The Importance and Benefits of a Health Savings Account (HSAs) Health Radio April 6, 2007 Mark Baker. Introduction

Transcription

1 The Importance and Benefits of a Health Savings Account (HSAs) Health Radio April 6, 2007 Mark Baker Please remember the opinions expressed on Patient Power are not necessarily the views of Health Radio, our sponsors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. Please have this discussion you re your own doctor, that s how you ll get care that s most appropriate for you. Introduction Hey, good morning or good afternoon wherever you are. It s a sunny day here in Seattle, and the flowers are coming up, and I went to my oldest kids track meet yesterday, and they won by two points. It was really incredible and just, the kids are excited. Spring Break starts here, you may have already had spring break in your neighborhood whether you have kids or grandkids or just neighborhood kids running around, but ours starts today so there is a lot of excitement going on at our house. My daughter made cupcakes for her whole class. That was a big production. So we are in a good mood. You know, there are many things to talk about when we talk about healthcare. We ve talked a lot this week about problems. Boy, we ve talked about avoiding infection if you go to the hospital. We talked earlier about avoiding medical mistakes, and we have posted; if you look at the website, it s right there on the bottom right; our interview with Dr. Clancy. I think we did it at the end of last week. She s a top federal official. So those are kind of the downsides. We talked about wellness this week, but whatever it is when you need medical care hopefully you ve got somebody to pay for it other than you paying for it out of pocket. Now let s face it. We ll find out this statistic, but I believe it s like over 40 million people who do not have medical insurance, and so that s a worry, but if you do have medical insurance, and we ll do segments on that for sure so I m not making that a trivial thing at all, but if you do have coverage you may have it personally but more likely you have it through your employer and now in the last few years, three years actually, there are additional choices than just the traditional kinds of insurance, and there s something called a health savings account. I know that was presented to me as I still worked for Informed Medical Communications and HealthTalk that I started. I m no longer an employee there, but when I was they came out with this health savings account, and I said, what s that, in trying to figure out what is it right for my family s situation. 1

2 So first, is it offered by your employer? Second of all, is it right for your situation, and they may have more than one choice. So we are going to try to decipher that today, and also if you are older, maybe you are on Medicare, well how do health savings accounts come in there? How does all that work? So we have an expert in it. He s Mark Baker, and he is with the Golden Rule Insurance Company, which has been around for 60 years. Mark is joining us from Indianapolis, and he s a health savings account specialist. Mark, welcome to Patient Power. Thanks Andrew. It s a pleasure to be with you. Just as a baseline, and then we are going to meet somebody who has a health savings account, somebody I know quite well who works with Patient Power and Health Radio, but for us to help us understand what is a health savings account, how long have they been around, and why are we paying national attention at tax time now? They ve been around as far as federal legislation for just over three years and then beginning last November Congress made changes to the law that improved them, but basically what a health savings account is, is the federal law allows you to buy a higher deductible health insurance plan. You want one of those because they cost considerably less than a traditional plan with a low deductible or a co-pay plan, and combined with that insurance is something called a health savings account, a special savings account that works like an individual retirement account. You get a tax deduction for every dollar that you save, and the law allows you to save more than enough money to cover your deductible in most cases, still you get a federal tax deduction. The money grows tax-deferred, and as long as you use it for qualified medical care you re spending money tax-free. So that s why with a health savings account there is this great interest around tax time. So for people who are out there looking for health insurance on their own tax time is a good time for people to take a look at their own situation and figure out if a health savings account makes sense for them. Now you mentioned looking at it on your own. Now the example I gave is where it was an option through my employer at the time. Companies are doing it, but are you saying individuals can do it too? Yes, individuals, that s the classic case; a self-employed person or someone who may be an early retiree or someone who works for a corporation, probably a small or mediumsized business, that can t afford to provide health insurance for their workers; the law 2

