Many employers offer an HSA in the benefit package as one of the coverage options. So it is possible.
Contribution amounts are limited. And most companies offer HSA for an employee to contribute to, but they do not contribute. Rather than them paying $10k a year into insurance I rarely use, put that money into an HSA.
My retirement medical costs would be well covered by that type of scenario.
Set aside funds when you are healthy to pay for deductibles when you are not. Then the $6,000 and $12,000 annual deductibles are not so scary, and catastrophic insurance becomes more common.
I use a health care ministry to insure our college age daughter. Her school has an affiliated hospital to train nurses and doctors, and campus clinics are basically free.
So she will likely never have a traditional health insurance claim, since all minor bruises and illnesses are very inexpensive. I can cover the deductible for a major event like an auto accident with savings before filing any sort of claim.
The unACA led to terrible insurance costs and deductibles if you didn't get a subsidy. One plan I saw offered a $12,000 family deductible and paid 70% after that, but cost minimum $1400 per month for a family.
Let's not pretend that the unACA truly helped anyone except:
Those families that could get a federal subsidy,
Insurance companies getting subsidies (at least until the feds stopped paying them),
Politicians that got campaign bribes to keep the system in place.