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Whatever else Congress may or may not do about health care, there's one reform that ought to be instituted now as a bipartisan initiative on which most Americans can agree. We're referring to the proposal for Medical Savings Accounts.

As Scripps Howard News Service points out, most of the numerous Medisave bills introduced in the last two years had predominantly GOP sponsors. But Indiana Democrat Andy Jacobs made sure MSAs are an option under the comprehensive bill that House Majority Leader Richard Gephardt hopes to pass this month. And Democratic senators on record favoring Medical Savings Accounts include John Breaux, Thomas Daschle and Sam Nunn.If they attract both conservatives and liberals, it's because Medical Savings Accounts are such a promising idea. In contrast to the untried health alliances and global budgets of the White House and Democratic leadership bills, they are even relatively easy to understand. Analysts predict they would save money, broaden insurance coverage, slash administrative bother, increase patients' choice of health services and make health protection portable from job to job.

Here's how they work. An employer now spending $6,000 on health insurance for a worker and family would instead spend $3,000 on high-deductible coverage and place the other $3,000 in the family's Medical Savings Account. Routine doctor visits would be paid for out of the MSA. In case of a serious illness, the insurance would kick in.

In good years, the family would spend less than $3,000, and the account would grow. (The average American has health expenses of under $500 a year.) This money could be used to buy more insurance - nursing-home coverage, for example - or any service the Internal Revenue Service now rules a deductible expense.

But at some point the family would be free to spend any accumulated savings as they saw fit. Jacobs would permit non-medical withdrawals at age 60 or if a person became disabled; other proposals permit withdrawals any time, though money withdrawn is taxed as income, and a penalty is charged (20 percent in one bill).

Medical Savings Accounts respect the autonomy of ordinary Americans, leaving them free to buy the health care they think they need. But MSAs also create an incentive for each consumer to spend wisely.

What a contrast to the grandiose health reforms that promise to cap costs by government fiat, a dubious approach that hasn't worked so far. Instead, MSAs would enlist every user of health care in squeezing waste out of the system. A simple change in the tax code would make them possible. What is Congress waiting for?