Congress may soon make Medical Savings Accounts (MSAs) the law of the
land. And even labor unions like the idea.
Medical Savings Accounts give people the opportunity to move from a conventional,
low-deductible health insurance plan to one with a high deductible (say
$2,000 to $3,000) and to put the premium savings in a medical savings account.
Employees and their families pay all medical bills up to the deductible
from their MSAs and out-of-pocket. Insurance then covers 100% of everything
else.
The political battle for MSAs has been long and hard, but even when the
political battle is over, the fighting will continue. That's because the
real issue behind the MSA debate is who will control our health care dollars.
MSA supporters want individuals to control more of their health care dollars;
MSA opponents want someone other than the patient - a manager, "gatekeeper"
or bureaucrat - to control those dollars.
It is becoming the ultimate in populist vs. elitist battles, and nowhere
is that more evident than in Bucks County, Pennsylvania, a suburb of Philadelphia.
During 1995 contract negotiations between teachers at the Bucks County Technical
School and officials of the Bucks County School Board, the issue of the
high cost of health care became a topic for discussion. Members of the Bucks
County Technical School teachers union had recently heard of Medical Savings
Accounts and thought that by shifting to an MSA plan, both the teachers
and the administration could benefit.
They learned that some 3,000 businesses have adopted some form of MSA plan.
The apparently universal experience is that MSA plans reduce employers'
health insurance expenditures over time and permit employees to benefit
financially by managing their health care dollars wisely. A win-win situation
for everyone involved.
Ed Moffit, who teaches air-conditioning and refrigeration technology for
the school and is president of the teachers' union, optimistically presented
the idea to the Board. After all, the money employees spend for health insurance
ultimately belongs to the employee. He thought the Board would be delighted
that a union was proposing a free-market solution to their health care dilemma.
He was wrong.
The Board's solution to restraining health care spending was to move the
teachers out of their fee-for-service policy and into a managed care plan,
lowering the Board's cost and pocketing the difference. Unwilling to let
a managed care plan make choices for them, union members opposed the school's
solution.
The battle thickened. Moffit and the union publicly asked the school Board
to release information about the union members' health care costs. Finally
it did, and now pressure is building for MSAs.
What the Bucks County Technical School Education Association has learned
is what union members and employees across the country are learning - MSAs
make sense. For example: ·
The National Center for Policy Analysis is a public policy research institute
founded in 1983 and internationally known for its studies on public policy
issues. The NCPA is headquarters in Dallas, Texas, with an office in Washington,
D.C.