Employees, Martingale notes, rejected health maintenance organizations as a way to ration care, and employers are rightfully leery of the other alternative--government rationing.

FORBES: Don't Bank On Health Savings Accounts

The big question, notes Martingale, is whether enough consumers can be attracted or pushed into such plans to achieve "critical mass" and influence providers' behavior too.

FORBES: Don't Bank On Health Savings Accounts

They think this may be a once in a lifetime opportunity to change the paradigm, '' says Joseph Martingale , national leader for health care strategy at benefits consultants Watson Wyatt (nyse: WW - news - people ).

FORBES: Don't Bank On Health Savings Accounts