You want health care with that?

BEFORE President Bush comes to Ohio again to tout the wonders of his health savings accounts, he might better consider his audience. He came to the corporate headquarters of the Wendy's fast-food chain in Dublin last week to pitch his health-care reform plan, but it was not one many Ohioans can applaud.

Perhaps he should offer his ideas for reforming health care - shifting the health insurance burden from employer to employee - to an audience that can better afford high stakes gambling with health-care dollars.

In a state where the economy continues to lag and the unemployment rate continues to creep above the national average, the last thing people need is higher out-of-pocket medical costs. Under the President's risky plan, workers could easily be stuck shelling out more if they get sick, or suffer from chronic ailments, or need less than catastrophic medical care.

The President likes to sell his tax-free savings accounts as a way to rein in health care costs for everyone. But what it does is make employee health insurance coverage more affordable for corporations.

It also lowers premiums for employees who gamble that the payroll savings they set aside for routine health-care costs will be enough to cover their health needs until insurance kicks in.

In a perfect world, workers would accumulate tax-free savings accounts above and beyond what they need for health care, companies would save millions in insurance costs, and ultimately more savvy medical consumers would pressure the industry to lower prices.

But individual health-care needs are unpredictable and every family, especially those with children, knows about regular doctor visits and the occasional trips to the hospital.

In theory it would be nice to save for all the routine and emergency medical needs that arise and have the time and resources to comparison shop for the best and least expensive medical providers and services.

But in reality one might never be able to build up money in a health savings account and wind up financially devastated by out-of-pocket costs that accrue before high-deductible insurance ever pays a dime.

Wendy's corporate leaders, operating in one of the wealthiest communities in Ohio, can't say enough about their health-savings accounts and how they have cut the company's health-care costs big time.

But how cost-effective is the President's health-care remedy to the minimum-wage workers who serve up Wendy's hamburgers? What if they exhaust their health savings accounts and need medical care they can't afford to buy?

Chances are they'd go without. Just like many others in Ohio whose depleted family budgets buffeted by rising gas prices and home heating bills could be wiped out by an uninsured medical crisis.

They might find it hard to relate to health savings accounts that could well make their tenuous financial predicaments worse.