The problem is, imo, that many people use those phrases without thinking. It's just like saying "Gesundheit!" when someone sneezes. It's something you do automatically, because it's what one does. But you don't consider first that it means "good health to you!" and then very deliberately wish that to the sneezing person.
I say "you're so good looking" instead of gesundheit or "bless you". If the person has seen Seinfeld, I'll get a chuckle, if not