3 allows these individuals or families to go out on their own and set up a health savings account with a high deductable health plan. The law is very flexible and also allows employers as you found out in your case to set these insurance plans that combine kind of 401(k) package where your employer and employees can deposit dollars and then use that money tax-free for their lower dollar health-care needs. Ron s Story We will have to talk to you in greater detail about that, but you know it s funny, we were chatting with my producer Ron Crider, and he s at mission control or broadcast control for Health Radio, and he s in Vero Beach, Florida. It sounds so, I love that place. It just sounds so great. Let s go play golf. Let s go swimming. Let s hit the beach. Ron s going to join us now. Ron you have one of these, right? Ron: That s exactly right. I certainly do have a health savings account. Okay, so is that for you and your wife? Why did you do it, and who s covered? Ron: Alright, let me tell you how this whole thing started. Three years ago when this first came out I had a company in Colorado, and I needed to cover the employees. They wanted health insurance. Some of them had never had health insurance, but most of them were fairly young, and I was looking for an efficient way to do it for everybody. So by having a high deductible, a nice policy but a high deductible, and then the company, my company, agreed to put in the maximum amount of money for the employees into the health savings account. I saved money. The employees got money into their health savings account. Everybody was happy, and it was actually kind of a perk that we offered that no other company offered, and it worked out quite well. It also worked out pretty well for me too. I m so glad, and you find now at tax time and all that with your, it s a good thing from, the government has given you a benefit? Ron: Well, now put me on the other side. I have now retired, on Medicare, and you go to the doctors, and occasionally Medicare doesn t pay for something. That s okay. Get your health savings card out. It s a credit card. It says it s a MasterCard, but it s your money 3

4 basically, and you just whip your card out and pay for it, and you are paying for it out of that money that was put away for you, and there are no tax consequences on it whatsoever. Wow. Well Ron, we will let you keep running our broadcasting station now, Internet Broadcasting, but we will come back and get some further comments from you. Flex-Plan versus Health Savings Account Mark Baker from Golden Rule, I have a question then. For anybody who has been at a more modern company; now my wife works at Microsoft; and even a mid-sized company that I ve been at; they also offer thing like a flexible savings account, Flex-Plans, either for childcare or for health costs that were not covered by your traditional health insurance, and that was with pre-tax dollars deducted from your salary. Right. So we still use that fund that my wife has with Microsoft and often deduct the maximum that we can, particularly for childcare. Is a health savings account like that at all? Yes, just like that. In our situation at our company we have them obviously, and the dollars you decide to take out of your paycheck come out pre-tax, and they go into the health savings account. The one advantage to a health savings account is unlike a flexible spending account is the money does not disappear at the end of the year if you don t spend it. With a flexible spending account you ve got to kind of gauge what you re going to spend Use it or lose it. because it s going to revert back to your employer at the end of the year if you don t spend it, but with an HSA that money remains in the account and rolls over to next year, and as long as either your employer maintains the plan or if you re buying it on your own and you maintain the qualified health plan, you can add additional dollars up to the legal limit. 4

5 Now does it earn interest? You know if you have various life insurance policies it s accruing additional money if you haven t drawn on it. So does it work like that too? Yes. In our case we are paying 5% interest on it, and most institutions you go to will pay you a decent interest rate. You can set them up at your local credit union and the same thing works. Alright we are going to talk more with Mark Baker from Golden Rule Insurance Company. We are learning about health savings accounts, which have just been around a few years. We ll have Ron Crider back to hear more how it works for him. It s all on Patient Power as we help you get smart. I don t know if you pay attention to the commercials, but I like to, and I want a voice like Kevin McCarthy. What does he say? Health information for everybody. I gotta do that. He s going to have to give me instruction. I ve got that medium voice. Here I am, hopefully I sound good to you, but I m here every day with Patient Power, and you know how committed I am to your health. There are all sorts of issues we do. I want to mention that on one of our special edition webcasts next week, next Tuesday night 7 p.m. Central, 5 p.m. Pacific where I am in Seattle, and what would that be 8 p.m. Eastern with Dr. Kevin Bethke from Northwestern Memorial Hospital and the Feinberg School of Medicine at Northwestern. We are going to be talking about breast cancer and breast cancer screening, and maybe you saw the paper a week or so ago. There are new guidelines from the American Cancer Society on whether there are some people at higher risk who should get MRIs of their breasts; not just mammograms but MRIs. Kevin is going to help us decipher all that. So that s next Tuesday night 7 p.m. Central. Be sure to tell anybody you know who is concerned about breast cancer, and I know that s like every woman worries about it and may know someone. So it s screening for you if you haven t had breast cancer or certainly if you have you do not want to have a recurrence. So we ll talk more about that. When you get down to the bottom line it s how did you pay for the care you need? Today we re talking about health savings accounts with Mark Baker from the Golden Rule Insurance Company, which has been one of the pioneers in this as the legislation has allowed for that. So Mark lets get back to it. 5

