MSAs — What’s Good for Idaho is Good for America

Vernon L. Goltry, MD
Article Type: 
Report from the States
Winter 1997
Volume Number: 
Issue Number: 

Medical Savings Accounts (MSAs) provide freedom, security, and affordability The MSA concept is the only moral, ethical, and economically sound medical care reform today. And, it works because medical care is returned to the free market where it belongs along with food, clothing, housing, and other products and services. The patient, now put back in charge of his medical care dollars, is free to choose his physician and hospital facility, and has a self interest to press the medical care industry into providing him prompt, high quality, and affordable medical care by means of free market incentives. It reverses the 50 year error of someone other than the patient paying for goods and services.

Over 3,000 companies in the United States today are providing MSAs to their employees with savings ranging from 10 to 40 plus percent in medical care costs through savings obtained by means of a high-deductible, catastrophic insurance policy coupled with a MSA versus a low-deductible standard indemnity policy. With MSAs the patient does not face the fear of medical care rationing for profit inherent in the HMO/Managed Care concept. The patient/physician relationship is maintained within the banks of the Oath of Hippocrates (i.e., First, Do No Harm). The physician remains the true patient’s advocate and is not deterred from this by the perverse financial incentives imposed by the HMO/Managed Care concept.

There is no record of any MSA program having failed. Employee satisfaction is intense. One large insurance company reported 98 percent of its employees stating satisfaction with their MSA plan. A Rand Corporation study found families with a $2,500 deductible catastrophic policy spent half as much on medical care as those with no deductible, yet there were no differences in the health of the two groups. MSAs encourage people to get preventive care contrary to the often heard clichè by its detractors that MSAs are for the “healthy and wealthy.” Nothing could be further from the truth. Although MSAs encourage people to remain healthy and obtain preventive care, studies have shown that MSAs are particularly attractive to the sick as well as the healthy. In fact, MSAs can now be structured to eventually completely privatize Medicaid, Medicare and even the V.A. system. MSAs can solve the problems of portability and pre-existing conditions. MSAs encourage saving.

Without exception, companies who have made MSAs available to their employees have found that overall health expenses go down. The opposition voiced against MSAs comes from government and corporate interests representing Medicare, Medicaid, the V.A. system, parts of the insurance industry, and the Managed Care/HMO industry. Their concern remains that MSAs will work only too well and at their expense.

Studies supporting the above statements are available through the National Center for Policy Analysis (NCPA), CATO Institute, and The Heritage Foundation. The Ada County MSA program will be up and running in Boise in January 1997 through efforts of Commissioner Gary Glenn. The Idaho Medical Association’s MSA, Patient’s Choice Inc., and American Health Value are already in operation in Boise.

In the island country of Singapore, a mandatory MSA program has been in operation for approximately 10 years. A study by the NCPA found that the island country of 2.9 million people spends 3.1 percent of gross domestic product on medical care and far less than the United States which spends 14 percent. Within the Singapore medical care delivery system there are five doctors and nurses versus America’s two for every medical care administrative employee. Singapore has done what no developed country has succeeded in doing. It has developed and maintained high quality medical care and controlled costs without rationing. Truly, the Medical Savings Account concept is medical care reform that works.


Vernon L. Goltry, MD
Boise, Idaho


 Dr. Goltry is an otolaryngologist in Boise, Idaho, and a member of the Editorial Board of the Medical Sentinel. His address is 200 North 3rd, #203, Boise, ID 83702.

Originally published in the Medical Sentinel 1997;2(1):35. Copyright ©1997 Association of American Physicians and Surgeons.



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