President Bush thinks health saving accounts just might save employers and their employees from out-of-control costs that will make medical care unaffordable even for the middle class.

Dr. Bruce Landres and the insurance broker who helped him cut the health insurance costs at his 15-employee physician practice in Brentwood would find that hard to argue.

Landres had been paying up to $6,000 a month on premiums for his employees and their dependents at Brentwood Comprehensive Medical. But he now pays about half that because he adopted a plan that includes health savings accounts. Not only is he paying less, but he's covering more employees.

"What we've saved has significantly reduced our overhead," he said. "It's amounted to a significant difference."

His insurance broker, Jeff Miles, puts it more effusively.

"These things can be a dream come true for a business," Miles said. "Anyone who calls these programs just a tax shelter for the wealthy, that's phony."

HSAs are the most talked about vehicle in the trend toward consumer-driven health care, which aims to hold down rising costs and business premiums while also giving employees more choice in how they spend their health care dollars.

The accounts allow employees to squirrel away pretax dollars to pay their deductibles, and are combined with high-deductible insurance plans that lower monthly premiums.

The combination aims to ease soaring health care costs for employers and it furthers the Bush administration's long-standing goal of steering Americans from an entitlement mindset to an ownership society.

At least 25 percent of employers reported they were very or somewhat likely to offer an HSA-eligible plan in 2006, according to the California Healthcare Foundation's most recent employer survey. But just how many have done so is unclear.

"All firms are really looking hard for a solution to mitigate the increasing premiums, but it will take a while for that data to get reported to us," said Jill Yegian, the Oakland-based foundation's director of health insurance programs. "California's longer history with managed care than the rest of the country held down premiums for quite a while. But while HMO rates are still lower than the national average, PPO rates are now higher."

Several big name Los Angeles-area employers such as Northrop Grumman Corp. offer HSA-eligible plans, but others such as Rosemead-based Edison International and Thousand Oaks-based Amgen Inc. are holding off offering such plans as an option for their workers.


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