I read your link tom418 (which is to a blog, BTW), and I stand by what I said. There are many HDHPs available in Mass, but they do have to meet minimum standards. That by no means makes them "deluxe" policies, to use your term. For example, in order not to trigger the tax (or fine, if you prefer), a MASS HDHP: must not limit benefit payments because an individual develops Alzheimer's, mental illness, alcoholism or other chemical dependency after the policy is issued; it can't have a pre-existing condition limitation that lasts for more than six months after the policy's effective date; it must be guaranteed renewable or non-cancelable, etc, etc. Standards like these are a long, long way from demanding that people can only buy "delux" plans, which is what your post claims. What will happen and who will pay their health care costs if one or both of the Williams eventually develops Alzheimer's and their policy doesn't cover it and they, themselves, run out of money? Why should the rest of the taxpayers of Mass pay for them just because they opted for the cheapest type of insurance they thought they could get away with? Apparently, the plan the Williams couple has doesn't meet the minimum standards, but there's just no way to tell why from your link because no further info is provided. So given that you don't have the foggiest idea what their plan covers and doesn't cover, your question "In what way would a high -deductable plan (like the MA couple I mentioned had) be useless?" can be answered, "Don't know exactly, but maybe in a lot of ways."

We are discussing some of this on another thread that started out about retirement advice. No surprise soaring health care costs would come up there, eh? If a smoker pays more for life insurance and a driver with a bad record pays more for auto insurance, why shouldn't someone who *chooses* an unhealthy lifestyle (overeating, smoking, drug abuse) pay more for health insurance? Why should those who choose healthy lifestyles subsidize these people? (I'm leaving the funding for Public Health out of this because it benefits all of society.) Please, let's not inflame this with Sky Is Falling rhetoric about punishing people with bad genes who have, say Huntington's, and won't be insurable! This is about *choices* people make in their lives that affect their health -- and should, IMO, affect their insurance costs. Your doctor tells you to: loose weight; exercise; stop smoking; stop drinking; stop other drugs. You don't do it because...your family 'runs to fat'; you don't have time to exercise; if you quit smoking you'll gain weight; you 'need to relax with alcohol'; you're too stressed without 'recreational' drugs. He's not asking you to change your genes, but to make changes individuals CAN and DO make. If you won't change, should the rest of the people in your insurance "pool" (who very well may have had to make hard changes themselves) pay for the unhealthy risks you take?

Late husband worked for a health insurance company, and that was the last time we had a health insurance benefit. When he left that job, we got catastrophic care insurance, with a huge deductible. We eventually opened HSAs as well. Over the last ten years, each of us has had jobs that offered health insurance plans. We looked at the cost (to the employee) of those company plans, and the benefits, and restrictions imposed. We compared them to the cost of our current plans and benefits, (when you pay yourself, you chose who you want with no restrictions). The HSA balance creeps up over time, allowing more payments, (dental, doctor's office visits, optometrist exams,) on a schedule we controlled, instead of what the company plans would allow. Employers have been hit hard the last few years, too. The workplace plans we were offered had higher premiums than our individual accounts with Unnamed Health Insurance Company, and were not of more value to us. In spite of being a "catastrophic care" policy with a high deductible, It seems to be paying for things, or making partial payments for things, every time i turn around. Tick removed from back at walk-in facility: Paid half the bill. Prophylactic medication in case I was exposed to Lyme disease: I was stunned to have the couple bucks and change it cost. I asked the pharmacist "Isn't there a minimum dispensing fee?" Yes, she said, but the insurance covers it. If I hadn't had that policy, it would have been twenty dollars or so, for two pills. As it was, I paid less than three dollars out of pocket. I'm actually quite happy with the situation I'm in: the fewer people sticking there noses into my health care (policy wonks in DC or that lady in personnel) the better I like it. And it had no bearing on Poor Late Husband's demise: He had lung cancer, quite likely from his thirty eight years of smoking two packs a day. There were unusual circumstances that contributed to his sudden death only five weeks after diagnosis. No amount of chemo, surgery etc., would have saved him. I had a cancer scare myself, actually less than three months after his passing. I asked a nurse what would happen if I had cancer, and my insurance didn't cover treatment. She said she didn't know how that worked, and she said the doctors and nurses take precautions to not know anything about the finances of patients. That way, she said, those with or without insurance are treated the same way while in the hospital. I think it's stupid to go without insurance to have more money for lattes and cell phones, but I defend others' rights to spend the money they earn in a way that they find valuable. As for people who "End up in the emergency room because they couldn't afford a doctor" I've personally known, lived near, worked with some of those people...and they abused the emergency room option so they wouldn't have to pay. I've heard them rationalize taking a child with an earache to the emergency room to avoid a $20 co-pay at the doctor's office, and the hassle of scheduling an appointment. Then in the next breath they griped that they had to wait so long to be seen.

In response to Agnes, A few years ago I woke up one morning and noticed that colors were not very vivid in my left eye. A couple hours later I noticed that my vision had suddenly become very blurry in that eye. By that evening I could not see bright lights with that eye and everything was gray and white --- no colors at all. I got an eye exam that night and was diagnosed with optic neuritis and probable multiple sclerosis. Two days later I had an MRI and found out I did not have MS, but had two brain tumor instead. One of them was wrapped around my carotid artery and pushing on my optic nerve, which is why I was almost totally blind in my eye by this time. I had brain surgery a few days later. This is why the OP does not need to be without health insurance even if she is young and healthy. I was too, until I woke up that morning.