Every Blue down in Blueville liked Healthcare a lot...

But the Pinch, who lived to the left of Healthcare did NOT!

The Pinch hated Healthcare, the whole Healthcare system!

Just don't ask why, only he had the wisdom.

 

It could be his head was screwed on to the left,

It could be his ears were plugged up and deaf.

But I think the most likely reason of all,

Was that he thought the Blues brains were much much too small.

But whatever the reason, his head or his ears,

At enrollment season, Pinch took glee in their fears.

Staring down from his Tower he took some delight,

As they worked through enrollment and pondered their plight.  

"They're struggling, their choking," he coughed with a sneer.

"The deadline's approaching.  It's practically here!

Then he growled with his tiny heart nervously pumping,

"Each year they get an insurance thumping!"

"With enough pain in Healthcare, they'll eventually see...

The only way to Healthcare is directly through Me!

But every year undeterred, the Blues found their way,

To Healthcare solutions and new ways to pay.

HSAs, HRAs, an alphabet soup,

Consumer Driven Health made the Pinch feel like poop!

 

Then his brain started working, he came up with a thought.

A horrible, dreadful and awful old thought!

"I'll run for office, then they can be bought!"

"I'll promise them Healthcare.  Every man, woman, child.

We'll tell them it's FREE, he said with a smile. 

So he threw on his coat, and dragged along Mrs. Pinch,

With his trusty bullhorn, this would be a cinch.

 

A tight message, Ms. Pinch, and his bullhorn in hand,

He blazed into Blueville with promises grand.

FREE healthcare for all, if you all vote for me,

They lined up with big smiles and voted with glee.

Every Blue man and wife, cast their ballot for Pinch,

He won by a landslide, by more than an inch.

He cleaned out the Cabinet as quick as a flash,

Put them all in a bag and out with the trash.  

Into his new post, he jumped rather nimbly,

And anyone in his way, he rammed up the chimbley.

But while bagging and ramming, he heard a small coo,

He spun quickly around and there stood a Blue.

A wee little Blue, named Sweet Mary Lou.

 

"Is this some sort of micro, terrorist," he thought?

"Or maybe a rodent that needs to be caught?"

Without batting an eye, he asked, "What is it dear?"

"I'm here to take care of you, you have nothing to fear."

Then Mary Lou Blue, this sweet little tart

Looked straight in his eyes, then pulled at his heart.

"All the Blues, here in Blueville love you so much,

They want you to help them, but not be their crutch."

She said, "Dear Mr. Pinch, please don't act as our Mother,

Please stand beside us and be like our brother."

We want you to help us with Healthcare that's true,

There are so many, so many, things you can do.

Insurance companies need to be rid of their greed,

With some of their excess to help those in need.

Reward, those who are healthy with lower cost plans,

And breaks on their taxes, and more tools in their hands.

And what about good people whose health is not great,

But do all they can with what's on their plate?

They could use tools and insurance for sure,

But going broke in the process isn't the cure."

 

Then she paused for a moment and breathed deep some air.

Taken back by such wisdom, Pinch simply stood there.

But she was not through, little Mary Lou Blue,

The little Blue girl who was no more than two,

"Let all the Blue people, Blue employers and you,

Stand together and work all of these healthcare things through.

You see Mr. Pinch, the Blues are all very smart,

 And if you will work with them and for them, they'll all do their part."

 

With that Mary Lou Blue, walked out of the place

Mr. Pinch stood there standing, a strange look on his face.

For awhile Pinch stood there, with no place to go,

But he had an idea and it started to grow.

And what happened then...?

In Blueville they say

That Pinch realized Government healthcare was not the way.

That the Blues down in Blueville were pretty damned smart

And when faced with a challenge did take it to heart.

If all of the Blues worked together he knew,

That healthcare would not be reserved for the few.

So with newfound leadership they developed a plan,

That with carrot and stick brought healthcare to the land.

And when it was done, and the plan was released

He.....HE HIMSELF....

Got himself into shape, and Mrs. Pinch was well pleased.  

