Dr. Robert P. Nirschl seems unaware of pending legislation that empowers the patient and strengthens the patient-doctor bond. The plan he outlined in his June 21 letter is actually a Medical Savings Account (MSA). MSAs are highly restricted as part of a pilot program, open only to the self-employed and small businesses with 50 or fewer employees. But in March, MSA expansion legislation was introduced. Since then, no action has been taken while more than 250,000 Americans have lost their health insurance coverage due to its unaffordability.

MSAs get to the heart of the many issues. They tackle affordability, control of medical costs and care and choice of medical provider. Since they work much like an IRA, in that money invested by the policyholder is tax-free and earns tax-deferred interest, MSAs can even accumulate savings to create a long-term care or retirement account.

Patients and medical professionals alike should demand that policymakers enter MSA expansion into debate. Health care affordability and choice, the alarming growth of the number of uninsured and MSAs are all issues that could -- and should -- elect our next president.

ALLEN WISHNER

Des Plaines, Ill.

The writer is chief executive officer of an employee benefits firm.