6 Managing Costs of Healthcare Health savings accounts are not only not well understood by the general public but also not even well-known. What is it? I m not sure I ve ever heard of it. What s the problem Mark? I think that most of us still get our health insurance at work today, something like just under 60% of us get our health insurance at work, so unless the boss or the corporation says Hey we re going to offer this new health plan most people have no need to understand what s covered and what plans are there and what s going on. They just want to know what the premium is and what are the benefits. So we ve got a long education process in front of us. I mean somewhere now about 6 million Americans are covered by a health savings account. I think the Treasury Department has said by 2010 they re expecting 25 to 30 million Americans to be covered by an HSA, but it s just an education process, and employers are harder to reach I think. They re busy, and of course they re worried about keeping their employees happy, so something new is a little scary. But Mark, every day of the show, and the name of it is Patient Power, we are telling people you need to be at the center of your health care. Yep. You need to be knowledgeable about your health concerns about wellness, prevention, and also by nature if it s your money, or your employer putting it, but you re in control of it, and you re now in deciding how that money gets spent. I know that there are some insurance companies that have helped with employers helping people understand what does it cost to go to the doctor and encouraging people to use these nurse advice lines and others to say is this really a big deal and do I need to go to a specialist or maybe the watch-and-wait thing for that cold you have, or here are some things you can do at home, but it s all trying to help you and in this case your employer too use that money wisely. Absolutely. I think we re all in disbelief about the cost of medical care today. We re still well above inflation in terms of the gross and the cost, and employers and employees are looking for ways to get a handle on this thing. All of are. Of course you mentioned the problem with the uninsured in this country, but the backbone of a health savings account is empowering patients to become consumers, and that something brand-new in and of itself. There are not too many of us who are used to or maybe even comfortable with 6

7 having discussions with our doctors about what one of my treatment options given my situation, and what s best for me and what each one of those treatment options cost? You know interestingly here in Washington State where I am the Washington State Hospital Association has put online the cost of identical procedures at different hospitals. Now there are other questions about quality and who s the best doctor and who s the rock star surgeon if you need it, whatever it is, but just the costs and they vary greatly. I actually think this consumerism both for knowledge and an understanding of cost is a good thing because as you say otherwise the system is just going to crash under the weight of the economics and in other areas where it s broken. It s one of the few areas in our society where there are very few market forces, if you will. We all expect the best of care, and since the boss is paying the bill in most cases today, we don t care what it costs, but there is a cost whether it s paid through premiums, through our checks, or wherever it s coming from out-of-pocket nature it does have a cost, and I think the smarter we all become with knowledge; I can give you an example. In my case I take blood pressure medication. I have been for some years. My doctor is one of those guys who started me out on something that was developed 40 years ago. He said it s safe. We know it s safe. It s been around. It s cheap and it s effective, and if you need something more well will try, but I just in the last couple years there s been a big study of blood pressure medications comparing the stuff that I take compared to the brand-new things that cost dollars a day instead of pennies a day, and they found that the tried-and-true is just as effective as the brand new medications that are very expensive. Right, right. I think those are the kinds of discussions we all ought to have. Right, we re not just talking about, folks, people who are concerned about healthcare policy. We re talking about each of us as consumers. I mean, ladies, you go shopping. You comparison shop. Well, now if you re aware of what the different drugs cost and then you also learn about their relative effectiveness, and as Mark was just saying the blood pressure medicine that s been around for 40 years it was just fine for him and pennies a day versus dollars a day, well if you were shopping for a new dress you d know which one you d buy. So there you go. Ron Crider join us back for just a minute. So this whole consumerism both for you or even as you had your company with your employees and having people be aware of the cost, that s a good thing isn t it? 7

