There are many tests, vaccines and procedures that doctors, employers, government agencies or insurance companies want people to have that people would be hesitant to pay for out of cash.
For example, an employer, desiring a healthy work force, may want employees to get regular check ups. The employee might prefer letting this money build up in their savings account. The government might want everyone to get a vaccine to eradicate a disease. Doctors might want patients to take tests that provide information for the doctor's private research. Insurance agencies might want people to take additional tests because the extra tests reduce liability costs.
One can very easily accommodate these desires by subsidizing the procedures.
For that matter, if you pay attention, you will notice that a great deal of activity like this already takes place.
The medical savings and loan could become a conduit for formalizing such subsidies. For example, an employer could have payments to the employee's account set up so that it funds a yearly check up. The government already gives free vaccines in cases where they are trying to stop an epidemic. Pharmaceutical companies pay people to be test subjects, and foundations can subsidize procedures related to their given cause.
The heart of the free market is freedom. The free market enables individuals and groups to do what they want to do with their resources.
This observation on freedom leads into an observation about medical savings account.
When speaking of a medical savings account one imagines a system where a person suddenly needing care would draw down their savings for medical expenses first. If that is not enough, they take out a loan. Finally, if medical expenses veer too far off the norm, the funding for the care comes from insurance.
A truly robust medical savings and loan program would seek funding from multiple sources from the offset. A robust system would seek to prevent situations where a single medical problem exhausted the savings account. For example there might be a low deductible for certain accidents, or one might have a graduated deductible, for example a patient would pay 90% of the first $1000 in expenses, 80% of the second grand, 70% of the third grand, and so on.
The repayment of the loan would use a graduated approach as well. Our knee jerk reaction is that one should pay off loans first, then establish savings second; However, the MSL might be rigged so that half of future payments go to pay down the loan, and half goes into savings. This is just an accounting trick. But it has the positive effect of assuring the owner of an MSL account that they continue to have resources available for medical expenses even when they are in the red.
Once the basic structure of the MSLs is in place, I am sure that people will find all sorts of ways to make the system meet both the objectives of the individual and of the different players involved in health care.
The MSL structure does not deny the multidimensional nature of our world. What it does is give individuals direct equity in their health care.