Costs are determined by the free market. People, when they have to pay their own bills, shop around for the best service at the best price. A medical savings account would let you save for expenses, rather than pay huge insurance premiums. You could buy a less expensive policy that covers major expenses, but not routine appointments or meds. Over the years, you save more and more, and need less and less insurance.
Oh, it also serves as an incentive to stay healthy. You libs are always talking about how horrible it is that obesity and its co-morbidities are on the rise. Well, if people had to shell out their own money for the knee braces and insulin, they might not eat so many cookies.