Every once in awhile there will be front page news about the health care crisis. The escalating costs for hospital and physician services are making it more difficult for the insurance companies to stay competitive and at the same time take care of the needs of their policyholders. A family health insurance plan in todays marketplace is evolving into something quite different from years past. The employer group health insurance insures the majority of Americans but there is a trend developing. There are more folks leaving their employer to start their own business. When you add that group of people to the folks that leave their employer because of lay-offs, illness, and terminations then you are creating a great demand for family health insurance.

Insurance companies are working hard to develop new solutions. The federal government has great interest in health care insurance. The hospitals and physicians are deeply affected by the insurance industry.
There has been a major shift in thinking about health insurance. It has become increasingly clear that higher deductible health insurance plans are much more cost efficient in the long run compared to the low deductible plans of years past. The higher deductibles reduce the cost of health insurance dramatically. The lower deductibles are no longer in vogue. The high premiums for the low deductible no longer justify the premiums.

Todays Trends

1. High Deductible Major Med The insurance professionals are encouraging people to take the higher deductible major medical policies. You are well protected for a major illness or injury in exchange for self-insuring the smaller claims.

2. Health Savings Accounts This is the federal governments contribution to the health insurance dilemma. These savings accounts are established by the individual for medical expenses only. They are tax deductible similar to an IRA and are great vehicles to use for the out of pocket expense from the higher deductible.

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More than 1 million Americans have made a similar choice, signing up for high-deductible health insurance policies and associated HSAs since the program was introduced in late 2003 according to the Washington-based industry group, America’s Health Insurance Plans.

The new plans are a bit complex, but a growing number of insurers offer them.

Under federal law, the policy must have a minimum deductible of $1000 a year for an individual and $2000 for a family; maximum out of pocket expenses; for example, copayments required for surgical procedures, cannot exceed $5100 for individuals and $10,200 for families.

People Help With Their Own Health Insurance

Policyholders, meanwhile, can set up HSAs that they fund with their own money. Employers also can contribute to their workers’ HSAs. HSA contributions, generally set an amount equal to the policy’s deductible, can best be used to cover health care costs, and unused money can be carried over at year’s end. This differs from company sponsored Flexible Spending Accounts, health care savings plans in which unused money is forfeited after Dec 31 of each year.

Some companies are replacing existing catastrophic health coverage plans with the new plans because they see HSAs as a good way for workers to handle the higher deductibles. Others see them as a way of making workers more mindful of health care spending.

Health Insurance For The Young And Uninsured

The new policies are especially attractive to young singles, people in relatively good health and higher income people who can afford to cover higher out of pocket costs.

The new policies also are attractive to small businesses and the uninsured. Of the new policies purchased through eHealthInsurance, more than 40% were purchased by people with annual incomes below $50,000, almost half were families and more than one-third had been uninsured.

Affordable Health Insurance

It’s the affordability. Participants get a lower cost premium and the money they probably would have been spending can be run through a savings account to buy day to day medical services.

More companies will adopt the plans because the trend is that more of the burden for health benefits is going to be moved to the employee.

On the other hand, people who can afford to fund the HSAs and don’t need to draw them down entirely to cover annual medical expenses will be able to let them grow tax-free. In retirement, the excess savings can be used to purchase long-term care insurance and to pay for other qualified medical expenses.

That means that they’re more popular for those approaching retirement age, especially if they don’t have company plans available to them.

There are many health insurance alternatives, so it’s important that people asses their individual needs.

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As Health Savings Accounts grow in popularity, there is growing fear among those who want to nationalize healthcare that they will not be able to put the cat back in the bag. There are already over 3 million HSA owners, and by 2010, the Treasury Department estimates as many as 45 million Americans will be covered by HSA plans. They will have billions of dollars invested to cover future medical expenses, and by then it will be politically impossible to take that benefit away.

If you currently have a high-deductible health insurance plan, you can invest tax-free money in a Health Savings Account. You get to choose the type of investment anything from savings accounts or money market funds, to a full brokerage house. If you invest wisely, you could have well over $500,000 in the account when you retire. You will be able to use that money to pay for your healthcare in whatever way you please, tax free. You can go to the best surgeons, or the least expensive doc-in-a-box. If you decide to treat a condition with acupuncture, homeopathy, or psychic healers, you can do that too. Whoever offers you the service you want with the best combination of quality and price should get your business. And since you are the one paying, it will be completely your choice. You have healthcare freedom.

