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Understanding high-deductible health plans
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As banks and brokers catch on to the investing potential of HSAs, more are offering accounts with a variety of stock and bond investing options.

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Many experts, however, agree that it is unwise for consumers to invest money in the stock market that they may need in the next five years. If invest your HSA money in a stock mutual fund, you could find that you need the money to pay for an expensive medical test and have to take the money out when the fund isn't doing well. Such investments also carry fees, which directly cut into the returns consumers earn.

Consumers who need regular, ongoing care for chronic conditions such as diabetes might have more trouble than the average consumer, in terms of paying for their care through HSA savings, Collins says.

"In consumer-directed health care there is no real provision for people with chronic conditions who need regular treatment and medication," she says. "In our survey we found reasons to be concerned that these people are less likely to get needed care because of the cost and will either not fill prescriptions or skip doses. Then they will end up with more serious medical problems down the road."

Tools to navigate the system
In order to make the best use of a high-deductible health insurance plan and an HSA, consumers need access to tools that help them select health care providers, figure out a reasonable cost for different types of care and deal with the medical claims process. Many of the larger health insurance companies include a component that helps consumers determine the cost of common medical procedures and drugs.

However, if your employer offers a bare-bones policy or you are self-employed, you're on your own. In that case, you'll have to navigate the system yourself or spend money on the many Web sites and services that various companies are rolling out to take advantage of this trend in health care. These offer tools and help in deciphering your plan's benefits for a yearly fee, typically a couple hundred dollars.

Herrick contends that there is a good deal of information available on the Internet and on drugstore shelves to help cost-conscious consumers make better and cheaper health care choices, including information on generic alternatives to branded drugs; home testing kits for strep throat and other infections and e-mail interaction with doctors rather than more expensive office visits.

Collins disagrees, saying that the information available isn't that easy for busy consumers to access. "There is very little price and quality information out there, which means consumers have to make decisions with very little information."

And many consumers have little experience in navigating the ins and outs of insurance-policy claims and aren't savvy in terms of appealing claim denials and even understanding their policies and knowing their rights.

The bottom line
Whether consumer-directed health care actually saves money in the long run and catches on with companies and consumers is still open to debate. A study by the Deloitte Center for Health Solutions found that consumer-driven health care costs rose 2.8 percent in 2005, versus 6.4 percent to 8.5 percent increases for other more traditional health insurance plans.

Collins believes that consumer-driven health care imposes more inefficiency on an already inefficient health care system.

"There are a lot of administrative burdens on consumers and companies with HSAs and all their regulations and the other issues that employers have to explain and employees have to understand," she says. "There are lots of other ways to improve health care transparency and quality and save money that are more efficient."'s corrections policy -- Updated: Sept. 14, 2007
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