When is 40 percent growth not nearly enough? When it comes to improving our national model of purchasing health care.

According to a recent census of insurance companies (available in a PDF file), the number of Americans covered by health savings accounts (HSAs) and their companions, high-deductible health insurance plans, is up 40 percent in the last year.

In an editorial a few weeks ago, Investors Business Daily says that even after year-after-year growth, HSAs are still small players. Noting that HSAs represent only 1.5 percent of the covered population, the editorial argues that this product is still a niche product, with too little market penetration to have a significant impact on costs.

"Two outcomes are possible," the newspaper continues. "Either consumers drive the system toward greater efficiency through choice and competition, or the government steps in to set prices and ration care. Politically and economically, there should be no question about which course to take."