aims

In the ongoing MSA debate in the pages of both of Canada’s national newspapers (a debate sparked by AIMS reaction to a recent study by Evelyn Forget, Raisa Deber and Leslie Roos) Lawrence Solomon, an influential voice in the national debate on health reform, published an aggressive response to the characterization of MSAs as ‘zombies’ unworthy of serious consideration. Solomon argued that Deber and her colleagues “created a system of medical savings accounts so stupid in design that it would be guaranteed to fail.” Referring to an actuarial study of MSAs for Canada done by “Milliman & Robertson, one of the world's premier actuarial firms”, which showed that the approach would indeed work- and work impressively, Solomon went on to detail just one example of what a real MSA plan would look like. All Canadians -- young or old, sick or healthy – would receive a tailor-made health-care allowance from the government that would be more than they'd ordinarily need to meet their routine heal

In this piece from the Globe, the authors of a recent study on MSAs respond to criticisms raised by AIMS President Brian Lee Crowley and AIMS Summer Intern Brett J. Skinner. Raisa Deber and her colleagues reiterate the findings of their original study and emphasize their argument that no matter how MSAs are designed they will not work. Referring to MSAs as a ‘zombie’ of Canadian health policy, they argue that: “If people are not spending much money for medical care in the first place, one cannot expect "incentives" to economize on their use of care to generate meaningful savings…Our results hold for all age groups, and hold whether you are considering all publicly funded health expenditures or physician services only. Given the extreme skewing of the distribution of health expenditures, our results suggest that, no matter how you formulate MSAs, these accounts are not cost saving, unless coverage is cut to the extent that they no longer constitute insurance.”

In defending the idea of Medical Savings Accounts in the Globe and Mail from some recent published attacks, AIMS president Brian Lee Crowley and AIMS intern Brett Skinner write: "With MSAs, users of the system become accountable partners in health care decision making. If they spend the money in their account wisely, they get to save the balance at the end of the year. If they think about going to the doctor for the everyday complaints we all face, they have to face the fact that medical services cost money, something our system pretends isn't so. And if they fall really sick, they get exactly the same level of tax-provided care they're entitled to today. In other words, people are rewarded for using health care services sensibly, rather than penalized for using them appropriately." Publication: G&M, July 24, 2002

Medical Savings accounts have been tried, with success on the international scene. A recent article by Samuel E.D. Shortt in the Canadian Medical Association Journal has led AIMS author David Gratzer to review and re-emphasize the lessons learned elsewhere for the benefit of those engaged in the Canadian health care debate.

AIMS’ reaction to a recent study by Evelyn Forget, Raisa Deber and Leslie Roos has led to an interesting exchange of ideas in the pages of the Globe. The study claimed to show that MSAs would not result in any cost savings for government but would instead result in an increase in health spending by governments.

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