To the extent that medical IRAs encourage people to switch away from first-dollar indemnity coverage towards more catastrophic coverage, I think that will make them more resistant to doctors who either want to charge a lot of money or recommend a lot of services. Doctors will have to give me a better explanation of why they want to do a PSA test or colonoscopy if I'm spending my own money. However, patients should be wary of the proposal, says Clifton R. Cleaveland, MACP, the College's Immediate Past President. One of my personal concerns is that medical IRAs could create a barrier to patients seeking timely care. Someone with bronchitis may be less inclined to seek early outpatient care, and develop pneumonia.
Medical IRAs shift the burden of discretionary decisions to the patient.
If patients do, in fact, wait until illnesses are severe to get medical treatment, costs will actually rise, says Carmella Bocchino, GHAA's associate director of legislation. What is left for the remaining insured population is the sicker, less-healthy population with higher health care costs. In addition, Uwe Reinhardt, PhD, professor of political economy at Princeton University, points out that most health care dollars are spent on major illnesses, not routine care. Who really benefits Dr. Shapiro is also concerned about equity issues. Under medical IRAs, people in the higher tax brackets would receive the greatest benefit from the tax-deductible accounts.