The American media community recently alighted on "Joe the Plumber" like a fly on poop and I couldn't help but wonder if he was truly represented the face of the America or if, perhaps there was something else going on there.  This has been nagging at me for weeks until today, when I was bobbing up and down on the basement treadmill, trying to read an article in this week's edition of Business Week.

It suddenly hit me, with the force of a diarrhea bomb the morning after a dinner of Kung Pao chicken.  The U.S. media is obsessed with the toilet and all things related to it.  Joe the Plumber was merely the media's toilet obsession, personified.

The article of "inspiration" entitled, "Toxic Assets: Still No Takers," was flush with toilet related imagery.   In a mere eight paragraph article, covering just one page that included an illustration, a big headline and a chart, I counted 28 throne-related images. Key among them were:

• Bailout
• Plumbing job
• Toxic
• "Ass"ets
• Flowing again
• Passed
• S"crapped"
• "Sit where they are"
• Impasse
• Unload
• Dumps
• Pumping
• Lack of pressure
• No pressure
• Sitting on

My favorite, and the final sentence was, "You could have it back up on you in an ugly way."

Whether we agreed with the message of Joe the Plumber or not was irrelevant.  For me he was merely the allegory for American media.  Toilet obsessed. 

You may be asking, "what does this have to do with Health Savings Accounts, High Deductible Health Plans, Consumer Driven Health, HSA education, health or wellness?"   I suppose the only advice we can offer is, stay away from the Kung Pao chicken, and if you can't, remember, you can pay for Pepto Bismol from you HSA.  Can anyone "spare a square?"

A classic. 

About the only things I know about Massachusetts have to do with beans (Blazing Saddles), a bunch of whiteys dressed up as Indians (wonder if they were wearing wigs?), and burning witches at the stake (now that's hot).

 Being from the Deep South, my purview of the rest of the country is somewhat narrow, and I suppose for every one of us, there is enough history, news, and politics in our own states to keep up narrowly focused and narrowly minded for a lifetime.  Thank God, I never had to spell Massachusetts in a spelling bee growing up, because that would have for sure thrown me out of the saddle.

Being interested in healthcare, I have been hearing for a couple of years about this movement by the state of Massachusetts to mandate health insurance for all of its citizens.  Besides finding the idea of it generally suspicious, I've really not paid much attention to it.

I stumbled across an article online in The MetroWest Daily News, written by guest columnist Jon Kingsdale.   Being from the South, I had no clue what market this paper served, so I checked the obituaries for the paper and saw such locals as Sudsbury, Falmouth, Framingham, and Rockland, Westborough, and Westchester.  While I didn't know the people or places, I figured out pretty quickly they weren't  from around here.  This was confirmed when I saw many seemed to have died in various branches of the U Mass Hospital system.

I suppose if I were some policy wonk, I'd also recognize the name of Jon Kingsdale, but I didn't and had to look him up too.  But not in the obituaries.  Turns out he is the CEO of the Massachusetts Health Connector.  Didn't know what that was either so I had to look it up too....

Honestly, I don't know how you folks in Massachusetts keep up with all this stuff, but the Health Connector is the state run agency that is in the middle of making sure all the good citizens of that state get health insurance or get fined.  Don't you just love Government?

Anyway, the short story on Massachusetts health policy is that pretty much all adults in the state have to have health insurance in 2009 or face fines.  I'm not sure about kids, but presume they have to have coverage too, but I'm guessing it would be difficult to collect fines from them.  And the fines are not small.  They could exceed $900 per year.

Citizens of Massachusetts can't just have any old insurance coverage, they actually have to have policies that provide them with certain standards of coverage.  As an aside, it is sad that there are policies out there that purport to provide coverage, but that in fact are crap and will do nothing but make an individual health crisis worse in the event it ever had to be used.

So where is the The Gradock Bulletin going with all of this?  We can read policy geniuses comment on this all day long, but our attention spans are too short.  We want your input.

We want to hear some normal people's perspective on this state mandate. Either individuals or employers trying to provide benefits to their employees.

