Our small firm, a blend of 7 individuals/family units, just switched from a group plan to the HSA. The net savings in premiums is nearly $11k/year.

That the premium savings is enough to pay for the deductible is a testament to the power of moral hazard.

I had brief experience with a private experiment along these lines in the mid-1980s. It was more trouble than it was worth, but times have changed. Maybe it'll make sense now.

I doubt it, but better to wait and see.

Is brilliant too strong a word?

Insurance, by definition, protects against risk. Paying for dental exams,routine physicals, etc, has nothing to do with risk. You might as well have your car insurance cover oil changes.

One of the great tenets of convervatism--to me utterly inarguable, exposing, I suppose, a complete failure of imagination--is to resist arrangements that separate choices from consequences.

I sure hope this works.

My blah experience was purely administrative, had nothing to do with anything so cosmic as conservatism.

However, there is another problem lurking, and it's one that Orrin, who does not believe in psychiatry, ought to be sensitive to:

If you allocate money to prevention, how do you make sure it is spent on something actually preventive? A savings account that sends money to chiropractors and health food stores is going to do more harm than good.

You aren't allocating it to prevention--you're giving it (back) to people to spend as they will, or not spend, if they're smart. Many won't be smart.

I currently have a family non-group medical plan with a $2,500 deductible. The premiums are now around $400/mo. I would accept a higher deductible to get a lower premium.

So you end up paying twice for the dumb ones instead of once?

Why would I want to do that?

How pay twice?

Because when they get sick because they wasted their money on quacks, we're not going to either 1. let them die in the streets, or 2. send them to the chiropractic clinics to be cured on residual payments.

We're going to have to put them through the real scientific medical system anyway.

I saw a study once that claimed that 60% of doctor visits were not related to any organic complaint. One of my stock questions of medicoes is to ask them if they think 60% is believable.

I've been asking that question now for over 10 years, and so far everybody says 60% is too low.

Yes, which is why you need to give people a vested interest in not spending the money. The typical complaint is people will forgo preventive medicine in order to recoup the money, not that they'll run out and spend it too fast.