From a new General Accounting Office report on HSAs:
HSA proponents see the accounts as a way to incentivize account holders to shop carefully for health care services, but GAO did not find that to be the case in questioning members of focus groups. "Few participants researched the cost of hospital or physician services before obtaining care, although many participants researched the cost of prescription drugs," the report found.
"Participants said they would recommend HSA-eligible plans to healthy consumers, but not to people who use maintenance medication, have a chronic condition, have children, or may not have the funds to meet the high deductible," GAO said.
This would seem to confirm the fears of detractors: The plans aren't spurring more cautious health decisions, and are far better for the healthy than the sick. For now, my guess is that most adopters don't know that, and so those actually switching to HSAs are doing so for a mish-mash of reasons. If it becomes better known that HSAs advantage the young and well, healthy folks could flee traditional plans and risk sharing could disintegrate. I guess we'll see.
