RIght Cross

President Bush touted HSAs in his State of the Union address two weeks ago. According to the Treasury Department's Web site, an HSA is essentially a savings account into which you can deposit tax-free money you then use to cover medical expenses. To use the account, you have to buy what's called a High-Deductible Health Plan, which the government defines as "an inexpensive health insurance plan that generally doesn't pay for the first several thousand dollars of health care expenses."

In other words, your plan has to come with a fairly high deductible--at least $1,050 for single coverage and $2,100 for families, for those who sign up in 2006--which you deposit into that account each year. The annual contribution can't exceed that deductible, but if you don't spend the money one year, it carries over to the next (and the next and the next...), and, according to Goodman, those balances will earn interest that can be invested in stocks or mutual funds. According to a February 6 story in USA Today, supporters of the HSAs insist the accounts will "slow health care inflation by getting people to spend more of their own money on care."

But the story also notes that critics, including some conservative think tanks, loathe the proposal because the accounts "benefit mainly the wealthy," who could use the HSAs as tax shelters "and could drive up costs for others." Non-believers in the plan say it's likely that people will not go to their doctors for preventive care, since they'll have to pay for it out of their own pockets. Rather, they'll just wait till something's seriously wrong--by which point the cost of treatment will be exorbitant.

And on the larger scale, HSAs will lead to a substantial loss of tax revenue--$59 billion over five years, $156 billion over 10, according to most estimates. USA Today noted that that alone "will offset the savings Bush wants by limiting the growth of Medicare." Goodman, though, dismisses the criticism as coming from people "who don't know what they're talking about." He insists that in the long run, HSAs will reshape health insurance till it looks more like car insurance--that is, you have to pay out of your own pocket for regular maintenance, but insurance will take care of it when the car gets totaled. And as far as he's concerned, HSAs will lead to competition where it has never existed before: in the doctor's office.

"When it comes to HSAs, it appears the NCPA's fingerprints are solidly on that one," says David Callahan, who was writing about think tanks in The Nation in 1999 before founding his own, the New York City-based Demos, that very year. "Ultimately, though, this is a team sport. Ideological-change efforts are team sports, so it's hard to identify any single one player as being decisive." Even Goodman would admit that; ideas are like air, waiting to be inhaled.

Those who believe think tanks are invaluable to policy debates point to the success of NCPA's pushing of health savings accounts as proof the system works. Then there are others who believe think tanks like the NCPA are little more than "public relations fronts...generating self-serving scholarship that serves the advocacy goals of their industry sponsors," according to the Center for Media & Democracy's Web site.

There is no doubt at all that think tanks have become a tributary of political contributions: You donate to the candidate, to the party or the political action committee and then the think tank--with the latter option often being preferable because, hey, it's a charitable donation that gets you the tax write-off.

"I wish people thought that way," Goodman says. "We'd get a third of the money. But we don't."

Not that the NCPA has too much trouble raising dough.

In 2004, the think tank received $5,025,242 in donations and grants, according to its Form 990 filed with the Internal Revenue Service. Most of that money comes from right-leaning foundations; corporations and individuals round out the bank account.

Two years ago, the NCPA received $25,000 from the Scaife Foundations and, since 1985, more than $1.2 million from the pile of dough managed by Richard Mellon Scaife, referred to by The Washington Post in 1999 as "The Funding Father of the Right." The Scaife Foundations have spent hundreds of millions over the years financing conservative think tanks, law firms, university programs and publications, including The American Spectator, to which Scaife contributed $2.3 million "to dig up dirt on Clinton" while supporting "other conservative groups that harassed the president and his administration," according to the Post.

Of NCPA's revenue, some $200,000 was spent in 2004 on publishing a handful of books; another $500,000 went to traveling expenses (Goodman frequently travels the country and world, speaking and researching) and hosting conferences and lectures.