At a Fast Food Bastion, Bush Sells Health Plan

President Bush talked on Wednesday about good health, and his plan to help America pay for it, at the home office of the nation’s third-largest purveyor of hamburgers and French fries.

Speaking in the lobby at the headquarters of Wendy’s International, Bush urged Americans concerned about healthcare costs to consider a fledgling government program built around high-deductible insurance for catastrophic illness or accidents and tax-free personal savings accounts to pay for routine medical needs.

The health savings accounts, or HSAs, offer participants choices in healthcare while holding down costs because the payments will come from a patient’s savings account, Bush said. If patients shop for the lowest prices, doctors and others will yield to competitive pressure, he added.

The plan’s critics have argued that the program would attract the healthiest Americans, who would be able to put aside savings tax-free and spend little for healthcare, while traditional employer-provided plans would be filled with people whose health costs are the highest.

“If patients control how their healthcare dollars are spent, the result is better treatment at lower cost,” Bush said.

As an example, he cited what he said was the decrease in the cost of laser eye surgery, which is usually not covered by insurance. As a result, he said, patients sought the best price because they paid for the procedure themselves.

“The combined cost of catastrophic insurance coverage and HSA contributions are usually less expensive than traditional coverage,” the president said. “That’s important to know. In other words, HSAs are making healthcare more affordable.”

The one-hour speech is part of a weeklong administration effort to draw public attention to its healthcare proposals. Cabinet members are making appearances from New Hampshire to Washington state, and First Lady Laura Bush spoke Wednesday about heart disease in women at a medical center in North Carolina.

Separately, Ben Bernanke, the new chairman of the Federal Reserve Board, told the House Financial Services Committee on Wednesday that Congress must tackle rising healthcare costs, which he said were keeping insurance premiums high, forcing employers to cut plans or increase the amount employees must pay, and hampering the economy’s efficiency and competitiveness.

The president’s message drew sharp criticism, and the location of the speech was too delicious for some critics to resist.

“His healthcare scheme just helps the healthy and wealthy, and leaves the rest of America behind,” said Sen. Edward M. Kennedy of Massachusetts, a leading Democratic spokesman on healthcare issues.

In his remarks, Bush said that “40% of those who own HSAs have family incomes below $50,000 a year.”

The president’s decision to speak at the headquarters of a fast-food chain raised eyebrows at the Center for Science in the Public Interest.

In an e-mailed statement, the center’s executive director, Michael F. Jacobson, asked: “Was the lobby of Philip Morris unavailable?”

Wendy’s is listed by business research firm Hoover’s Inc. as the third-ranking hamburger chain by sales, trailing McDonald’s and Burger King. According to the research firm, it operates nearly 6,700 restaurants worldwide, about 78% of them franchised.

The White House was attracted to Wendy’s by its healthcare menu.

The company offers employees health savings accounts, paying a share of the catastrophic insurance and contributing to the savings accounts, Bush said.

After the program’s first year, “90% of the folks didn’t use all the money for the routine expenses,” he said.

“Maybe it helps preventive medicine, I guess, when you’re watching your own money and you realize that if you take care of your body and you exercise and you don’t do stupid things, you end up saving money,” he said. “And when you save money, it’s your money, not the company’s money.”

HSAs are different from flexible spending accounts, which also set aside tax-free money for medical expenses. But unlike the funds in the flexible spending accounts, which are forfeited if not used within a specified period of time, money put in a health savings account is the property of the account holder, is rolled over from year to year and travels with employees when they change jobs.

From a little-noticed start in 2003, health savings accounts have become the centerpiece of the president’s health program.

In the last 10 months, the health insurance industry reported two weeks ago, enrollment in the accounts has tripled, to 3 million people. About 198 million people in the United States are covered by private health insurance; 46 million have no insurance.

Under changes Bush is proposing, the amount that individuals could contribute to the tax-free HSAs would go from the current $2,700 to $5,250. The family contribution would increase from $5,450 to $10,500. The administration says this would allow people to pay all of their medical costs from the accounts; critics say the administration’s estimate is exaggerated.