Is it working?  What is it doing to healthcare costs?  Is it being administered efficiently?  Is it better than what was in place before?  Who is getting rich off of it?  Things like that.  

We have put up a discussion forum on the subject at HSAeducator.com in their Forum section and invite real people to share their experiences.  To tell the rest of the world, the real story.

And for all of us outside the great state of Massachuttes, to ask questions about the program.   Why?  Because it or some version of it could be "coming to a theater or drive-in near you."

To give those outside the state an idea of what those in Massachusetts must have in their insurance plans to avoid penalties, below is the list:     

• A comprehensive set of services (e.g., doctors visits, hospital admissions, diagnostic surgery, mental health and prescription drug coverage).
• Doctor visits for preventive care that are not subject to a deductible.
•  A cap on annual deductibles of $2,000 for an individual and $4,000 for a family.
• For plans with up-front deductibles or co-insurance on core services, an annual maximum on out-of-pocket spending of no more than $5,000 for an individual and $10,000 for a family.
• No caps on total benefits for a particular illness or for a single year.
•  No policy that covers only a fixed dollar amount per day or stay in the hospital, with the patient responsible for all other charges.
•  For policies that have a separate prescription drug deductible, it cannot exceed $250 for an individual or $500 for a family.

Folks, we want to know The Good, The Bad, and The Buttugly of healthcare in Massachusetts today.  Click Here to get to the Forum   -  You will have to register when you get there if you are not already.

....NOT! 

I saw a humorous YouTube video which led me down an interesting path of reflection and reinforced the extremes in thinking some people have on healthcare in America.   Healthcare is a complicated social issue, and to the best of my knowledge there is only one only perfect solution.  And that's  perfect health.

I've included the video here as it is humorous, but I present it with a large caveat.  Health insurance in America is indeed less than perfect.  It is kind of like owning a used car.  Most of the time it works and gets us where we need to go.  It might have a few accessories like power locks and windows that provide us with some creature comforts, but overall it's just not that pretty.  Sometimes it breaks down and unexpectedly costs us more than we have on hand expect to make it work which can be frustrating but not devastating.  And on rare occasion something major happens and the clunker leaves us high and dry, in the middle of some barren desert, without a chance of survival.

This video, if viewed in a vacuum suggests that health insurance companies are the cause of the problem, spawn of the Devil, the root of all evil (and healthcare problems).  The creators of the video would like us to buy into this premise and then blindly accept their healthcare dogma.

....But the video is funny.  Just take it with block of salt.

After watching the video I followed the link and landed on the Health Care for America Now website.  I felt compelled to read their story, which at an ideal level has some merit (qualitiy, affordable healthcare for all Americans), but at a practical level takes the incredibly arrogant, and naïve position that they are right and anyone who disagrees with them is wrong.  Their truth is a manipulated and contradictory truth at best.

Remember the video?  The one above that makes insurance companies to be the spawn of the Devil, if not the Devil himself?  Health Care For America disdains insurance companies, yet they basically suggest that if you are satisfied with your insurance you can keep it.  That suggests to me that they have either overstated their cause "insurance is not affordable for families...etc." or their true agenda is something else.

This organization states:

"Our government's responsibility is to guarantee quality affordable health care for everyone in America and it must play a central role in regulating, financing, and providing health coverage by establishing:...."

Aha, their agenda....

The thing that really annoys me about this organization is not their desire to improve healthcare for all Americans, but their suggestion that this is a problem for which the bulk of the responsibility for fixing it falls to the Government.  I love it that they are trying to expose social injustice and health issues, but it really frosts my gonads that they fail to suggest that Americans themselves are part of the problem.  That State and The Federal Government are part of the problem.  That healthcare practitioners are part of the problem.  That attorneys are part of the problem.  That big business is part of the problem.  The list goes on, and we nibbled around the edges of this a few days back in our article "The Unscientific Top Ten..."  Yet the face they put on it is one of insurance company greed; part of the problem for sure, but a small part of the problem.

