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I thought some might be happy to know that my heart scan showed no cholesterol effects after a lifetime of high readings.

Thanks to advice from my health-food store I, now 61, have been battling my problem with massive amounts of oatmeal, soy protein drinks, odorless garlic, exercise and the advice of Lafayette's Open Sesame store owner, who told me to lose 10 pounds.

The heart scan itself is an interesting experience because it is essentially a Magnetic Resonance Imaging (MRI) procedure that shows what's happening in the heart's plumbing system. The $495 cost of looking at my heart was not covered by insurance, but it was an eligible expense for the Section 125 Cafeteria/Flex plan we maintain here at my company.

This means that it was paid for with voluntary contributions I deposited into the plan that came off the top of my pay, before any taxes were calculated.

I saved federal and state income taxes as well as employer and employee social security and Medicare costs. If you add up the costs of all these taxes, the tax savings amounted to a 50 percent subsidy of the MRI cost.

To look at it another way, if I had had to bonus myself enough to pay this bill with regular after-tax dollars, the gross bonus amount would have had to have been slightly more than $1,000 to pay the taxes and leave me with enough in my checking account to pay the $495 bill to Heart Scan.

For the average California resident, the last few dollars of pay -- i.e., any bonus amount -- is taxed at the highest marginal tax rate, and the combined percentage of all applicable taxes is easily 50 percent or more for any family with adjusted gross income of more than $60,000.

For singles, that income benchmark is about $30,000. Social security and Medicare alone amount to nearly 20 percent, and the charade of splitting the cost between employee and employer is ridiculous.

The total cost of employing someone includes salary and all insurance costs. An employer's share is just money that otherwise could have been paid to the employee if it hadn't been paid to a mandatory government insurance payment.

Apart from the popularity of Section 125 cafeteria plans, Health Spending Accounts, or HSAs, are slowly working their way into the public consciousness. More than 2 million Americans have now set up these accounts, which dovetail with high-deductible health insurance plans.

The idea is that your health plan has a deductible of $1,050 for singles or $2,100 for families. To fill in the blanks, you are allowed to set up a pretax savings or investment account that will allow deposits of up to $2,600 for singles and $5,450 for families.

The money compounding in these plans, assuming any is left over from year to year, builds up tax-free and eventually can be extracted tax-free and used for retirement living expenses if it is never needed to fund health-related expenses.

Right now, the banks offering these programs are providing only savings accounts, but just around the corner is undoubtedly the possibility of mutual fund options as the dollar amounts begin to build.

In a perfect world, a couple with no health problems for 10 years could invest their $5,450 per year in a good, balanced fund and earn possibly 10 percent tax-free. At that rate, the money would compound to almost $90,000.

If their uninsured health expenses turned out to be an average of $2,725, or half of their annual contribution, they would still wind up with about $45,000.

Once Medicare coverage begins, the need for the account is reduced substantially. Used for health-related expenses in retirement at that point, a fully funded HSA account with the right financial institution could be a better vehicle than a Roth IRA. At least today's deposits are tax-deductible and those for a Roth are not.

The world of small business -- which employs about 70 percent of all Americans -- offers tremendous opportunities for flexibility and creative thinking that large companies have too much inertia to even consider.

The creative combinations of HSAs and Section 125 Flexible spending plans offer tremendous advantages that can help alleviate what is a dysfunctional system.

But don't hold your breath waiting for insurance companies, politicians, drug companies and hospital organizations. Wellpoint, with 33 million members, just announced record profits (more than $600 million for the quarter) thanks to the executives who paid themselves more than $250 million for accomplishing the Blue Cross merger.

Only public financing of political campaigns will ever lead to any substantive change in an area where everyone is making so much money that they will spend millions of it in campaigns to maintain the status quo.

In the meantime, our best defense is what is now called "the fitness lifestyle." Remember: No pain, no gain -- and no bulging HSA account to spend in retirement.

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