But the annual gifts do more than ensure that participants are financially secure; they give people skin in the game. Participants spend prudently because they

But the annual gifts do more than ensure that participants are financially secure; they give people skin in the game. Participants spend prudently because they know that any unspent HSA balances are theirs to keep. The result? Massively lower health-care spending without any decrement to health outcomes. HSA also discourage you from doing any preventative care because that's money you can probably find a use for in other ways. Thus inflating long-term healthcare costs as people only go to the doctor when it's an emergency. Anyone who supports HSA accounts is either an idiot or has suspect motives. Those may be a strong opinion, but it's one I stand by in this particular case.