The study specifically selected people with no substance abuse problem… if anything the author of the study were wary of what you say is a reactionary perspective.

True, and funnily enough french people don’t use yearly gross. Most of the time they use monthly net, and, in the context of salary negotiations, will specify over how many months. E.g. “2000 net sur 13 mois”

You probably are already aware of this but just in case:

• once you’re 65 you can withdraw from the HSA as if it was an IRA with no penalty.
• you can reimburse yourself for past medical expenses, presumably even 30 years in the past if you kept your receipts

If you’re worried about layoffs you should know that 401k loans put you in a precarious position if you do get laid off. Not only would you lose your income but you would also need to repay the loan or else it becomes a taxable distribution with penalty.

If you’re worried about layoffs you should know that 401k loans put you in a precarious position if you do get laid off. Not only would you lose your income but you would also need to repay the loan or else it becomes a taxable distribution with penalty.

If you’re worried about layoffs you should know that 401k loans put you in a precarious position if you do get laid off. Not only would you lose your income but you would also need to repay the loan or else it becomes a taxable distribution with penalty.

If you’re worried about layoffs you should know that 401k loans put you in a precarious position if you do get laid off. Not only would you lose your income but you would also need to repay the loan or else it becomes a taxable distribution with penalty.

Good discussion topic! I recently went through a similar exercise and my conclusion is that the HSA scenario financially wins in all cases as long as my OOP cost remain below 90% of the max on average. In my case both plans had low/no premiums.

There is one major caveat though: The advantage the HSA plan has comes from tax savings on the pre-tax contributions and from the tax free growth of the HSA. This only works if you do not spend any of your HSA funds and instead invest them, paying for healthcare with post tax money. Meaning you need to have 1-2x your max OOP set aside at all time to be safe.

The HSA is a very advantageous account for tax saving but I think it’s fundamentally flawed for actual healthcare costs because no one can predict what their costs will be next year.

I think a better approach is to assume your costs can be anywhere from 0 to the max OOP and see how the numbers work out for different scenarios. Then you can make a decision based on financial (not health) risk tolerance.