Medical Savings Accounts in South Africa

Policy Reports | Health | International

No. 234
Thursday, June 01, 2000
by Shaun Matisonn


For most of the last decade - under the leadership of Nelson Mandela - South Africa enjoyed what was probably the freest market for health insurance anywhere in the world. Although only about one-fifth of South Africans actually buy private insurance, their options have ranged from American-style HMOs and PPOs to Medical Savings Account (MSA) plans.

"Under Nelson Mandela's regime, the popularity of Medical Savings Accounts soared."

Furthermore, South Africa's insurance regulations were and are sufficiently flexible to allow the type of innovation and experimentation that American law stifles. For example, in South Africa there is no law that says HMOs cannot have deductibles. Nor is there a law that says MSA plans have to have minimum or maximum deductibles.

This study addresses one of the most interesting outcomes in South Africa's experience with a free market for health insurance: the emergence and popularity of Medical Savings Accounts.

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