The Magazine


Sep 13, 1999, Vol. 4, No. 48 • By ROBERT M. GOLDBERG
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The kinds of patient protections that Democrats -- and some Republicans -- are proposing (more lawsuits, more mandated health benefits) will probably make health insurance less affordable for small business, leading more companies to drop coverage. Hence, MSAs, if truly available, could become an important way for consumers to obtain health insurance. Whatever else a Patients' Bill of Rights contains, it must make MSAs permanent. It must make them available to everyone. Employers and employees must be able to contribute to MSAs at the same time. And people must be permitted to deposit all the money they'll need to cover their out-of-pocket expenses, up to the full amount of their deductible.

These changes in the law would pull a lot of uninsured people off the sidelines. Billions of dollars now locked up in insurance premiums would flow into investment accounts earmarked for health care services, and the play of money and incentives throughout the health care system would be realigned. Consumers would have more control over decisions about their own health care. Whatever Republicans do in the name of patient protection or health care coverage this session will pale in comparison to making MSAs available for everybody. Nothing else they have proposed comes close to creating a real market for health care in America.

Robert M. Goldberg is senior research fellow at the Ethics and Public Policy Center in Washington, D.C.