[nradov]

High deductible health plans are widely available and members pay for most routine care out of pocket (often via an HSA). However in practice this does little to hold down costs. Most patients aren't able to do effective price comparisons, and can't really switch providers just to save a few dollars.

https://www.healthcare.gov/high-deductible-health-plan/hdhp-...

There's pretty much a free open market for cosmetic medical procedures not covered by insurance. But markets can never really work for medically necessary treatments. Demand is essentially fixed regardless of price. Patients who are in pain or at risk of death will pay everything they have and go into debt besides in order to get treatment. On a large scale basis the only effective means of holding down costs is some combination of rationing and price fixing.

[Amezarak]

Not only are HDHPs widely available, they are widely used! I've seen numbers to where a third to half of all private-industry health insurance coverage is under a high deductible health plan.

These people, me being one of them, are extremely cost-conscious, believe me. It doesn't help for basically the reasons you mention.