 Government owned, run, and mandated insurance is a slippery slope.  In the end, if the Government is true to form, like that old used care, it will leave us broke and disheartened. 

What frightens me about Health Care For America Now is their proposal rings of the entitlement bell shrouded in the guise of a right.  Unfortunately, rights are entitlements the minds of many.  If healthcare is a right, then it needs to come with an enormous amount of personal responsibility, accountability and some level of sacrifice.  We need to take care of each other.  If we believe  the Government cares a rats about us, I believe we are sorely misguided.

We should treat healthcare must be treated as a privilege for there are people in this world far less fortunate than us who drink dirty water and live in homes with dirt floors and minimal shelter.  Our focus should be on health first and then on healthcare.  For more thoughts on this please read, "Mountains Part Deux."

I think the solutions to our healthcare challenges need to be more collaborative.  I believe organizations like the Healthiest Nation Alliance are healthier at their roots than say Health Care For America. We've shown this video before, but it is worth another look. 

If you have read this far, then you are thinking.  That's good.  Now think a little more about how you can change the world.  Too big?  Then think about how you can change your world or maybe your child's world.  Start with your own health and you will be on your way to better, more affordable healthcare. 

 When I was a kid, up until the age of about eleven, my Grandmother used to conduct Doctor Jekyl-like experiments on my hair with her handy scissors.  I was a total toe head and when she was done they could have slapped me on the side of a paint can and called me the Little Dutch Boy.

I revolted at eleven and began a 30 plus year quest to find the perfect barber.  Recently though, in my quest to save more money into my health savings account I decided to give Betty, my barber, a little vacation and let my wife cut my hair.

The first haircut she gave me was disasterous and fully documented in an article on this site entitled "Hair Savings Account,"  and the second haircut, well that one was nearly apocalyptic and covered in "Health Savings Accounts and my Left Ear."

Because of the partial skinning I received last go round, it has taken longer for my hair to recover.  My wife, on the other hand still hasn't.

Still looking for ways to save, after considering allowing my teenaged daughter to have a run at it, or maybe that lady who I see walking around my house once a month reading the meter, I decided to take matters into my own hands.

I got out my Conair turbo pet grooming sheers, dropped a number 7 on them and let her rip.  It was absolutely exhilarating.  As a guy I felt like friggin' Rambo.  In control, self sufficient, even able to give himself his own haircut.  Now I did have to deal with hair pretty much everywhere. It was kind of like being in a New York tickertape parade.  Hair flying in my ears, all over my face, I was just covered up.  I was spitting out hair the whole time and I'm pretty sure it was multiplying as it fell toward the ground. 

Now, you may be thinking, big whip, he just shaved his head.  Hardly.  Cut and style baby, and if I say so myself it looks good.  Real good.  Well at least the parts I can see.

Are self haircuts a good idea?  Well, finding creative ways to save more money into one's Health Savings account is a good idea.  If I could figure out how to get my wife to do her own hair; now that would be big bucks but I don't see that happening.  With the right tools, a good vacuum cleaner, independence and creativity, you will be amazed at how you can save more into your HSA.

I have an HDHP.  When I go to the Doctor to have them look at the creatures crawling around in my throat, causing me to itch all over, or making my hair fall out in clumps, I am expected to pick up the full tab until I hit my deductible.   I even have a little stash of money, called an HSA to pay for it.  BUT, I don't pay a nickel when the Doctor is done with me.  Not immediately.

The Doctor has to put in a claim to my insurance company, the insurance company tells the Doctor how much they are going to pay, they then tell me how much I am supposed to pay, I then send the Doctor a check, the doctor tells the insurance company they received the check, and then insurance company tells me that the Doctor told them that they received the check.  If this laser-like process of precision breaks down in any way or God forbid, I don't send the check, honestly, I have no clue what happens.

For the past year, I have been writing for the Gradock Bulletin about health savings accounts, high deductible health plans, consumer driven health, healthcare and wellness and pretty much anything else that comes to mind that might be educational, worth a rant and/or is somewhat entertaining.

