It depends on your situation (age, health, dependents). Last startup I worked at did a high deductible health insurance and subsidized it with a $2000 Health Savings Account (deposits made with each paycheck on your behalf with pretax dollars). Done this way the HSA is like an FSA, but better. The HSA carries over from year to year, the FSA doesn't. If you had a big expense before the $2000 was fully deposited it could be lent by the company and paid back from paychecks. Since the company was already putting this in really what it what meant is that if you left the company before it was recovered from paychecks it would be deducted from the last paycheck. I don't remember the prescription coverage, but from what others said it wasn't bad. Some examples of the coverage:
Founder's son had a lung collapse and spent days in the hospital, but only paid 4K out of the HSA.
Co-worker had a preemie that spent a month in the hospital before they could take him home. Once again, $4K out of the HSA. High deductible covered the rest.
Another co-worker with a long term illness had $400/mo in prescription meds they needed. Covered.
Needless to say, they upped our rates the following year...
HSA's are a good thing, but when your COBRA plan expires, no matter how much you've banked in your HSA, they don't matter: a collapsed lung, complicated childbirth, or long-term illness will bankrupt you.
That's something that should be better normalized. Unfortunately, it varies sometimes based on the state and whether that coverage is required to be extended, but under a different plan.
I still think a single-payer system would be best for the economy overall. Decoupling healthcare coverage from employers should free up the market for people to switch jobs and take some risks that might otherwise be unthinkable. If the only thing keeping people working for a company is the healthcare, then maybe that company's practices actually have a negative net impact on the economy even though the balance sheets are in the black. Productivity, stress, and morale may actually be improved by a company with better work-life balance. It's worth considering the side-effects the structure of our society has beyond the highly visible numbers.
This is exactly right and many people would be surprised to find out exactly how much a hospital stay can cost. Our son was partially delivered when the OB moved the umbilical cord from his neck and it ruptured. Long story short, three days in the neonatal intensive care unit cost about $40k. We paid almost $5k out of pocket after the insurance and some hospital discounts were done covering the rest. The costs could have been significantly higher if there had been any further complications or treatment, we were lucky the three days were essentially just for observation.
Max contribution per individual per year to an HSA is $3050 currently. Assuming you did a good job investing and didn't lose money in this last market downturn, you might have saved like $15000 in the past 5 years. Remembering that your HD plan only covers 80% beyond your $5k deductible, this won't even last 2 years if you have a serious illness.
I don't see HSAs as an add-on to insurance (i.e., offers any kind of protection). I see them as a way of paying for meds, office visits, etc. with pretax dollars as long as you are healthy and continuing to work.
You're right, but the point of an HSA is to cover the cost of paying most low-to-medium-grade medical problems out of pocket, and to relegate health insurance back to its original role as insurance.
Also, you don't have to be good at investing to fully fund an HSA; the difference in cost between low- and high-deductable insurance is supposed to offset the cost of funding an HSA, and currently does do that.
Founder's son had a lung collapse and spent days in the hospital, but only paid 4K out of the HSA.
Co-worker had a preemie that spent a month in the hospital before they could take him home. Once again, $4K out of the HSA. High deductible covered the rest.
Another co-worker with a long term illness had $400/mo in prescription meds they needed. Covered.
Needless to say, they upped our rates the following year...
As they say, YMMV.