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Reform of America's medical insurance and the delivery of healthcare is coming in 2009. There will be winners and losers.

Unless your voice is heard, you are likely to be one of the losers as Washington works to reform our medical care system.

Whatever you call them - flexible spending accounts, section 125 plans, health savings accounts, cafeteria benefit plans, health reimbursement arrangements - pre-tax health benefits are under threat.

Both the White House and Congress have advanced plans that eliminate all or part of the tax saving employees receive on their medical benefits through work.

Many groups representing employers have given up the fight.

You can't give up unless you want to be hit with a big tax bite and fewer choices when healthcare reform is finished.

Becoming informed is one of the best ways to start fightng for what you want.