8 Ron: It s really a good thing, and there are a couple of better things about it too. It can become a bargaining chip, and it can be a good bargaining chip. One of the things that an employer wants to do is be able to have their arms around costs, and if the employee says, would you contribute a hundred dollars a month to my health savings account, that s all it s going to be. It isn t going to go up next year unless you want it to go up, but the employer has complete control over how much money goes in, and it will not escalate unless the employer wants to make it go up or unless there s a change. The other thing is that you can use it for dental or eye care, and many, many insurance policies, now your wife works for Microsoft so of course they cover everything up there. She gets everything, right. Ron; Yes, but a lot of companies do not cover dental and they don t cover eye care because they re trying to keep their costs down, but you can pay for it out of the health savings account, and that s a great way to go. Okay, well thank you for sharing that Ron Crider. So you know, you ask around, and Ron s one of our producers, and here he s experienced it as an employer and as a consumer as well for his own benefit. Now Ron retired, but Mark his health savings account went with him. So it wasn t tied to just his old company. Nope. They re very portable. Even if you work for a good corporation that sets a health savings account up and deposits money on your behalf, the IRS says that that is the employees money and for whatever reason when you leave the company it goes with you, and as Ron just described he s now on Medicare. He has this kitty of this health savings account, this fund, and he can use it still tax-free to pay his qualified medical expenses that he has out of pocket. He could use it for normal living expenses just like and IRA and pay normal income taxes on it if he wants. Wow, so it s a savings plan as well beyond just a health savings plan. We ll find out more as we continue our discussion with Mark Baker who s a specialist on health savings accounts, kind of an innovation in healthcare and dealing with the costs of healthcare, but doing it in a way where the government is trying to give us a break and help us get a control of health costs and us to play a role in how that money is spent. We ll be back with more of Patient Power and health savings accounts right after this. 8

9 Next week on Patient Power I m going to hit an issue hard. I have a beef with the FDA, and if you look at my blog both on HealthTalk.com or on I ve been concerned about the FDA s review procedures for some medicines, particularly for cancer and one for the leukemia I have, chronic lymphocytic leukemia, where I actually last fall went to an FDA advisory hearing, and I just quite frankly folks thought it was a kangaroo court and that it was not fair, and I know those are strong terms. Not to dis the FDA, and look they ve been protecting us with pet food now and all this stuff. I m not down on that, and I know they are very concerned about safety, but I ve met some people who in clinical trials have had some of these experimental medicines, and they would have been dead had they not had them, and if the process of reviewing whether more people should have it and the drug on the market is not fair, boy that is just terrible, and as a taxpayer I felt it was a problem. Why am I saying all this? Because on Monday on Patient Power we re going to have Sam Kasman on as general council for a group called the Competitive Enterprise Institute. He s concerned about the FDA moving too slowly in some cases. I want them to protect the public health, but we don t want them to keep drugs off the market that could be lifesaving for you. So, it s a tough job, I understand, but it needs to be a fair process, and I worry about that. You re going to hear a lot more from me about it next week. Let s go back to health savings accounts, which are to help us pay for therapies that are available, so Mark Baker, we ve got the sirens going on here I was going to say you ve got medical care going on there. Yeah, no, no, no. You know, when I used to live in New York City, the fire trucks went by all the time and right by our apartment. We lived on like the 12 th floor, and it sounded like we were in the firehouse, but on Mercer Island, Washington, it doesn t happen too often. Who Can Get One? Let s go back to health savings accounts. Who can have them? Can anybody get one? What are the rules? The rules are pretty simple. You can t be on Medicare. I think I mentioned that one before. You can t have any other health insurance, and you can t be someone s dependent and set up your own plan, and the law just requires you to maintain what the law describes as a qualified, high-deductible health plan. So you can t be on Medicare, no other kind of insurance, and basically you just need to keep that special high-deductible health plan in force that the law requires. 9

10 Okay, now when I had this employer I was trying to determine did I have the traditional plan or did I have a health savings, and I can t remember the calculation, but the traditional plan seemed to make sense for me. How do you determine that? Well what the law, let me tell you what the law requires. If you re buying a family plan the minimum deductible this year for a family plan is $ For a single person the law requires a minimum deductible of $ So those are the deductibles on the health plan. Now for a family the law allows that same family to save just over $ this year. So you can more than pay, more than cover I should say, that $ deductible, and again you re going to get a tax deduction right on the front page of the 1040 form for that deposit for an HSA. There s no itemizing for these things, and again you use that money tax free for your qualified medical care. Those are the basic parameters. The law adjusts those a little bit every year, the deductibles and the deposits, and you asked how should you choose between plans I think was your other question Andrew? Yes, and particularly I know in our case we have a family member who has a chronic condition, and the medicines are not inexpensive, and so we were trying to calculate well if we know that there s going to be certain costs because there s someone with health that you know they have something going on that s ongoing Absolutely. does that put us in a situation where because of that ongoing expense a health savings account wouldn t make sense? Maybe, maybe not. I tell people what you really need to do is to put pencil to paper. Now in your case if you ve got a very good employer-provided health plan, and the premiums are low, the co-pays are low, or whatever the situation, that s probably going to be pretty hard to beat because you re not paying much of the premium. The employer s paying most of that, but if you re in a situation in a small business or a medium-sized business or you re buying health insurance on your own, most of those people find that a health savings account makes a lot of sense because when they sit down and they ve got to be responsible for the whole premium, then when you start doing that kind of payment every year, then the health savings account with the tax deduction just makes sense. Let me give you an example. I know a family, and I ve talked to several families in this very position, a mom, dad, and a teenage daughter. Mom and dad were in their 40s and 10

