The Commonwealth Fund has testified in Congress against high deductible health plans.  Of course, they're right when they say we should all have the choice to see any doctor we want for anything we need.    But the Commonwealth Fund's main objection to HSAs (Health Savings Accounts) is off base: higher deductibles, they say, discourage people from seeking needed care.  It's not that they're wrong, it's that they're so far out of the reality of peoples' daily choices.  When people buy high deductible plans, they generally do it to protect themselves financially against bankruptcy.  The crisis of the uninsured has as much to do with health as it does with making sure you protect whatever nest egg or asset you've managed to build up.   The real problem is that in the year 2006, the middle class is just getting so squeezed that they have to make terrible tradeoffs.  Do I spend so much to get great health coverage, or do I put something in an IRA so I can have some kind of retirement (though, I believe I will be working, like, forever)?  Or do I just gamble and enjoy some regular old middle class pastimes – having a vacation, occasionally eating out? More later, Sara