With that said, I have compiled Gradock's "Top Ten Reasons Why Healthcare Is So Friggin' Expensive!"  This is a very unscientific survey of one, but it points to a the gaggle of reasons that collectively (along with a few others I'm sure) that cause you and me to pay more when we go to the Doctor and put health insurance out of the reach of millions of Americans.

10.) We can't figure out how to spell "healthcare."

The fact that sometimes it is spelled as two words (health care) and sometimes as one scratches at the surface of inefficiency (it takes more keystrokes and kills more trees when spelled as two words)

9.) The right hand don't know what the left hand is doing:

See paragraph #2 above

8.) Americans are fat slobs:

Which makes us loveable and friendly, but contributes to chronic illness like heart disease, hypertension, and diabetes which cost us billions if not trillions of dollars a year in healthcare costs.

7.) State Mandates:

Did you know that your state may require insurance companies to cover certain illnesses no matter whether you are at risk of it or not, whether you are healthy or not, whether you care about the illness or not.  So for example, if you are a single male living in Arkansas or any of the other 20 states that require maternity coverage, you are paying, in your premium for someone else to have a kid.  Or if you live in Connecticut or any of 9 other states you get to pay for wigs.  Or if you are a non-smoker living in Maryland, you are paying for some lung burning smoker's, smoking cessation treatment when you pay your insurance premium.

6.) The uninsured and non-critically ill in hospital emergency rooms:

Emergency rooms, by their name and nature are set up to deal with emergencies, not the coughs of the illegals and uninsured, or the weekend colds of the insured.  This mindset may be compromising emergency rooms, and certainly is driving the cost of healthcare up for all of us.

5.) Regs on Meds:

My insurance company will not pay for, nor will they allow for money I spend on meds that come from Canada to count against my deductible.  Now some of this is to protect me from witch doctors, voo doo priestessesire and shady drug companies whipping up toxic drugs in oil drums on the streets of some third world country, and I understand that.  But part of this is driven by drug companies desire to tamp down competition.

4.) Three Card Monte Mindset:

Or in other words lack of transparency in healthcare.  Healthcare is set up so that we do not know what procedures, tests, and treatments cost, leaving us to guess where the most cost effective care is to be found.  And it is almost impossible to find the best doctors at the best prices in this environment.  There is some progress being made in this area with the establishment of minute clinics and services like outofpocket.com that are exposing the cost of healthcare which can help create more competition and ultimately drive costs down.

3.) "The Doctor's Handwriting" and malpractice law suits:

If the Pharmacist can't read the Doctor's hand writing and mis-dispenses meds or has to spend more time figuring out what the thing says, then we are talking time and money.  Or if the Nurse in the hospital gives the wrong dose or the wrong medicine to a patient, that can be a bad day.  Do you know that if a drunken, illegal alien with not a nickel to his name rolls into the hospital with his arm half cut off and doesn't like the way the attending surgeon sewed it back on, he can sue the surgeon?  Now I believe the guy has a right to sewing but not suing, unless there is horrific and obvious gross negligence.    

2.) Cleanliness is next to godliness:

Now I'm not a germaphobe but do realize how much stephastrepasyphacoctolis gets spread around because folks don't practice basic hygiene.  That lands folks in clinics all the time with preventable illness and, yes, drives the cost of healthcare up.

1.) What about executive compensation?

We can't let that one slide.  I'm all for people making money and if they make armored cars full of it that's fine it they are truly responsible for creating most of the value.  But I do have a tough time with guys who get paid huge sums of cash for what sometimes ends up to be short term value, or get paid huge sums of money when they screw up and get fired.  Hey, I could screw up any big publically traded company for way less than these guys get paid.  And what kind of money are they making?  Well I took a look at the AFLCIO database on executive comp and here are a few examples:  In 2007 the CEO of Abbot Labs was paid $33 million in total comp; the CEO of Aetna got $23 million total comp; the CEO of Merck got paid $20MM in total comp; the CEO of Humana got $10 million in total comp: the CEO of UHC got $13 million in total comp and the CEO of Cigna got $26 million in total comp.

