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Previous Volume 353:1199-1202 September 22, 2005 Number 12 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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When President George W. Bush, in his second inaugural address, described his vision of an "ownership society," he specified not only the ownership of homes, businesses, and retirement savings, but also that of health insurance. Today, the most visible embodiment of this goal in the health care sector is the health savings account (HSA), which reflects a philosophical shift in emphasis from collective to individual responsibility for the management and financing of care. HSAs form the core of the emerging "consumer-directed" insurance plans, imposing greater cost sharing on enrollees but permitting broader choices than the health maintenance organization (HMO) plans . . . [Full Text of this Article]

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Dr. Robinson is a professor of health economics and chair of the Division of Health Policy and Management at the University of California, Berkeley, School of Public Health.

An interview with Dr. Robinson can be heard at www.nejm.org.

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