Euro Observer, Winter 2008, Vol.10, No.4

The concept of a medical savings account – in its purest form, a vehicle to allow people to save money to spend on health care – was initially developed in the United States in the 1970s. In the 1980s and 1990s the concept was translated into policy in a handful of countries, either as part of a private health insurance market (South Africa and the US) or to complement publicly-financed health care in south-east Asia (Singapore and China). Two threads link these four initiatives: a desire to address the problem of ‘moral hazard’ in health care and a belief that individuals should take some responsibility for their health care costs. It is only in the last five to ten years that medical savings accounts (MSAs) have begun to be discussed as an option for European health care systems.