Health Savings Accounts: Putting Patients in Control

Today, some workers have piled up $8,000 in their health accounts.

"And then that's their money," Mackey said. "It builds up over time … and so, that's great because the money is compounding for them."

Weirs said he can save up his money and afford to have a child later on. It's because he controls the money and as it builds up, it can cover all sorts of future out-of-pocket medical expenses.

'How Much Will This Cost?'

Mackey said this changed his employees' behavior.

"They start asking how much things cost. Or they get a bill and say, 'Wow, that's expensive.' They begin to ask questions. They may not want to go to the emergency room if they wake up with a hang nail in the middle of the night. They may schedule an appointment now."

They didn't ask what things cost before?

"Why should they?" Mackey said. "Somebody else was paying for it."

When she went to the doctor, Whole Foods employee Mary Ann Buttros never asked, "How much will this cost?"

"Because it didn't matter," Buttros said. "And now it matters to me, because it's my money."

Because it is Buttros' money, some people worry that Health Savings Accounts will discourage people from getting the preventive care that they need or that they'll shortchange their health to economize.

"The premise in those kind of questions … are that people are stupid. They're not smart enough to make these decisions for themselves. It's sort of an elitist attitude," Mackey said. "The individual is the best judge of what's right for the individual."

Shopping Around

Apparently, most individuals are making smart choices.

Regina Herzlinger, a Harvard Business School professor and author of "Who Killed Health Care?," said that "people who have these high-deductible health-insurance policies take better care of themselves. … They have more yearly physicals," she said. "Because they're saying, if I keep myself healthy, in the long run, I'm gonna be spending less money."

Whole Foods employee Cheralyn Schmidt used her account when she wanted to get a physical. Because it was her money, she shopped around. She found prices varied by hundreds of dollars.