hsa is a healthcare device, a savings account you put your own money in, it is tax preferred and you can use that money in conjunction with a high deductible health plan. what you are given is the incentive to shop. doctors are given the incentive to treat you like the client. when you go into a doctor's office you are a patient and might be sick but the fact is you are not paying the doctor. you might pay 10% of what the doctor gets paid but the real doctors are the insurance companies, hospitals or the government. so the hsa puts that in place. 99% of the time government doesn't to stand the profit motive of the people in politically we don't understand the profit motive of the bureaucrats implementing it and that is one of the bigger issues. >> host: from your book, elon musk is one of the capitalists who knows he is in a war and built a company prepared to fight each and every crony battle to give his businesses every advantage possible. >> guest: he is an interesting character. i work with inventors. he is that weird peace, two inventors are well-known. everybody knows you have

an hsa is a healthcare device that, it's a savings account that you bring your own money in. it's tax-deferred and you can use that money and use it in conjunction with a high deductible health plan what you're given is the incentive to shop and the doctors are given the incentive to treat you like the client so when you go into a doctor's office normally, yes you are a patient, yes you might be sick but you're not really paying the doctor. you might be paying 10 percent of what the doctor gets paid, but the real payers are the insurance companies or the hospitals or the government the hsa puts that back in place but 99 percent of the time, government doesn't understand the profit motive of the people and politically we don't understand theprofit motive of the bureaucrats that are implementing it and that's one of the maybe bigger issues . >> from your book if you could expand on this. elon musk is one of the capitalists that knows he is in a war and has built a company prepared to fight each and every crony battle to get his businesses every advantage possible . >> guest: ye

the annual hsa market survey is showing 80% of savers are using their health savings accounts, hsas,tially as an extra spending account versus the tax-free savings nest egg it could be. based on per year savings limits, experts estimate savers who maximize their contributions over a 20-year period could accumulate up to an extra $75,000 toward retirement and $140,000 for a couple. all those funds go tax-free, mature tax-free and can be withdrawn, yes, you guessed it, tax-free. there's no minimum age at which you have to start withdrawing from an hsa account. the only catch is that the money does need to be spent, you need to prove it with all kinds of receipts, et cetera, but has to be spent on qualifying medical and health needs. you got to say that $280,000 number gives you heart palpitations. have you seen what the apple series iv watch can do? i liken it to slapping a doctor on your wrist. it has a built-in ekg scanner that's been cleared by the fda. the data collected on the watch can be directly shared with your doctor. the watch also does other things like track activity and n

do you think if congress passes some of these hsa expansion plans allowing hsas to cover conditions onpre-deductible basis, that will help make the government's more attractive and help change that trend? >> absolutely. i think employers are interested in adding more flexibility to these plans. there are certain services that can be covered and then it applies to the deductible. if you think about single deductible health care plans, it went back to pre-managed health care, back to a time before co-pays. there is a lot of rigidity around what you can do and can't do if you have a house savings account. most companies have a house savings account with a consumer-directed health plan. so building back in plflexibili, employers would like to start covering more value-based services and offering a higher coverage. so whether it's more preventive services or steering to standard of excellence, there is a lot more design based on value. and i think some of the proposals are beginning to move in that direction. >> would you expand on that? could you provide more color as to why there's been l

do you think of congress passes and the president signs a lot with hsa expansion plans, to cover conditions on a deductible basis, implements more attractive and change the trend? >> absolutely. employers are interested in adding more flexibility to these plans, certain preventive services can be covered and everything has to apply to the deductible. employers, they rebooted plan design back to save pre-managed care, back to a time before co-pays and there is a lot of rigidity around what you can do or can't do with a health savings account. with consumer directed health plan. building back in flexibility, employers would like to start covering more value-based services providing higher-level coverage, so whether it is around chronic condition management or preventive services or standards of excellence, there is a real opportunity to get back in design based on value. some of the proposals are beginning to move in that direction. >> expand on that, can you provide more color on why there is a dialing back and what has been happening to networks. >> speculation on why we are seeing a dialin

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especially with high deductible hsa's, they do not want to monitor all of their co-pays on one -- a hernia, for example, costs $3000. sen. alexander: do you have a guess? mr. tippets: i think it would be very low. i do not have narcissistic come up with the individuals paying cash usually do not have insurance, but they have the means to do so, or they have high deductible plans. generallynder: speaking, 55% or 60 percent of most americans are insured, more than 90% of americans. 55% or 60% of those who do have insurance have employer insurance. they get it on the job. get it from 40% medicare or medicaid. mandatesect, we have from washington about transparency on cost and quality for medicare and medicaid, but employer-sponsored insurance, correct? how useful -- i have two questions -- one is -- how useful are the current federal mandates on government-sponsored insurance? i mean, can the consumer really figure anything out from those, or do they need to be rewritten or may more meaningful? and two, should the federal government create similar mandates on the -- for the 55% or 60% of the

. >> that's correct especially with high deductible hsa they don't want to burn through in one year because of cost 3000 bundled maybe 15 or 20000. >> you have an 81 percent that pay cash have insurance they don't use i believe it is in use for high deductible. >> generally speaking 55 or 60 percent. 55 or 60 percent of those have employer insurance that get in on the job 35 or 40 get it from medicare medicaid. am i correct we have mandates from washington about transparency for medicare medicaid but not employer-sponsored insurance. how useful are the current federal mandates on government-sponsored insurance? >> did they figure anything out or do they need to be rewritten or made more meaningful products and should the federal government create similar mandates for the 55 or 60 percent of policies that are employer insurance? >>. >> great question senator. what we see especially with high deductible plans more and more individuals have these excessive burdens on them. we see a consumer driven system becoming more educated not just on price and quality to deal with these issues. because th

>> on the contract director with hsa. people are coming out of mental health facilities and are being transported from the hospital to a program or back. it is not like a normal transportation where you are just going in there. it is the rare circumstance when you have to bring in someone under that type of situation so they can move from a facility to a home where they will live for back. so there is higher liability. >> president serina: commissioner pappas? >> commissioner pappas: typically services are provided by the driver themselves. if there are places where the park and accessibility, or if there is no parking where an attendant has to assist in this location to the actual permit

what we are seeing especially with high copayment hsa didn't want to burn through your deductible co-paysfor one hernia example that will cost $3000 bundled. where it might cost 15 or $20,000 in a hospital. >> any gas on the percent of people that pay cash at your center also have insurance? that they do not use? >> i think will be very low. i do not have the exact statistics but the individuals paying cash usually do not have insurance but they have the means to do so or that have high deductible plans. >> a memo to this question. generally speaking, 55 or 60 percent of american -- most of americans are insured. more than 90 percent. >> correct. >> 55 or 60 percent of those that have insurance have employer insurance, on the job. maybe 35 or 40 get it from medicare, medicaid. so am i correct, we have mandates from washington about transparency. on cost and quality for medicare and medicaid. but not for employers sponsored insurance. correct? >> yes, sir. >> how useful. i have two questions. how useful are the current federal mandates on government sponsored insurance? can a consumer real