BANGOR- A small group of area businessmen and businesswomen gathered at the Sea Dog Restaurant on Wednesday to hear a presentation about health savings accounts, a form of health care coverage that promises to save money for businesses and their employees. But a leading consumer advocate in Maine said health savings accounts act as a tax shelter for the wealthy and are little more than “a cruel hoax” for average Mainers.

About a dozen people attended the educational luncheon organized by the politically conservative Maine Heritage Policy Center, which is based in Portland.

“It’s always easier to spend someone else’s money,” said speaker Joel Allumbaugh, chief executive officer of the Hallowell-based National Worksite Benefit Group. If employees must first spend their own saved money, he said, they’ll think twice before seeking unneeded medical attention or ignoring advice to choose healthy lifestyles.

While health care spending accounts have been available in some form for many years, the specific version discussed Wednesday was authorized by the federal government in 2004.

Health savings accounts can supplement eligible high-deductible health insurance plans by allowing both employers and employees to deposit pretax dollars into specialized employee accounts. The money can be used solely for paying deductibles, co-payments, uncovered expenses and other out-of-pocket health care costs. Once the policyholder’s out-of-pocket spending limit has been met, the high-deductible plan’s regular insurance benefits take effect.

Unused money in the health savings account can accumulate from year to year, can “travel” with an employee when he or she changes jobs, and may be spent on nonmedical costs – though certain penalties apply if nonmedical spending occurs before retirement.

The system allows employers to purchase less expensive health plans with higher deductibles, saving money for themselves and their employees, Allumbaugh said. Setting up a health care savings account is optional for employees covered by eligible high-deductible accounts.

Eligible policies for 2008 have a minimum deductible amount of $1,100 for single-person coverage, and $2,200 for family coverage, and a maximum deductible amount of $5,600 for single-person coverage, and $11,200 for family coverage. The amounts are adjusted annually for cost-of-living increases.

After Allumbaugh’s talk, Tarren Bragdon, director of health policy reform initiatives at the Maine Heritage Policy Center, said his family, including his two young children, has been covered with a health savings account linked to a high-deductible insurance policy for the past four years. His account has about $17,000 in it, he said.

“I like to get the statement and see the money in there,” he said. “But obviously, I want my kids to be healthy, too.” Because an office visit with their pediatrician costs at least $100, Bragdon said he and his wife have learned to call the practice’s triage nurse to discuss any concerns before requesting an appointment or bringing their children to unscheduled “walk-in” hours at the practice.

“Even when you’re a prudent user to begin with, financial incentives make for an even more prudent user,” Bragdon said.

But according to Joe Ditre, executive director of the nonprofit advocacy group Consumers for Affordable Health Care, health savings accounts benefit the wealthy and have little to offer average Maine residents.

“These are tax shelters for the wealthy,” he said in a phone conversation Wednesday afternoon. For people who have contributed as much as they legally can to their Individual Retirement Accounts, he said, health savings accounts offer a place to sock away another $5,500 a year for an individual account or $11,000 for a family account. That’s the upper limit that can be deposited each year into a health savings account.

With the average Maine household income about $49,000 a year, Ditre said, most families are not in a position to save the amount of money needed to meet a high annual deductible and other out-of-pocket spending. And since many high-deductible plans don’t cover routine and preventive care such as cancer screenings or childhood vaccines, low- and middle-income families are likely to find they still struggle to afford the health care basics, Ditre said.

A recent report from the federal Government Accounting Office found that participation in the high-deductible plans linked to health savings accounts has increased significantly, from 438,000 participants in September 2004 to about 6.1 million in January 2008. But nearly half of those policyholders had opened a health savings account, according to the report, with about 25 percent saying they either could not afford to or did not think they needed to. The average income of those who did open a health savings account was about $139,000. The GAO report may be read online at www.gao.gov/new.items/d08802t.pdf.