Lowering the barriers to consumer-directed health care: responding to concerns.

Consumer-directed health care is a potentially promising tool for moving toward more efficient use of health care resources. Tax policy has long been biased against health plans with significant patient cost sharing. Tax advantages created by health savings accounts (HSAs) began to change that, and proposed tax reforms could go even further. We assess various critiques of these plans, focusing on why they benefit not just the healthy and wealthy. Lower costs and more efficient health spending would help all patients and reduce uninsurance. Potential negative distributional effects are important but can be remedied more efficiently without distorting insurance design.