Depending on your AGI, you might be able to contribute to a plan via the consulting income. Self employment plans to explore include SEP IRA, Solo 401k and Simple. Note that the deductible 'regular' IRA limits change if you are covered or are not, so creating a plan that covers you may, or may not, impact your levels on the regular side.
For HSA, you don't want one when you have high healthcare costs. A HSA is only allowed if you have a HDHP (High Deductible) which means that you would pay a lot more out of pocket per year in most cases. You could certainly search for HDHPs to see if they cover 100% of the medical needs that your wife has, in which case, it might work out. EG I looked at a HDHP recently and thought it a bad move because my 1 yr old has pretty expensive regular 'ish' visits for immunizations etc, however the plan I saw covered such visits, so it wouldn't be that bad.
Generally speaking though, you might find yourself losing out as you spend more due to the less favorable health plan.
In terms of not paying taxes or lowering taxes on the balance. You could consider married filing singly. This tends to come with a lot of penalties (including related to the IRA) which makes it likely a bad choice. The medical expenses can be generally deducted when they exceed 10% of AGI (a floor).
Therefore, if you filed jointly and earned $81000 (you $49000, her $32000) you could claim $100 ($8200 minus 10% of $81000)
In a filing separately case of the above, she could claim the $8200 on her return so could claim $5000 ($8200 minus 10$ of $32000)
The impact of that would be a 'deduction' not a 'credit' meaning that her AGI for the year would be reduced from $32000 to $27000, this number would further be lowered by other allowable credits or deductions.
So... depending on her salary it 'may' be more favorable. However, you'd need to consider income disparity between the two of you, and also factor in that you would receive penalties in other aspects of your taxes to get this. Here's some more on what you lose out on.
http://www.efile.com/married-filing-separately-tax-filing-status/
If I could eyeball this, based on not knowing your income I would say that the medical expenses may be not high enough to really make the Married Filing Separately a benefit. One other thing to look at may be an FSA - this is a way to create a deduction on certain out of pocket expenses, prescriptions etc.