HSA critics ask whether individual accounts will encourage people to save money at the expense of their health.
Mackey has the right response. "The premise in those kinds of questions is that people are stupid. They're not smart enough to make these decisions for themselves. It's sort of an elitist attitude. The individual is the best judge of what's right for the individual."
And apparently, most individuals are making smart choices.
Harvard Business School professor Regina Herzlinger says studies show that "people who have these high-deductible health-insurance policies take a lot better care of themselves. They have more yearly physicals. Because they're saying, 'If I keep myself healthy, in the long run, I'm going to be spending less money.'"
The critics also argue that spending on health care is too complicated and important for individuals to control.
Mackey isn't buying it. "Should we allow people to make decisions about whether they have children or not? I mean, that's a pretty important responsibility!"
I pointed out that most people know nothing about complex cancer treatments.
"I don't know anything about cars," he said. "But if I buy a Toyota or an Audi or a Lexus, I know I'm going to get a pretty good automobile because competition ensures that it will be that way."
It does. And competition will do the same in medical care. All we need to do is put the individual in charge of his own money.
Next week: Where competitive health care is already working.