11 ran a small, seasonal business. They were facing a $ a month health insurance premium bill for the three of them; $ a month. They wondered if they could continue to afford that. They knew they couldn t go without insurance, but they looked at a health savings account, this was a couple of years ago, and they cut their health insurance premium down to $ a month from $ , and they had a $ deductible now though, but clearly with that savings; they saved what $ to $ every month, they were clearly able to save to cover that $ deductible, take a tax break, have that money sit in the bank and earn interest, and they still had money available for just the kinds of things that every growing family needs. So I think that really it just depends on your personal situation and where you re going to be getting your healthcare from. Is it your employer or does your employer not provide it or not provide a very good plan? Mark, in the time before the break help me understand though. Everybody worries about that really bad thing happening to them. You have symptoms and then it s a bad diagnosis, it s going to be costly. So if you don t have enough money in your health savings account what happens then? Don t forget that once you meet the deductible, so you get a $ family deductible, once you meet that deductible in the year you re covered. The health plan picks up and pays the rest of the covered expenses once you meet the out-of-pocket required. So you re covered for the rest of the year Next year the process would start over. You could add additional dollars, and you ve got the deductible to meet. Yes, because people worry about that scary visit to the doctor, and just so I understand. The health savings account you re contributing, you re covering the certain costs to a certain point, but if something really bad happens there s insurance that s backing it up. Absolutely, you re got a high deductible health plan that will take care of those big hospitalizations, those big out-of-pocket needs, whatever you need after you meet that health insurance deductible. It works just like a lower-deductible plan; you just have more to cover. We re going to get some more details from you as we continue in just a second on Patient Power. We re visiting with Mark Baker who s from the Golden Rule Insurance Company, 11

12 which as I said has really helped people better understand, as he is today, these health savings accounts. Take a look at their website, We ll give you some other websites too in just a minute as Patient Power continues. Starting a Health Savings Plan We ve been talking about health savings accounts today, and often in radio happily a lot of the people in front of the microphones are older because we re experienced, and we have all this wisdom, and we re so entertaining right, but a lot of our employees in broadcasting are young, and so I ve been on instant messenger with some of them and they re saying, well how does this HSA, they ve been listening Mark, you know, how does this, whoa it sounds really good. So Mark, how does somebody get started whether they re a small business like me or they work for a company and they re wondering should they, you know, hey guys have you thought of offering this? How does it happen? I tell people to do a couple of things. You ve got to do some homework clearly, and I would recommend you go see your independent insurance agent, he or she are an expert, and they d be happy to speak with you and run through some plans and some scenarios with you, but there are a couple of other websites I d recommend, and one is the U.S. Treasury s website, which is and they have really good basic information about the health savings account law and the kinds of tax savings that you might see. Also a nice website is We set this up, but no sales pitch whatsoever, just good basic information on what a health savings account is and how you can set one up, but I would just recommend that you look around, do some homework, and maybe even go to your local tax advisor and get the lowdown on what makes sense for you and particularly if you ve got a small business Andrew they make perfect sense for folks in small business because group insurance for a small business is just simply not affordable for folks. So Ron Crider, how did you do it with your radio empire? Ron: What I did Andrew was I decided that I didn t want the obligation of owning the insurance policies, the health insurance policies for the employees. I just thought it was something that I could empower them in. They could select their own insurance policy and they re own plan. They cleared it with me first obviously. We did it in concert, but they went online, found Golden Rule of all places, and ended up calling Golden Rule. Golden Rule must have 200 different policies available for, anything you could think of they have. I sound like a commercial for Golden Rule, but I was so happy with the company and what they did for me that I sent all my employees there, but many other companies do exactly the same thing. So the employees selected their own policies. It s not a group policy. They selected their own. It belongs to them and if they left working for me and went off to work 12

