A survey of primary care doctors found that less than half felt ready to discuss medical budgets and reported low knowledge of how HSAs work.

If physicians don’t understand how high-deductible plans work, how can patients?

One problem is that there is no formal training. I learned pretty much everything I know about the various types of insurance plans and basic health policy issues from reading blogs. Not every doctor does so.

Another is that a typical doctor’s office accepts upwards of 10 different insurers, each with their own byzantine rules. Knowing the nuances between each plan is a lot to ask, especially when schedules are overflowing with patients.