The problem of Californians without health insurance is not as awful as generally portrayed. Most of the discussion revolves around the often unstated assumption that Californians should enjoy health “coverage” that pays for all or most of their health expenditures. However, laws and regulations that force health insurers to provide policies on this basis ensure that many Californians will choose not to buy them.

Let’s take a break from wringing our hands about how confusing and complicated the Medicare Part D prescription drug benefit is for our “needy” seniors (the wealthiest generation in the history of mankind), and examine a healthier offspring of the Medicare Modernization Act of December 2003: Health Savings Accounts (HSAs). President Bush’s State of the Union speech on January 31 will likely propose expanding the flexibility of this powerful tool that patients are using to take control of their own health care.