Overall, AHIP says that 6.1 million people had HSA-eligible high-deductible plans in January 2008, and about a quarter of them bought those policies in the individual market, where workers without employer-based coverage seek insurance. But if only half of those people have HSAs, and the rest just bought high-deductible policies because they couldn’t afford anything else, CDHPs are having a relatively small impact on the 47 million uninsured.

The authors illustrate cost-benefit relationships for several cancer drugs, including cetuximab for treatment of non-small cell lung cancer, touted as "practice changing" and new standards of care by professional societies, including the American Society of Clinical Oncology. They ask, "Is an additional 1.7 months [the additional overall survival for colorectal cancer patients treated with cetuximab] a benefit regardless of costs and side effects?"

"The reason preventive care doesn’t save money is simple. To prevent a single stroke, for example, doctors must treat thousands of people who have high blood pressure and therefore are at risk of stroke. The same goes for use of cholesterol-lowering statin drugs, which can prevent heart attacks."