[TBH]

I've heard it said that HSAs benefit healthy people the most. The scary thing is that you can't predict when your body is going to need some serious work. It may happen the day after you sign up for an HSA, when you have only a few bucks in the account. There's just no way to know.

I would try an HSA if I could save significant amounts of money by doing that. My spouse and I both work part time, so our out of pocket insurance costs are pretty high. If our out of pocket costs were the same, but the $$ was going into an HSA instead of the insurance company's pocket, I would sign up. But like rexdart I would first make sure I had enough in my E fund to cover the deductible until my HSA balance grew enough to cover it. Even then, I'd breathe a lot easier after the first year or so, when the HSA balance had crossed that important threshold.

I have some of the same concerns as VJW about the fairness of this plan. I think there will be a big tendency for people, especially lower income people, to forego medical care if their HSA doesn't have enough to cover it. So I have serious reservations about a large scale move to HSAs.

But for me personally, if the circumstances were right, I think I could come out ahead with an HSA.

I also think that HSAs may create a health care environment where people paid closer attention to medical bills. More errors would be caught, and there would be less opportunity for overcharging for routine medical services. But doctors are just so strapped as it is because of the low fees paid by HMOs, and because of the high malpractice insurance premiums they have to pay, that honest doctors with small practices are probably not going to be able to budge too much on their fees.