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Because I keep on meeting mentally challenged Scouts with Health regen maxed out, and some people might not know that it can help with Spy's health problems
Well anyway, it's your guide and your choice.
One thing I'd note, though... neither Health on Kill or Health Regen stop you from dying in one hit to a giant crit robot with +50000% damage, or dying in half a second from a horde of crit robots. You should mention that resists are important for the classes on the front lines, not just Health on Kill.
As far as hok vs regen on him, for the most part you'll be fighting giants, and you won't always get the last hit. Plus, at the core of spy, it's a class where you usually be taking damage AFTER you do your job, rather than before, so regen synergies better. After you get other key upgrades of course.