California could be the first demonstration of health reform'sability to improve a health care system. The state has a massivenumber of low-wage or self-employed workers (32 million) enrolledin high-deductible plans because they can't afford higherpremiums.

As we reported before, analysts at UCLA are worried highout-of-pocket costs remain tied with a reluctance to seek care.They're also concerned the lower monthly premium is a risky trapthat lures low-income individuals and families who could possiblyface thousands of dollars in expenses if they have a healthemergency. And the gamble gets even riskier when most participantsdon't have a health savings account to help with those costs.

These experts are banking on the state's new "Health BenefitsExchange" to ease the cost burden by capping out-of-pocketdeductibles at $2,000 for individuals and $4,000 for families andoffering subsidies for those with low incomes. And with healthreform's requirement for free preventive care services, the state seems poised todevelop a nicely woven system of reform and consumerresponsibility.

However, at this point, it might be too early, and we'reassuming too much. Just because it's stamped into law doesn't meanconsumers will change. Will they truly become aware of the valuableservices they can get at no cost? Do they know they could beeligible to receive help meeting their deductibles? And will theyactually take responsibility for routine checkups or screeningsthat could save thousands in the long run?

When Michelle Obama championed free preventive care, lawmakers finally appeared tobe breaking through insurer limitations and maybe now they couldstabilize the root of rising health costs by allowing easier accessto preventive measures. But like her childhood obesity campaign, it's a good theory with a flimsyexecution.

Though we have power as consumers, our stubborn nation is inneed of guidance. If the brokers and agents who advise on healthplans won't do the job to educate their clients, there's alwaysanother federal task force ready to intervene. That is, if anyoneis willing to listen.