For example, the RAND Corporation conducted a study of changes in people's health care decision-making in relation to the size of the consumer's copayment. The study found that an individual who had to pay 50 percent of the cost of health care spent 25 percent less than an individual with no copayment. The study also showed that, contrary to the assertions of some critics, those reduced expenditures are not caused by individuals' forgoing truly necessary health care. Rather, the savings result from reduced utilization of optional services and cost-based selection among competing providers. Moreover, health expenses paid out of an MSA would entail no insurance administrative cost.
Insurance is a very inefficient way to pay for small or routine health expenses.
MSAs would cut insurance companies out of the vast majority of health care transactions. That would reduce both the overall cost of health care and the paperwork burden on doctors. MSAs would also increase the quality of medical care by strengthening the relationship between the physician and the patient. One of the great tragedies of medicine today is that the medical ethic, according to which the doctor is responsible to the patient, has been replaced by a veterinary ethic, according to which the doctor is responsible not to the patient but to whoever is paying the bill. MSAs would reverse that trend.