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In page Comparison of the healthcare systems in Canada and the United States:

"

In the United States, Congress has enacted laws to promote consumer-driven healthcare with health savings accounts (HSAs), which were created by the Medicare bill signed by President George W. Bush on December 8, 2003. HSAs are designed to provide tax incentives for individuals to save for future qualified medical and retiree health expenses. Money placed in such accounts is tax-free. To qualify for HSAs, individuals must carry a high-deductible health plan (HDHP). The higher deductible shifts some of the financial responsibility for health care from insurance providers to the consumer. This shift towards a market-based system with greater individual responsibility increased the differences between the US and Canadian systems.^{[citation needed]}

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