Why not? Do you expect to not pay any part of your normal, expected annual heath care costs?

Insurance is for unexpected expenses that (a) you cannot foresee and (b) would be catastrophic to your finances. Thinks like major storm or fire damage to your house. A car accident that results in a total loss or worse, liability for someone's injuries.

Your annual physical, eye exam, and dental hygiene vists, and other routine medical expenses are as predictable as your utilites or grocery expenses. You can plan and save for those in an HSA, and your HDHP can cover anything catastrophic.

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kccqzy 4 days ago | parent | next [-]

It's not that people don't expect to pay. It's that plans like HDHP do not have predictability. An average person getting an average number of injuries cannot reasonably work out how much it will cost them to treat these injuries and whether the HSA is enough. The fact that there is the distinction between in-network and out-of-network means the deductible isn't a constant.

Your idea that insurance is only for things that are catastrophic to your finances is wrong. Health insurance is mandatory for the common good, even if your net worth is in the millions. You can't forgo health insurance just because you are rich enough. There have been long debates about ACA that led to mandatory health insurance that I will not rehash. And auto insurance is another example: you are still required to buy it even if covering liability for accidents and covering the loss of your car would be completely affordable for yourself.

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aidenn0 4 days ago | parent | prev | next [-]

What we have in the US is the opposite of insurance; the insurance companies tend to pay for normal health-care and then suddenly find a reason to not pay when something catastrophic happens.

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ImPostingOnHN 4 days ago | parent | prev [-]

Insurance is for unexpected expenses that (a) you cannot foresee and (b) would be catastrophic to your finances

I do not agree with that view, and I'm not sure that is how it is used in the US at least. In the US, for many people, health insurance is the only realistic means to obtain any healthcare, not just catastrophic care.

I get injured at least annually due to mostly-outdoor physical activities, and have a chronic health issue or two, so the prospect of paying thousands of dollars out of pocket before my insurance even kicks in, doesn't sound great (and wasn't, when I had HDHPs for years).

I think the issue is that pretty much everything which isn't preventative care is considered "catastrophic" under this logic (because it requires paying hundreds or thousands out of pocket), even non-major issues, so "catastrophic" happens a lot.

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BobaFloutist 4 days ago | parent [-]

I guess the idea is that you put a deductible amount of money into the account annually, and the tax-advantaged investment makes up for any difference between the deductible and the savings you get on premiums for having a HDHP (I.E. HDHP premiums + deductible - tax savings ≈ normal premiums + deductible).

It's an insane way to run health insurance, and it just goes to show that expected value and mathematical benefit isn't the end-all be-all, but it's supposedly mathematically coherent.

	▲	ImPostingOnHN 4 days ago \| parent \| next [-]
		It's mathematically coherent, but it's value relies upon the assumption that we are already spending thousands out of pocket (but it's not taxed). I prefer the option of don't spend thousands out of pocket, pay taxes on the unspent income. If I'm paying 100% of my healthcare costs, what good is the health insurance? Here I think it boils down to whether one thinks it's okay for everybody to spend tens of thousands of dollars per year on medical care, as long as they (probably) aren't bankrupted. If so, then they are probably more likely to view "don't bankrupt me bro" as the use case for health insurance, rather than "I need affordable medical care".
	▲	4 days ago \| parent \| prev [-]
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