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CMAJ • July 23, 2002; 167 (2)
© 2002 Canadian Medical Association or its licensors

Review
Synthèse

Medical Savings Accounts in publicly funded health care systems: enthusiasm versus evidence

Samuel E.D. Shortt

Dr. Shortt is Director of the Centre for Health Services and Policy Research, Queen's University, Kingston, Ont.

Correspondence to: Dr. Samuel E.D. Shortt, Director, Centre for Health Services and Policy Research, Queen's University, Kingston ON K7L 3N6; fax 613 533-6353; seds{at}post.queensu.ca

Abstract

MEDICAL SAVINGS ACCOUNTS (MSAS) HAVE BEEN SUGGESTED as a possible solution to Canada's health care funding woes. This approach is intended to reduce demand for health services by making individuals financially responsible for their pattern of consumption. MSAs may have appeal in the private insurance industry. A review of the scant literature on the experience in the public systems of Singapore and China, where such plans have been implemented, and on a simulation using United States Medicare data, suggests that the approach alone has not controlled costs and may increase inequalities in publicly funded systems. The conclusion is that current knowledge of MSAs is too limited to recommend their incorporation into the Canadian health care system.




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