Transcendental Meditation is a form of mantra meditation rooted in the ancient Vedic tradition of enlightenment in India.  In that chronic stress is a leading factor contributing to high medical expenses, some experts posit that stress reduction may help to offset such costs. Robert E. Herron, from the Centers for Health Systems Analysis (Iowa, USA), compared the changes in physician costs for 284 consistent high-cost participants—142 Transcendental Meditation practitioners with 142 non-practitioners, over five years in Quebec, Canada. The non-TM subjects were randomly selected from Quebec health insurance enrollees with the same age, sex, and region to match the TM participant profiles. The TM participants decided to begin the technique prior to choosing to enter the study. In the year before the intervention began, there were no significant differences between the groups in payments to physicians.  During the five-year assessment period, the TM group's annual rate of change in payments declined significantly, while the comparison group's payments showed no significant changes. After the first year, the TM group decreased 11%, and after 5 years, their cumulative reduction was 28%.