He had a long gash in his hand, but it didn't look deep. Still, there was blood, and he was screaming. So it goes.

But should we go? To the doctor, that is.

Not so long ago, the thought wouldn't have crossed my mind.

But times they are a-changin', and so too is our insurance coverage.

My husband Jerry and I, both self-employed, were tired of paying $700 a month for health insurance that we, thankfully, didn't use much.

So we recently switched to a high-deductible health savings account, or HSA.

And the switch has set my mind racing with new worries and, although I'm no expert, new strategies for healthcare.

In a nutshell, an HSA typically lowers a person's monthly premiums.

Ours were cut nearly in half. But to compensate, we'll pay most everything out-of-pocket with the exception of preventive care like mammograms, yearly physicals and the like, which, to my understanding, are free.

It's a gamble, really.

You hope you don't need to go to doctor too often; if you do, you pay the agreed-upon reduced rate the insurance company has negotiated with the provider -- in full -- with a little debit card that accesses however much money you've managed to squirrel away for these anticipated expenses.

Then, you bow your head and pray that at the end of the year the total you paid out-of-pocket is less than your combined monthly premiums would have been.

There's one more thing that should help us; those out-of-pocket payments (but not the monthly premiums) are paid with tax-free dollars, and the card can be used to purchase things such as prescriptions, saline solution and ibuprofen.

If you end up needing surgery or if you're hospitalized, you have to meet that high deductible.

Ours is $5,450. (I know, it scares me, too). Once we meet it, we have full coverage for everything after that, including prescriptions.

The whole thing has changed us in very subtle ways.

We're a lot more careful these days. ("Don't put your hands in your eyes or your mouth!" ... "Don't crash on your bike!").

And I have a hunch we're going to be a lot more conservative about going to the doctor.

In realizing all of this, I've come up with my plan for healthcare: Get a doctor friend.

I've actually been trying to make friends with a physician for years, but now it makes even more sense. Unfortunately, the closest I've ever gotten is my brother, a dentist.

"Look at this," I'll say, showing him a mole. "What do you think? Suspicious? Not suspicious? Should I get it checked out?" Just so you know: Moles and freckles are giant money pits.

My basic rule of thumb is that if you go to the dermatologist, he's pretty much going to cut something off. That's not to say you shouldn't go, but still.

Pre-HSA, I had a freckle removed, and I asked my brother to take out the stitches while on vacation at the beach.

He obliged with a pocket knife and a pair of tweezers. Not bad, but I think my imaginary physician friend would've had better tools.

I wouldn't mind paying a co-pay to my physician friend. He or she could come over. We could talk about current events, recent movies. Have a beer or two, a glass of wine.

Then, I could show off my malady.

How many of us have found ourselves in situations where we just need an opinion -- not a half-day excursion and a $20 co-pay?

"Ah, wait it out. I've seen worse," they'd tell me. Or "Let me just take care of that right now. Have some more wine."

Of course, it wouldn't solve our healthcare crisis, but it might help with the little things.

Now, how do I get a referral?