Government should revisit HAS model

Economist Milton Friedman once said the most efficient and effective way to spend money is to spend one’s own money on oneself. He reasoned this would result in the purchase of the highest-quality goods with the greatest value. And so it must be with health care. Until such time as patients have “some skin in the game” or first dollar accountability, health care costs will continue to rise and outcomes will continue to be suboptimal.

In the mid-1980s, Dr. John C. Goodman proposed the Medical Savings Account (MSA) and in 1996 a federal program for Archer MSAs was authorized allowing for tax-free MSAs for the self-employed and small businesses like mine. These programs paired a high-deductible (catastrophic) insurance plan with a tax-free savings account. Knowing that the first many dollars of health care spending would come from my pocket transformed me into an incredibly astute purchaser of health care goods and services. I began shopping for health care the same way I shopped for TVs and automobiles. My personal experiences led me to believe that there are almost no limits to the savings available to the cost-conscious.

Today, health care costs and “affordability” are once again front page news. The Affordable Care Act (“Obamacare”) has proven to be far more expensive than predicted and collapsing under its own weight. Congress and the president need to find a cost effective alternative to today’s system and only one that allows (or forces) consumers to shop competitively. Clearly sending huge sums of taxpayer dollars to huge insurance companies and expecting them to spend it in someone else’s best interest hasn’t worked in the past, isn’t working today and won’t work the next time it’s tried.

During his first term in office President Trump raised the possibility of resurrecting “catastrophic” health insurance policies and coordinated MSAs (now called HSAs). I strongly suggest that this avenue be revisited.

Martin A. Dettmer

Wheaton