13 for another company they still had their own insurance policy that they could then get the next employer to fund. So that s how I got it started. They bought their own policy. They signed up for their own policy and did all the things that they needed to do. I just reimbursed them for it and then I also agreed to put X number of dollars into their health savings account. Now on some of the key people I paid 100% of the maximum amount of money that we were allowed to put in that particular year, and some of the other people that weren t key people or brand new people I only funded many 25% or 50% of it. Okay, Ron thanks for sharing that from the employer s perspective. So the instant messenger is heating up on my computer as employees are saying, what about, you know, how do we do this for me, and let me give you those websites again; government information on health savings accounts, and also and you can look at Mark s company website too, Golden Rule Insurance Company, Does that cover it pretty well Mark? I think that s pretty good and what I ll just add if I can that what Ron did is very common. A lot of employers will say hey we want to limit our, we can obviously only do so much, so we ll give you all so much in a year to pay towards your health insurance and we ll give you some guidance, but it s really up to you, and that just seems to make more sense for a lot of small and medium sized business. It means a lot to me I think as we look at these innovative approaches to try and cover healthcare costs, give us some tax benefits, and have us as I talk about all the time be smarter not just about the care we get but also about the way the money is spent for us and our family. We re going to take a break, and we will be back with more of Patient Power as we continue. Remember next week we re going to take on the Food and Drug Administration. That s a big deal, and talk about the way they approve drugs. Is it too slow or are they working really hard to protect the public safety, maybe some of both for sure, and what does it mean to you if you have a chronic condition like I do or maybe one develops and you re hoping that that wonderful medicine will be available to you when you need it to help you stay healthy. Those are all things that we re going to be tackling next week. Also I want to remind you again about that webcast that we re doing with Northwestern, which is on Tuesday night 7 p.m. Central, Dr. Kevin Bethke who is a breast cancer surgeon. We re going to help you know the latest in screening for breast cancer or looking out for a recurrence. We re going to be back with much more of Patient Power, some final comments from Mark Baker from Golden Rule so that we can take action and understand 13

14 this now, and I hope we do, on health savings accounts and whether it s right for you, if you have a small business for your employees, or for your family members. We ll be back in just a minute. I mentioned at the beginning of the show that it s about to be spring break here, or our school district is, and so I m headed with some of my kids, one of them is looking at colleges, he s a high school junior, so I m going from here where it was like 74 degrees in Seattle yesterday, like record high temperatures, and my kids are going to be selling lemonade. They re setting up a lemonade stand after elementary school today, and we re going guess where? Boston. Do you know what the temperature in Boston is right now? It s 38 degrees, and you have wet snow, and you re in Indianapolis That s about what it is here. Oh goodness. And I said well you ve got the Indianapolis Colts to keep you warm, you know, the thrill of world champions and all that, but goodness gracious. It changed pretty dramatically. Yes, well it better change because I don t want to get my heavy coat out. Okay, we ve been talking about health savings accounts Mark. Final comments from you from the perspective of not just Golden Rule Insurance Company, which has helped pave the way in this, but just your health savings account specialist. Obviously you want to sell these plans, but it sounds like you really believe in it. I have one, and I have had one for a long time, and I think the bottom line for most folks is just affordability. What good is health insurance if you can t afford it, and for those who are out there on their own that s the key and with a health savings account you get good health insurance, you have a higher deductible, but you get lower premiums and then the government is now allowing us to take some special tax advantages for building some savings to cover that deductible, and some of your other healthcare needs as our buddy there Ron mentioned, vision and dental care, things that many self-employed people or others buying their health insurance on their own just can t afford or don t have policies that cover, so with an HSA you get more affordable coverage, you get to build some savings, and you have the protection of good health insurance. 14

15 Now we can be critical of a lot of things the government does, but it sound like this is one where somebody in Congress and whatever departments thought this through, and it s a pretty good deal. We just think it makes sense. It s an evolution. I mean, we did try managed care in this country, HMOs and managed care, and most folks were not too satisfied with that, but we still have the problem of the rising costs of healthcare, and with an HSA I think the idea is basically hopefully to empower us all to become more like consumers and to get good care but hopefully get some handle on this increasing cost. There you go. It s all about being smart as healthcare consumers. Have a great weekend everybody. Thanks to Mark Baker from Golden Rule, and remember, knowledge can be the best medicine of all. Andrew Schorr signing off. See you Monday. Please remember the opinions expressed on Patient Power are not necessarily the views of Health Radio, our sponsors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. Please have this discussion you re your own doctor, that s how you ll get care that s most appropriate for you. 15