MSAs are accounts owned by the individual and earmarked for health care. They are funded from the premium savings gained by having large deductibles on individual health insurance plans. The funding of the accounts would come from tax deductible contributions. This would put them on an even field with the tax deductible premiums used to pay for PPO and HMO health insurance. People can then decide what kind of care they want to pay for.
People can shop for bargains if they desire.
The money in the account can also accrue interest while it sits there. The funding for people who work for large corporations could be paid by the employers the same as they pay insurance premiums now or it could be paid by individuals if they are self employeed. The HMOs are lobbying strongly against MSAs because they claim that they would take the well people out of their plans. Their complaints are theoretical and frankly, in my opinion, if they can't compete on an even level then perhaps they shouldn't exist. Finally, there is a new and exciting concept being tried by a few employers.