Health Savings Accounts: Case Study
The United States has arguably the most advanced health care in the world. And yet, a large proportion of Americans do not have access to this care due to its high cost. Providers, consumers, and the government have long searched for a way out of this paradoxical situation. HSAs offer one solution.

The American health care system is complex. A part of the population has access to health care through Medicare and Medicaid. Another part simply pays for care out of pocket. A substantial proportion of the population uses third-party payers to pay for care.

Payers have reacted to the rising costs of care by introducing various gatekeeper mechanisms. These have not been popular with consumers who see them as restrictive. The American population is aging and the need for care is likely to increase over the next decade.

While the earnings of health care professionals have been increasing, insurance premiums have also increased. Among hospitals, many are non-profit organizations offering substantial charity care. But for-profit and non-profit hospitals alike must show return on investment to remain viable. Providers must also factor reimbursement policies of payers into their decisions, sometimes even clinical decisions. These groups of stakeholders—patients, providers, payers, and the government—have different goals and different responses to the rising cost of care.

Based on your understanding, answer the following:

In your opinion, can HSAs be aligned to the expectations of all these groups?
Do you think HSAs can help improve health care cost, quality, and access? Why or why not?
Use the following resources, use outside resources and your textbook for this discussion:

How health savings accounts work: Contributions and tax benefits. (2006). Congressional Digest, 85(3), 69.

Duke, A. C., & Cude, B. J. (2016). Motivating Personal Contributions to Health Savings Accounts. Journal Of Consumer Affairs, 50(3), 652-665. doi:10.1111/joca.12094




Sample Answer

Sample Answer


The Role of Health Savings Accounts in Addressing Healthcare Challenges in the United States

The United States healthcare system faces challenges related to cost, access, and quality of care, prompting stakeholders to explore alternative solutions. Health Savings Accounts (HSAs) have emerged as a potential tool to address these issues. Let’s delve into how HSAs align with the expectations of different healthcare stakeholders and their impact on healthcare cost, quality, and access.

Alignment with Stakeholder Expectations

1. Providers: HSAs can benefit healthcare providers by encouraging patients to be more cost-conscious and involved in their healthcare decisions. Providers may support HSAs as they promote patient engagement and financial responsibility, potentially leading to more efficient use of healthcare services.

2. Consumers: For consumers, HSAs offer a way to save for medical expenses tax-free and have more control over their healthcare choices. This aligns with the desire for greater autonomy and flexibility in managing healthcare costs.

3. Payers: Insurers and third-party payers may see HSAs as a way to shift some of the financial responsibility to consumers, potentially reducing their own costs. However, payers may need to adapt their benefit structures to accommodate the HSA model.

4. Government: HSAs can align with the government’s goal of promoting consumer-driven healthcare and reducing overall healthcare spending. By incentivizing individuals to save for future medical expenses, HSAs could potentially alleviate some of the financial burden on government-funded programs like Medicare and Medicaid.

Impact on Healthcare Cost, Quality, and Access

1. Cost: HSAs have the potential to lower healthcare costs by empowering individuals to make informed choices about their healthcare spending. When consumers have a financial stake in their care, they may seek cost-effective options and avoid unnecessary services, leading to overall cost savings.

2. Quality: The impact of HSAs on healthcare quality is mixed. While cost-consciousness can drive efficiency and value-based care, there is a risk that patients may forgo necessary care due to financial constraints. Ensuring that HSAs are paired with education on preventive care and essential services is crucial to maintaining quality.

3. Access: HSAs can improve access to care for individuals who may have previously been uninsured or underinsured. By providing a tax-advantaged savings vehicle for healthcare expenses, HSAs can help bridge the gap for those with high-deductible insurance plans or limited coverage options.

In conclusion, while HSAs offer potential benefits in aligning with stakeholder expectations and addressing healthcare challenges, their effectiveness depends on factors such as consumer education, provider engagement, and regulatory support. By promoting transparency, cost-consciousness, and individual responsibility in healthcare decision-making, HSAs have the capacity to contribute positively to the U.S. healthcare landscape.


– “How health savings accounts work: Contributions and tax benefits.” (2006). Congressional Digest, 85(3), 69.
– Duke, A. C., & Cude, B. J. (2016). Motivating Personal Contributions to Health Savings Accounts. Journal Of Consumer Affairs, 50(3), 652-665. doi:10.1111/joca.12094


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