If proponents of a single-payer system were to ever have their way, you would be at the mercy of a government bureaucrat when it comes to your healthcare. To see what this may look like, all one has to do is look at the state of health care in Canada, England, New Zealand, and the parts of Europe that have not yet abandoned single-payer systems.

Proponents of a single-payer system tend to point to Canada or England as countries that cover all their citizens with quality healthcare, while spending less money per person than the U.S. But if we look a little more closely, we see that these publicly financed health insurance systems are breaking down, the quality is low, and the costs can be quite high. Here’s what Canadians have to deal with if they need medical care:

Long waits. Hundreds of Canadians go to Detroit and other U.S. cities every year for procedures like CAT scans, which they can obtain treatment in a matter of days. In Canada, the wait is typically six months. Currently 876,000 Canadians are on waiting lists for medical procedures.

Difficulty in getting life-enhancing procedures done. If a Canadian is having a heart attack, they will be treated right then. But if the surgery is considered “elective” (meaning that possible death is not eminent), the wait could be months or years. Average wait for cataract removal is 18 months. Average wait for a knee replacement is one year.

Increased risk of dieing. The average Canadian waits eight weeks to see a specialist, and another nine weeks before getting treated. This is even the case with conditions that are likely to get much worse if there is any delay in treatment. For example, the median time for a mastectomy is 14 weeks, enough time for the cancer to spread to other parts of the body. In fact, 28% of those diagnosed with breast cancer in Canada die from it, while the mortality ratio in the U.S. is only 25%.

Things don’t look any better across the ocean. Each year the British National Health Service cancels 410,000 surgeries because of resource shortages. According to the London Sunday Times, there are currently over 1 million Brits awaiting elective surgery. Thomas Cook, a British travel agency, is even considering offering “sun-and-surgery” packaged trips to Indian hospitals for British citizens fed up with low standards and long waiting times for surgery.

The British and Canadian governments have the power to make healthcare “free”, but they are unable to control its costs. So the costs become longer (and potentially fatal) delays, and fewer innovations.

Its not surprising when you think about what is happening. Universal health insurance systems always encourage over-consumption by patients, and such over-consumption always leads to financial crises. The result is inevitably broken promises about universal access and quality care. Because there are always limited resources, single-payer systems tend to overspend on primary care for the healthy, while denying more expensive specialist care to those with serious medical problems. This is because most people (voters) are healthy most of the time, and the sick and dieing are less likely to be able to organize into a political force.

What makes the United States such a great country is the “freedoms” we enjoy. Though our freedoms seem to be constantly under attack, there is still no nation in the world that has the freedom of the press, freedom of religion, freedom of association, or the free markets that we have in the United States. As anyone who understands even a smidgen of economics knows, free markets encourage competition and innovation, which lead to lower prices and better quality.

Though the U.S. system of health care can not really be considered a “free-market”, it is certainly much more free than any single payer system. Some of the benefits we see as a result of our current healthcare system include:

U.S. medicine produces the best outcomes for virtually every patient, from premature babies to elderly cancer patients.
American companies are the chief source worldwide of new treatments and procedures which each year are used to save millions of lives.
U.S. medical training and research facilities are the best in the world.

Though Canadians might have to wait a year or two for hip replacement surgery, they can get the same operation done on their dog in less than a week. This is because veterinarians are competing for that business, finding innovative ways to deliver service more quickly and less expensively. Another example is laser eye surgery, a procedure that is rarely covered by insurance, so laser eye surgeons must compete on the basis of cost and quality. While costs for most medical procedures have been going up every year, the cost for this procedure has dropped by 80% over the past decade.

Unfortunately, U.S. healthcare policies still tend to limit competition, restrict consumer’s freedom to choose, and discourage consumers from shopping for value. Thus, there are too few choices and there has been little attention paid to price and quality of service. The answer is clearly not more government intervention, but instead letting competition and the power of the marketplace drive down prices and increase quality and access to care.

Health Savings Accounts are the Solution

There is increasing recognition that third-party health insurance payers are actually a major cause of escalating medical costs and the decline in the quality of service. The increasing adoption of HSA plans has already begun to cause greater transparency and competition in the medical marketplace. There are now physicians available by phone, medical kiosks setting up in malls, doctors that accept only cash (and who charge significantly less), and others competing directly for the consumer’s healthcare dollar.

