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December 7, 1994

JAMA Editorial Position and US Health System Reform

Author Affiliations

Federal Way, Wash

JAMA. 1994;272(21):1656. doi:10.1001/jama.1994.03520210039018

To the Editor.  —In response to Dr Lundberg's Editorial1 on US health care system reform, his "My Way" seems closest to Senator Gramm's proposal, yet the Gramm proposal received bum marks on both cost control and promoting continuing quality, as well as other areas. Looks to me like we need some new analysts!As I understand it, the Gramm proposal calls for tax reform so that individuals can purchase tax-deductible catastrophic insurance and place the premium savings (catastrophic vs other insurance premiums) in tax-deductible, tax-free MSAs to spend on health care however they wish (including seeing specialists without a referral if they so choose). The policy belongs to the patients and not employers, so they cannot lose it by changing or losing jobs. Employers can still be expected to offer premium contributions, but the individuals choose and control their policies.Administration is a snap: most years, most patients will

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