I think the problem for most governments is that they cover the cost of health care; and indirectly, we taxpayers.
I know my company changed the policy and pricing very quickly so that few if any could afford the small deductible 20/80 coverage up to a max out-of-pocket to a HSA with first dollar out of pocket until the max is reached.
A few people griped that it would be $6500 out-of-pocket if they got hospitalized.
For government employees, those on Medicare and Medicaid, or through a family member in those groups... not a lot of financial incentive to pay attention.
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