Don’t be fooled by the politicians who advocate a single-payer system, claiming their only concern is the uninsured. If a single body (such as a government bureaucracy) controls healthcare, they control one seventh of the national economy. And everywhere in the world that central control of the economy has been tried, it has been a colossal failure.

As public policy reforms centered on individual choice continue to gain wider footholds, the result will be greater prosperity, greater choice, and a better value for all. The culture of dependence and entitlement will begin to fade, as millions of individuals demand further policy reforms that will reinstate the values of freedom and personal responsibility that helped establish this great nation.

As more consumers turn to health savings accounts, the market will respond. Innovative providers will begin to compete more on price and quality of service, and those that provide the best value will get wealthy doing so. And all consumers will benefit.

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These high-deductible health insurance plans coupled with IRA-style savings accounts are really pretty easy to understand, offer a number of benefits and are becoming more popular.

What is an HSA? HSAs were developed to maximize your savings on health insurance while providing a valuable tax break. The two parts of an HSA program are an eligible, high-deductible health plan and a tax-advantaged savings account. For an individual, an HSA-eligible health insurance plan must have an annual deductible of at least $1,050 for individuals and $2,100 for families. Online health insurance agents like eHealthInsur ance.com have a variety of HSA-eligible health plans from insurance companies you know and trust.

The second part of an HSA program is an IRA-style savings account that allows you to reduce your taxable income by building savings. You can deposit funds up to the total of your health plan’s deductible into the HSA each year. So, within certain regulatory limits, the higher your health plan’s deductible, the more you can tuck away tax-free.

How does the Tax Savings work? If you make $40,000 a year and you put $2,000 in your HSA, you’ll only pay taxes on $38,000. Like an IRA, the HSA is meant to encourage you to save for retirement. Funds placed into your HSA can be invested and the balance will roll over each year into retirement.

You can use your HSA funds to cover medical expenses such as over-the-counter drugs, eyeglasses, co-payments and any medical costs incurred before your annual deductible is met.

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• Health insurance plans (0)

The biggest reason more people don’t retire before age 65 is lack of health insurance, and many Americans reach age 65 woefully unprepared for the medical expenses they’ll face once they do retire. One of the most important long-term reasons for establishing an HSA is to build up some money for medical expenses incurred during retirement.

Fidelity Investments reports that the average couple retiring in 2006 will need $190,000 to cover medical expenses during retirement. This assumes life expectancies of 15 years for the husband and 20 years for the wife.

HSAs are, without exception, the best way to build up money to pay for medical expenses during retirement. You should not contribute any money to your traditional IRA, 401 (k), or any other savings account until you have maximized your contribution to your HSA. This is because only health savings accounts allow you to make withdrawals tax-free to pay for medical expenses. You can take these distributions anytime before or after age 65.

Your HSA contributions won’t affect your IRA limits — $3,000 per year or $3,600 for those over 55. It’s just another tax-deferred way to save for retirement, with the added advantage being that you can withdraw funds tax-free if they are used to pay for medical expenses.

For early retirees who are healthy, a health savings account can also be a smart option to help lower their health insurance costs while they wait for their Medicare coverage. The older someone is, the more they can save with an HSA plan. For many people in their 50’s and 60’s who are not yet eligible for Medicare, HSAs are by far the most affordable option.

Any money you deposit in your health savings account is 100% tax-deductible, and the money in the account grows tax-deferred like an IRA. For 2006, the maximum contribution for a single person is the lesser amount of your deductible or $2,700. In other words, if your deductible is $3,000, you can contribute a maximum of $2,700; if your deductible is $2,000, then that is the maximum. For families, maximum is the lesser of $5,450 or the deductible.

If you’re 55 and older, you can put in an extra $700 catch-up contribution in 2006, $800 in 2007, $900 in 2008, and an additional $1,000 from 2009 onward. The contribution limit is indexed to the Consumer Price Index (CPI), so it will increase at the rate of inflation each year.

How much you accumulate in your HSA will depend on how much you contribute each year, the number of years you contribute, the investment return you get, and how long you go before withdrawing money from the account. If you regularly fund your HSA, and are fortunate enough to be healthy and not use a lot of medical care, a substantial amount of wealth can build up in your account.

