Philadelphia Reflections

The musings of a physician who has served the community for over six decades

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Expanded Health Savings Accounts



For advice and support about the thrust of this much-revised book, I owe new debts to the many people who read the first versions and commented. The first book was written as ideas developed in my mind, and rather in a hurry. The second revision was written so later thoughts might be introduced earlier in the argument. This one was written and rewritten to rise above the twin possibilities that either, the Affordable Care Act would be completely repealed, or it would essentially survive forever. I still don't know its future, whether it is too big to fail, or too big to survive. Either way, I think it failed to reform some things which should be reformed. The best way to defend that position is to propose an alternative which is much simpler, but more radical.

In particular, I am eternally grateful to John McClaughry for his help in the basic formulation of Health Savings Accounts, to my son George for his extraordinary computer skills and his Wall Street insights, to my book designer Elaine Lanmon, to my entire family for its support even when they were initially dubious, and to my secretary Torie Affrunti, who relieved me in the endless drudgeries of producing a book. ----------------------------------------------------------------------

Originally published: Tuesday, November 22, 2016; most-recently modified: Monday, May 13, 2019