Medical savings accounts: lessons from China.

Abstract

Dur ing thi s era of the triumph of free enterprise and the demise of big government, medical savings accounts (MSAs) have gained rapid popularity as a means for financing health care. The U.S. Congress recently passed a law to experiment with MSAs, and the United Kingdom is heatedly debating this approach.China has been a laboratory for testing health care financing models formany years. Confronted with rapid health cost inflation and a growing uninsured population, China experimented with an ingenious scheme patterned after the Singapore MSA, but with major modifications. These pilot experiments were designed in 1993 and implemented in December 1994. In this UpDate we describe these urban health care financing experiments and their early impacts and draw lessons for other countries contemplating implementation of anMSA scheme.