Health savings accounts are self-directed, meaning that you have almost total control over where you invest your funds. There are numerous banks that can act as your HSA administrator. Some offer only savings accounts, while others offer mutual funds or access to a full-service brokerage where you may place your money in stocks, bonds, mutual funds, or any number of investment vehicles.

One of the biggest advantages of retirement accounts like HSAs are that the funds are allowed to grow without being taxed each year. This can dramatically increase your return. For example, if you are in the 33% tax bracket, you would need a 15% return on a taxable investment to match a tax-deferred yield of only 10%.

As another example, if you are in a 33% tax bracket and were to invest $5,450 each year in a taxable investment that yielded a 15% return, you would have $312,149 after 20 years. If you put that same money in a tax-deferred investment vehicle like an HSA, you would have $558,317 – over $240,000 more.

Because catch-up contributions are allowed only for people age 55 and older, if one or both of you are under age 55 you should establish your HSA in the older spouse’s name. This will allow you to capitalize on the expanded HSA contribution limits for people in this age range and maximize your HSA contributions. Once that person turns 65 and is no longer eligible to contribute to their HSA, you can open another health savings account in the younger spouse’s name.

Strategies to Maximize your HSA Account Growth

If your objective is to maximize the growth of your HSA in order to build up additional funds for your retirement, there are three important strategies you should implement.

Strategy #1: place your money in mutual funds or other investments that have growth potential. Though this is riskier than placing your money in an FDIC-insured savings account, it is the only way to really take advantage of the tax-deferred growth opportunity that an HSA provides.

Strategy #2: delay withdrawals from your account as long as possible. Though you may withdraw money from your HSA tax-free at any time to pay for qualified medical expenses, you do have the option of leaving the money in the HSA so that it continues to grow tax-free. As long as you save your receipts, you can make medical withdrawals from your account tax-free at any future date to reimburse yourself for medical expenses incurred today.

As an example, let’s say a 45 year old couple places $5,450 per year in their HSA over a period of 20 years, they have $2,000 per year in qualified medical expenses, and they get a 12% return on their investments. If they withdraw the $2,000 from their HSA each year, they’ll have a net contribution of $3,450 per year into their account, and they’ll have $248,581 in their account when they begin their retirement years.

If on the other hand they delay withdrawing that money, they will have $392,686 in their account at age 65. If they choose they can withdraw the $40,000 to reimburse themselves tax-free for the medical expenses incurred during that 20 year period, and still have $352,686 in their account – over $100,000 more than if they had withdrawn the money each year.

Strategy #3: make the maximum allowable deposit to your HSA at the beginning of each year. Even though you are allowed until April 15 of the following year to make deposits to your HSA, you should take advantage of the tax-free growth in your account by funding it as soon as possible. The extra interest you can earn by contributing to your account on January 1 of each year rather than the next April 15 can amount to over $40,000 in a 20 year period, and over $100,000 in 30 years.

Using Your HSA to Pay for Medical Expenses during Retirement

When you enroll in Medicare, you can use your account to pay Medicare premiums, deductibles, copays, and coinsurance under any part of Medicare. If you have retiree health benefits through your former employer, you can also use your account to pay for your share of retiree medical insurance premiums. The one expense you cannot use your account for is to purchase a Medicare supplemental insurance or “Medigap” policy.

Though Medicare will pay for the majority of health expenses during retirement, there many be expenses that Medicare will not cover. Nursing home expenses, un-conventional treatments for terminal illnesses, and proactive health screenings are all examples of medical expenses that will not be paid for by Medicare, but that you can pay for from your HSA.

Long-term care is assistance with the activities of daily living, such as dressing, bathing, or feeding yourself. It can be provided in your home, a retirement community, or a nursing home. Long-term care expenses can be paid for using funds from your HSA, and long-term care insurance can even be paid for from the HSA up to the following maximum annual amounts:

- Age 40 or under: $260
- Age 41 to 50: $490
- Age 51 to 60: $980
- Age 61 to 70: $2,600
- Age 71 or over: $3,250

To establish a health savings account, you must first own an HSA-qualified high deductible health insurance plan. Compare HSA plans side by side to determine the best value to meet your needs. Once you have your high deductible health insurance plan in place, you can open your Health Savings Account with the financial institution of your choice.

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