False promises: 'consumer driven' health plans.(View point: THE CONSUMERS UNION PERSPECTIVE)

A promotional pamphlet for a health savings account (HSA) boasts, "If you plan correctly, you may find that you spend far less for health care than ever before." True, if you could plan to avoid cancer, being hit by a car, or growing older. But you can't.

Three million Americans have signed up for high-deductible health plans, which are often paired with tax-advantaged HSAs designed to give them the funds they need to pay those deductibles. Proponents call this "consumer driven health care." They claim that patients who have to take on more of the costs themselves-annual deductibles range from $1,050 to a total deductible and costs of $10,500-will avoid unnecessary care and look for medical providers who deliver high-quality care at the lowest price, thus driving down costs. The plans are touted by some, including President Bush, as a solution for the U.S. health-care crisis, with its 46 million uninsured.

The reality is that these schemes shift increased financial risk to consumers and will surely weaken our already fragile health-insurance system. HSAs provide little assurance of affordable, quality health care to those with chronic illnesses, families with children, those of moderate incomes, or older Americans with more health-care needs. HSAs do nothing to address the factors that really drive up health costs: care for those with chronic diseases; overuse of technology; hospital care; prescription drugs; and end-of-life care.

WHO BENEFITS, WHO DOESN'T?

HSAs may benefit young, healthy workers without dependents, who don't spend much on medical care. They're especially advantageous for the wealthy of all ages, since the higher the tax bracket, the more valuable the tax break. Contributions to HSAs are tax-deductible, the account grows tax-free, and money pulled out for medical expenses is not taxed. After age 65, money saved in the account can be used for any purpose, without a tax penalty. But the income level of the vast ...