Tweak HSAs to create IMAs?
American Medical News
July 5, 2004
Physicians want HSA access for Medicare recipients
By Katherine Vogt
The AMA will work to ensure that Medicare-eligible individuals have access to health savings accounts and will also study alternative means of financing health care.
The policies, passed at the AMA’s Annual Meeting in June, seek to help fine-tune health savings accounts, which were created under last year’s Medicare reform act. While the AMA supports HSAs as an option for consumers, the law “could use some tweaking,” said Duane M. Cady, MD, chair-elect of the AMA Board of Trustees.
“Health savings accounts are clearly part of our overall program for health system reform,” Dr. Cady said. “[But] we need to get it right.”
Under current law, HSAs are available only to people younger than 65. But in 2005, the Centers for Medicare & Medicaid Services is expected to establish Medicare savings accounts, which are essentially HSAs for Medicare participants. The AMA resolution calls on the organization to monitor the pending regulations to ensure that Medicare participants can take advantage of these tax-saving tools.
In a separate action, AMA delegates voted to further study alternative means for financing health care. The resolution sprang from a call to improve HSAs. That original call included a push to seek legislation establishing a new kind of account called an “individual medical account” that could be created without requiring consumers to have high-deductible insurance.
While the final resolution did not specifically address the idea of individual medical accounts, it left the door open for further study.
http://www.ama-assn.org/amednews/2004/07/05/gvsc0705.htm
Comment: Health savings accounts (HSAs) are funded through regressive tax policies that benefit the wealthy. Under these policies, lower income individuals pay more for their health care than do the wealthy. Eliminating the requirement for high deductible insurance coverage would only increase the inequities of these policies targeted to selectively benefit the wealthy.
AMA members who support health savings accounts (HSAs) and individual medical accounts (IMAs) do so because they perceive them to be income sources that have no restrictions on fees nor on which services would be covered.
Try this. Write a list of the issues that must be addressed in health care reform. As a starter, I’ll suggest a few: the uninsured, inadequate coverage, affordability, accessibility, inequitable funding, flawed distribution of capacity, deficient support for a primary care infrastructure, inadequate IT support for error reduction, elimination of administrative waste, and the list goes on. Go ahead and add to the list some of your other concerns about our health care system. Then when you are finished, look over your list. Do you find on there the need to make health care purchases a better bargain for the rich than for the rest of us? Do you find on there the need to replace risk pools with individual accounts which remove all constraints on physicians’ fees and services?
The difference is clear. The AMA advocates for doctors; PNHP advocates for patients.