HSA+catastrophic coverage plans (i.e. saving money + traditional insurance) is indeed a good model.
The only real improvement I’d suggest is to impose a premium structure which would enable the following: the money put into the HSA each year still rolls over year over year, but at year N, rolled-over money from year N-2 and earlier year can either
(1) 100% roll over as well; or
(2) 90% roll over, and 10% out as cash
Imbuing money in the HSA with a degree of liquidity would put an additional incentive to shop around for value - and thus put more downward pressure on health costs - without introducing arbitrary market distortions.
(10% without penalty)
More and more people I know are choosign the HSA plans.
Right now, my family’s medical needs fit the older, lower-deductible and “Flex Spending Account” model, but I think the idea of “insurance” is being re-thought and returned to the original concept.