The article is based on an odd premise. It sounds like the employees in the study were given an HSA with a deposit equal to their deductible, so they could spend up to that limit without incurring any personal cost. The trick here is that an HSA <i>should</i> encourage you to eliminate unnecessary spending because you get to keep the money you save and bank it for bigger health care costs down the road. I&#x27;m 27 and healthy, had a really uninformative annual physical last year where my doctor bilked me for a totally unnecessary EKG, and as a result I skipped my annual physical this year and am banking the savings for a serious illness in the future. The study should actually look at whether people went to the doctor less over the long-run for serious issues -- like not going to the doctor for symptoms diabetes, which left untreated can cause much larger long-term costs to the system -- rather than whether they simply avoided &quot;valuable&quot; medical visits, which in this case as &quot;preventative care&quot; has unclear value.<p>EDIT: The answer to her question &quot;Why wouldn&#x27;t this group get the care they wanted, pay for it with the HSA, and just run through the out-of-pocket spending earlier in the year?&quot; is that &quot;the care they wanted&quot; is treatment for a catastrophic illness later in my life rather than dubiously valuable preventative care right now. I&#x27;d rather skip a doctor visit for the flu and have more money banked in the future for cancer treatment or a heart attack.