A Test of Relevance

Is anyone paying attention to the president anymore?

Consider today and tomorrow a test of presidential relevance, as the White House tries to get the nation to turn its attention to the topic of health savings accounts.

At a White House meeting this morning, and then in a so-called "panel on health savings accounts" in Connecticut tomorrow afternoon, President Bush is trumpeting the accounts as a free-market antidote to the nation's health care crisis.

But with war raging in Iraq and pandemonium breaking out in Congress, Bush is having a harder time than usual making himself heard. And in this particular case, even if people do pay attention, it doesn't mean they'll buy his argument. Much like Bush's failed attempt to restructure Social Security, the argument for health savings accounts is, on its face, problematic.

Bush's chief economic adviser, Allan B. Hubbard , kicked things off yesterday with a New York Times op-ed in which he insisted that health insurance premiums are up because consumers of health-care services aren't being smart shoppers.

"To control health care costs, we must give consumers an incentive to spend money wisely," he wrote.

But that brings back memories of how managed-care health plans became the dominant players in the industry in the 1990s: By promising that, as super-efficient mega-organizations, they could put a needed squeeze on doctor and hospital bills.

So that didn't work -- and now we're supposed to believe that individual patients have the leverage?

Sarah Lueck writes in the Wall Street Journal: "Mr. Hubbard, a buddy of President Bush's from Harvard Business School days, is the White House's lead pitchman on the president's health-care proposals. They include providing bigger tax breaks for health-savings accounts, or HSAs, and making hospitals' and doctors' prices available to consumers.. . . .

"Democrats say the emphasis on HSAs does little to help the uninsured and favors the healthiest and wealthiest Americans."

Hubbard was formerly on the board of and an investor in Medical Savings Insurance Co., which sells HSAs.

"When Mr. Hubbard arrived at the White House, his main task was pushing Mr. Bush's Social Security plan. That fizzled, and by last summer Mr. Hubbard was chairing an internal work group on health care."