content: Actually, I would not vary the accounts based on condition.  I'm largely in favor of the single payer concept, which is why I think that after the HSA account is depleted the government should take over, but I'm also being realistic in that I realize single payer has no hope of passage given the power of the insurance lobby and single payer does not provide sufficient incentive for people to make healthy life choices. The one interesting side effect of my "mostly cash" system is that doctors would likely reduce costs for those paying cash, much as my doctors (including my dentist) do now.  For example, an average checkup with x-rays at my dentist was $325 when I had insurance, and is $190 without.  It's all a scam to get as much money out of the insurance companies as possible, but we all know who ultimately pays for that abuse of the system.  My philosophy is to eliminate the insurance companies from the equation to the extent possible for routine and the once-in-a-lifetime non-routine care (recovery from a car crash).  For everything else, government pays.