I'll take the posting of the latest Health Wonk Review to belatedly respond to Bryan Caplan's snarky argument that HSA's will too bring down the costs of health care, because it's basic economics. Much of his post relies on some analogy about traveling to China, but I tend to think chemotherapy is different from jaunts to Shanghai in obvious enough ways that it's not a terribly useful metaphor.
What Bryan actually argues is that if everyone had to pay the first $10,000 out of pocket, they would get less care. Problem is, Bryan doesn't mention or doesn't know that the legal limit for a personal HSA's deductible is $5,200. Only when you're dealing with a family does it go up to $10,200. Butwaitthere'smore! Those are maximum deductibles. The average deductibles are far lower: $2,011 for an individual, $4,008 for a family. You're going to tell me this is where the savings are, given that the costs are among rare individuals spending in the five or six digits? I don't buy it. Those folks will bust through the cap on their first surgical consult, and this doesn't disincentivize their care at all.
