AIMS author David Gratzer, (author of Code Blue and Better Medicine) challenged a recent account of the record of MSAs in other countries. Gratzer, publishing in a recent issue of the Canadian Medical Association Journal wrote:
“Today, Singapore boasts more diagnostic machinery for its population than Canada (waiting times for MRI scans in the city-state are a couple of days versus months here). Singapore has a lower infant mortality and a longer life expectancy than we do. Waiting times for surgery are minimal. Singapore, incidentally, spends less than 4% of its gross domestic product (GDP) on health care; we spend 3 times that. China’s experiment with MSAs has dramatically lowered health care expenditures. The cost savings from the original pilot project amounted to 24.6%; this is particularly impressive given that in neighbouring cities, where citizens still enjoy “free” health care, spending grew by 35%–40%. The initiative is expanding to include Shanghai, Beijing and more than 40 other cities, accounting for some 70% of China’s urban population. In South Africa, MSAs are the most popular type of private health insurance, covering 4.6 million people.”