One of life's great mysteries is how really dumb people are able to function in society. You've probably asked yourself that question a million times – when the price of your groceries is $15.51, you hand the cashier $16.01, and she hands the penny back to you because she thinks you gave her too much money; when the sign says the left lane is closed half a mile ahead but people wait until the last 100 feet to put on their blinkers; when you do the math for your clients to show them they're clearly overpaying for health insurance but they're still too scared to give up the copays.

There was a 2006 movie called "Idiocracy" that tried to explain this phenomenon. The movie's narrator explains after thousands of years of evolution, man no longer has any natural predators. And because smart people often wait longer to have children, we're experiencing a sort of anti-selection where stupid people out-breed intelligent people, resulting in the dumbing down of society. Ridiculous, but it's easy to find yourself nodding in agreement.

So if people really are as dumb as they act, how can we possibly, in good conscience, sell them a consumer-directed health plan? Can they really figure it out? And if not, is it our fault for recommending it? In other words, should we sell our clients a more expensive product with higher out-of-pocket exposure because they're not smart enough to understand an HSA?