These were the ten I was able to rattle off without too much difficulty and I know there are many more.  Feel free to comment on this article with additional reasons.  Maybe we can compile it and share it an another article or post it on this site's forum.

Last Christmas, my kids gave me this little sign to post in my yard.  The little sign came with no post so I got a piece of scrap re-bar, about 2 feet long, stoked up a good fire in the fireplace and heated that sucker until it was white hot.  I then carried that glowing steel torch down to the basement where, having managed not to burn down my house whilst hauling it through the den, down the stairs and into my workroom, I managed to bend and hammer a nice "S" curve into the end of that sucker.  Once cooled and painted, it looked better than anything I could have bought at the hardware store.  

I might add, that while pretending to be a blacksmith, no burns, injuries or casualties were incurred requiring neither a visit the local emergency room nor a dip into my Health Savings Account (HSA) to pay for said visit.   For the record, I do not recommend home blacksmithing because it could be very dangerous to your health.  Besides that, it is stupid and just plain moronic.

But this is not a story of an idiot/handyman blacksmith.  This is a story of my 4 year old nephew.

On Sundays after Church, my in-laws often take their grand kids to the Taco Bell for some fat laden, gas producing toxic taco eating.  After one such fine dining experience a few months ago, my in-laws ("Baggie" and "Pa Pa" to their grandchildren) were delivering the kids home when my nephew who can't read, noticed the sign in the grass.  "What does that sign say Baggie," he asks?

And she responds, "Well Clayton, it's a sign for dogs that says, ‘NO POOPING ON THE GRASS.'"  With a somewhat puzzled look on his face he counters, "That's silly Baggie, dogs can't read."

Now I would argue dogs can read, because since I put that sign up, my son has not dragged nearly as much poo on the bottom of his shoe into our house.

If you've read this far, good, because there is a point to all this and it does relate to Health Savings Accounts (HSAs) and High Deductible Health Plans (HDHPs).  In fact it relates to literacy in America in general.  We have become a nation of "skimmers," "sound biters," and "sign readers."  There are dogs out there who read as well as we do, and some even better than our children.   The point is this; the folks at HSAeducator.com,  recognize that this business of health insurance, HSAs, HDHPs, Consumer Directed Health, is not the easiest nor the most stimulating information to read, understand and digest.  So, through this website, they have tried to make it as informative and painless as possible.

They  can't boil it down to a few signs and sound bites, but hopefully if you visit the site on a regular basis, you can be entertained and more importantly educated about health savings accounts (HSAs).  Then you can take what you learn and use it to become a better health care shopper and be more aware of yours and your family's health.  And if you don't see what you need to answer your HSA questions, the folks at HSAeducator invite you to become a member of the site and then you can tee your questions and comments regarding HSAs, HDHPs, health and wellness up in the community forum on this site and your peers and HSA experts can help you out.

About this time every year employers all over the nation unveil their latest, greatest insurance offerings for the coming year. They've worked over their brokers, agents, and consultants, dusted off a few old tricks and brought a couple new ones to the game.  They've frosted up this package with Betty Crocker's finest, served it up on their finest china, put it on a fork and are now playing the "airplane" game with you.

Now you're probably thinking, "what's this hillbilly talking about?"  Tell me, am I right?  You've got your enrollment package, your employer is patting him or herself on the back at what a great job they did at keeping your premium from rising, or at least rising too much and you're saying, yeh, but what about my co-pays, why do I have to pay more for drugs, what about my deductible?

Health Savings Accounts are still relatively new, having just come into law at the end of 2003.  And every year, more and more employers are beginning to offer them to their employees.  Sometimes as an option for employees and sometimes as the only option for employees.

For the past couple of years, at this very time of year my friends come to me with quizzical and dim looks on their faces and begin asking me about the high deductible health plans (HDHPs) and health savings accounts (HSAs).  My friends are fairly bright folks, but as you know, the subject of insurance is about as exciting as a flat keg of beer at a fraternity band party.

