Letters to the Editor - Jan. 3/10, 2000.

AMA president-elect: HealthCarePro Connect empowers physicians - Too many medications on too-messy prescription

Medical savings account well worth the effort required to set up a plan

Regarding "MSAs will lead to fair, flexible system for patients and physicians" (Letters, Dec. 6, 1999): I enjoyed the letter to the editor by Pepi Granat, MD, of South Miami, Fla. In it, Dr. Granat gave some compelling reasoning behind medical savings accounts and the great possibilities that method of health care financing promises. However, Dr. Granat also stated: "I tried to find one for myself and staff, but couldn't; they aren't a 'flop' -- they aren't here yet."

This assertion reflects the very reason that MSA-qualified health plans are so rare today, even though they have been legally one of the best tax-advantaged savings vehicles since their establishment in the Kassebaum-Kennedy Act of 1996. If there is a demand in the marketplace, then a supply will develop!

I searched far and wide to find both an account administrator and a qualifying health insurance plan. The latter was especially difficult. I have had to search the insurance marketplace nationally, outside of my home state of Utah, as the Utah insurance market is so skimpy and so biased toward nonqualifying managed care plans. It was a struggle, but it was worth it.

In three short years of making contributions, my MSA now houses almost $10,000 of tax-deferred (and if I do it right, completely tax-free) savings. My insurance deductible is less than half that amount and, in effect, I have no risk as my deductible will always and forever more be far more than covered by the savings already in my account. My MSA money will purchase health-related items at huge tax savings even if they are not covered in my health plan. In other words, the money will function as "self insurance" for items such as glasses or dental care that may not be a covered benefit under my plan, but is a "qualified medical expense" under the law.

I plan to contribute the maximum to this savings vehicle for the rest of my working days, as no other savings plan I know of can function in the essentially tax-exempt manner that MSAs can. I'll tap this money when I need it -- and only then. If I save as I plan to, my MSA will have tens of thousands of dollars in it when I reach 65 -- 24 years from now -- when Medicare will either be bankrupt or of little usefulness. Thank goodness I'll have my own health care "war chest" to draw from.

Physicians should provide leadership to our patients and colleagues with regard to new and innovative health care financing options. Stop waiting for someone to hand you your MSA on a silver platter! If your current insurer does not offer a qualifying plan, ask them why! If they won't offer one, go to an insurer (even if you have to search outside of your own state) to get one. Get on the Internet and find an account administrator, and get going now! The money you lose by waiting is your own. Offer huge discounts in your own practice to MSA-insured patients -- they pay cash up front. Create the demand that will create the market! --Paul J. Sheya, MD Price, Utah

Too many medications on too-messy prescription

The prescription featured in your article on illegible penmanship (Article, Nov. 22/29) contained three medications on a single prescription blank. A prescription order blank should be dedicated to only one medication. --Leonard J. Morse, MD Worcester, Mass.