies. Our goal again is to help create a level playing field. The companies that were playing by the rules are happy that we're taking these actions.

You've said that health savings accounts are one part of a 10- or 12-step recovery plan for the health care system. What are the other parts?

A good tort environment that discourages frivolous lawsuits will keep down costs and make sure that doctors can afford to practice here and want to practice in Colorado.

You've also said that overuse of health care is the main contributor to rising premiums.

We clearly have perverse incentives, or no financial incentives, to make the right decision in health care. We have little financial incentive to shop around, or little financial incentive to pick up the phone and say, "Do I really need to come in to the doctor now?"

When our family had $15, $20 copays in the old system, if it was a minor cold, we'd just go to the doctor. Now we have an HSA, and at least we ask the question, do we really need to?

How are HSAs going to make a huge dent in costs when they are based on a false premise: namely that unnecessary doctor visits and procedures are the source of sky-high health costs?

If you look at HSAs, they are paired with high-deductible health plans, so you're talking about a $1,050 deductible for someone with a chronic illness, but it's a 30 percent to 40 percent reduction in premiums.

There might be a lot of people who would have had no health insurance at all to take care of those chronic illnesses and who now have access to affordable health insurance.

Tell me some other ideas on your 10-point list.

Health information technology: moving us out of the 19th century, by implementing electronic medical records that preserve privacy and give doctors the information they need so they are not duplicating care.

Who is going to pay for those records?

That's going to be one of the challenges, and government may have to play a role - either through grant funding or financial incentives.

Taxpayers?

Yes, if you are looking at government playing a role.

Find out more about Health Savings Accounts at: http://www.health--savings--accounts.com