HORSE?:

Pitfalls of Private Health Insurance (Scott Gottlieb, M.D., April 4, 2007, New York Sun)

One alternative to having more government agencies regulating health care delivery would, of course, be more empowerment to individuals to buy affordable insurance and make their own decisions. What is the popular idea proposed by the right? To level the playing field between the big purchasers and individuals who make up the bulk of the uninsured, while giving those with limited means money to enter the private market on their own, a concept called premium support.

Toward these ends, the current proposal of Health Savings Accounts may be another Trojan horse tucked inside the new Medicare law, poised to redesign the health market in unexpected ways, akin to how simple provisions enacted as an accommodation to a world war set in motion cataclysmic change more than 50 years later. Who in 1940 thought that an inducement to entice tight labor into factories would give rise to an entire health care industry? HSAs may set in motion similar change. In health care policy, like political scandal, it is the seemingly innocuous experimentation that seems to have the most lasting consequences.