> However, it's my understanding that traditional health insurance in the US pays for those things (often without co-pay) because preventative treatments are ch

> However, it's my understanding that traditional health insurance in the US pays for those things (often without co-pay) because preventative treatments are cheaper. If you add a co-pay for getting a flu shot, or even worse don't cover it, many more people might skip it and some of them will inevitably develop the flu. Treating those cases will likely end up costing way more than paying for flu shots for all the insureds. So full disclosure: I work in insurance and adjust claims myself. This is certainly a reasonable cost-reduction strategy, but it isn't necessarily the most cost effective strategy, nor is it the only strategy. Indeed, Singapore has shown us that you can achieve more efficient per capita health spending WITHOUT covering flu shot co-pays, etc for everyone. > But (to me) it comes off as a self-managed insurance plan that you use to pay for your actual health insurance. It's insurance for insurance. Which is slightly bananas. I recommend listening to 3 or so minutes of this Reuters podcast (starting at 12:30)[1] that talks about Singapore's healthcare system, its journey trying different systems out, and some of its learnings. One key insight that they picked up on was that for the vast majority of people, the bulk of one's healthcare expenditure in life occurs at older ages once health starts to deteriorate. In that regard, it's almost like social security, where you save up over the course of your lifetime and build up this trust fund that you would eventually expect to use once you're older...which is largely what HSA's are: a savings account in a wealth fund that grows over time. [1] https://soundcloud.com/reuters/the-exchange-too-small-to-fail https://soundcloud.com/reuters/the-exchange-too-small-to-fai...