They don't mind asking me about it because

My family has had our High Deductible Health Plan (HDHP) for just under one year, and last month we discovered that what we believed to be an embedded deductible was nothing of the sort.  Huh?  What's an embedded deductible you say?

When shopping for health insurance you'll often see an individual deductible and a family deductible quoted side by side.  In our case the individual deductible was $5,200 and the family deductible was $10,400.  From our reading of the insurance policy, if an individual within my family hit the $5,200, their coverage from that point forward for that person would be at 100%. Warning Will Robinson, WRONG, WRONG, WRONG!!!

There are policies with embedded deductibles that do what I thought mine did, but you've got to be very careful that if that is a need you have, that your policy will actually provide that benefit.  In fact, you really should talk to your insurance agent, and if you don't have one, get one.  They are free and if they are any good, they can steer you clear from this fly trap.

The last thing you want is to hit what you thought was your deductible and find you still have a ways to go before your insurance starts paying.

It's really quite easy actually...

United Healthcare recently released the results of a survey they did on their HDHP policyholders.  They took a look at the demographics and behavior of depositors and found that 86% of those surveyed opened health savings accounts when their employer contributes on their behalf.  However, only 27% of consumers opened HSAs when their employer did not contribute.

Ok, so if you are new to health savings accounts (HSAs) and your employer offers to contribute to your HSA and you do not open one, I'm sorry, you are probably the biggest LOSER of all losers.  You are being offered FREE MONEY for goodness sakes.  It takes very little time to open an HSA, and many employers will steer you toward the bank of their choice (be careful though, you can put your HSA dollars in any bank that offers them and just because your employer recommends one probably means there is something in it for them as much as you).  This is not "Let's Make A Deal."  If you decline the money, you are not going to be asked if you would like to choose what's behind Door Number 2.  Read between the lines:  TAKE THE MONEY LAZY BONES!

Now, if you are in the 73% of consumers whose employer does not contribute to your HSA and you have, for whatever reason, not opened one, there is hope for you.  Also, we'll cut you a little more slack because you are not being offered FREE MONEY (but you kind of are, and maybe just don't realize it).  First off, you can avoid becoming a LOSER by opening an HSA.  According to the survey 68% of individuals with HSAs actually contribute to them on their own, so half the battle is simply opening the derned things. Once you open one, the law of averages and momentum say you will contribute to it.

I know, but you are saying, why should I?  Well, here's a few reasons that are far better than simply being insulted and called a Loser by a total stranger:  First, you can deduct 100% of the contributions from your federal income taxes up to the annual maximum contribution.  So for example you are single and make say $30,000 per year, your annual maximum contribution is $3,000 for 2009.  If you can squirrel the full $3,000 into your HSA, then your tax base is reduced from $30,000 to $27,000 and you pay federal tax on the lower amount.

But if you are still not sold, here is another reason.  The money sitting in the HSA grows tax free.  So say you put the $3,000 into an account and it earns 2% annual interest over the course of the year you make $60 off your money and the sixty bucks is not taxed when you spend it, provided you spend it on qualified medical expenses.  So if you are thinking $60 is hardly worth tying up $3,000 for I'd say Bully!  $60 would cover a big chunk of a visit to the Doctor if you had to go in for a visit.  Plus, it's FREE MONEY.

Still not sold?  OK here's another reason not to be a LOSER.  Say you wake up one day and want to tell your boss to take his crummy $30,000 a year job and stick it where the flowers can't grow.  If you have an HSA you get to keep it.  Unlike an FSA the HSA is your account, so even if your employer has been funding it, that money is yours to keep.  If your new employer offers high deductible health plans with HSAs, then you simply go on bout your business.  Or if you are an individual and you decide the only boss you want to work for is you, then you can purchase your own HDHP and still keep the HSA you're your original employer.

If you have read this far, hopefully you have learned something and get the picture.  If you have the opportunity to open an HSA and fail to do so, you are not taking advantage of a very important piece of your health care plan.  Go do a little research and then open an HSA.