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I think HSA's have major drawbacks for the poor and uneducated. There is great incentive for them to save healthcare dollars, but there is a disincentive for them to pay for preventive care. The uneducated will not look at the long term benefits of preventive care, preferring instead to keep the cash. And thus we will continue to incur incredible costs from easily preventable complications of chronic conditions.

Nowadays, insurance companies tend to sell their products easily to those with ailing health. The reason is simple: they know that at some point they will be likely to need the benefits that these policies offer. However, people with middling health tend to be the ones whose financial situation does not really allow them to pay all those premiums. And the insurance companies will have to raise the premiums if they don't want to go out of business. At the end of the day, a limited number of financially weak individuals will be paying the high premiums they can't really afford. Those healthy men and women who would be able to pay even higher premiums, will never even think of buying a policy.

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