Peter Zorin provides examples of the misunderstandings of those who only seem to have a “No, because..” attitude. If he looked at the facts, (1) individuals better control utilization and to some degree they shop for costs. The history is lower costs for Rx as individuals move to generics and use fewer prescriptions. They don’t suffer any healthcare loss, they simply better utilize services that are currently use to excess as they appear free or have a good ROI ($10 copay for a $120 medication). Second, lower income purchasers (<$25k) are saving funds nearly as well as higher income, especially if employers make HSA contributions. If products allowed HSA rewards from insurers for fully insured plans, the savings for all would be even more enhanced.

HSA eligible plans are mainly about increasing personal responsibility and changing health and healthcare purchasing behaviors. If we don't focus on behavior change, we will never have a change to control the growth of healthcare costs. It is a major opportunity to increase the focus on health rather than sickness.

Sorry for the inconvenient truths, Peter.

Any and all comments are welcome.

Most HSA money is used for co-pays and prescriptions, where consumer awareness is actually useful. The idea was never to encourage people to price shop for a trauma center or brain surgeon.

I think HSAs, pro or con, are the least of our concerns right now.

I appreciate your perspective and might go along with it. However, most of health concerns requiring medical attention aren’t allowing time for shopping – it isn’t a car repair. The concept you have in mind, perhaps, would work and probably worked in the past for family practitioners. However, nowadays, most of them are associated with big medical practices, which, so far, do not post any price lists.

In addition, how a simple consumer would know what procedure to inquire about? Also, should one select major procedure based on its price or qualification of specialist and his staff that would perform it?

Should doctors earn salary based on their qualifications or be businessmen and investors as their main life goal?

What are the primary reasons for high cost of our medical care?

If you can shop for an accountant, or a dentist, or….???, you may do the same for physicians. All you need to do is ask. Any practice will quote standard fees for visits and procedures.

Why do you want to entrust all your decisions to a 3rd party, especially a government whose payments don’t cover expenses in many cases?

I suppose if you haven’t had much contact with health care, centralized decisions make sense, but any practicing M.D. knows one size doesn’t fit all.