Healthcare

To say that healthcare has been getting a lot of press lately would be an understatement. The common theme from many in Congress, whether Republican or Democrat, has been that the government needs to do something to “fix healthcare.” As with so many things in Washington, the politicians are not only going in the wrong direction, they are also asking the wrong questions! I disagree with the premise that “healthcare is broken” and that the government can fix something by adding more regulation. The question they really need to be asking is “Is this a function of the federal government?”. I believe that what Ronald Reagan said about government being the problem, and not the solution, is certainly applicable to healthcare.

First, how is our healthcare system broken? If 85% of Americans are happy with the healthcare they have and people with serious health problems come from all over the world to the United States for treatment, is our system broken? It seems to be working pretty well in many ways. Doctors are researching, drug companies are inventing new ways to treat and cure diseases, surgeons and medical equipment manufacturers are working to come up with new ways to better the lives of people all the time. The vast majority of the world’s medical research and patents come from the United States. So if all of this is true, what is broken?

What’s broken has mostly to do with the federal and state governments: How the money flows, who gets it, how much they get and regulations regarding how things are run. The part that is broken is the very part that the government has been involved with the most in the last 70 years. Ever since the 1940’s there have been those that think the federal government should take care of all of our medical needs. It started with FDR. He wanted universal coverage back in the 40’s but it was rejected as too socialist.

So, if the government can’t get outright control of something, what does it do? In the healthcare industry, as with many others, it tries to regulate it to death. Liberals have been trying to do that ever since FDR’s plan was rejected. Now, 70 years later, we have Medicare and Medicaid – passed by LBJ in the 1960’s. These two money losing programs for hospitals, along with other overbearing regulations, have given the government too much control. Doctors have enough to worry about and don’t need federal or state governments telling them how to run their businesses, bill their customers and heal their patients. Add to this the regulations that favor insurance companies by preventing more companies from entering that market, as well as the limits placed on us as consumers (with respect to how we can buy insurance) and the question becomes not “How do we fix things?” but, “How has the industry done so well with all of this extra overhead?” The answer to that, of course, is that the extra overhead has been passed on to customers – at least, those customers (85 percent of Americans) currently with insurance or those that pay their bills without insurance.

Obviously, there are problems with healthcare, I just think those problems are more a result of excessive regulation, not something that can be cured by adding more regulation. I am an employer. I pay for the healthcare for my employees, and I know about the increased insurance costs. We have been able to keep costs under control but more needs to be done. It just isn’t a function of the government doing more. It needs to do LESS!

To lower healthcare costs and to keep them in check as efficiently as possible I believe we need to do the following:

Whose Insurance is it?

The first thing we need to do is to get insurance coverage into the hands of individuals instead of employers. Think about this question: “Why is it that we buy car insurance but we use our cars to get to work every day? Why shouldn’t our employer pay for our car insurance?”. Wouldn’t that be a crazy thing to ask? If you said yes, they why should our employer provide our health insurance?

The reason insurance is provided by employers is that it is tax deductible for them, but not by us as individuals. The deduction is a product of the 1930’s wage freeze controls put in place by FDR. Companies couldn’t offer better wages to attract workers but they could offer better benefits so the companies lobbied Congress to make those benefits deductible and got it.

This seemingly small government intervention in free markets, along with how medical costs are billed to customers (or not billed to them), has created a lot of the problems we have now. For instance, we don’t realize how much the medical care we utilize costs, so we don’t worry as much about trying to control those costs. There is no reason to shop around for better-priced healthcare providers. The insurance company is going to pay for it and we, in many cases, don’t pay the premium (unless you have private coverage or you own the business). With no price signals to the customer, there is no reason to control the amount of care we consume or to control costs.

Another consequence of having coverage through employers is that we can become attached to a particular job because our insurance is with that company. If we own our coverage – whether individual or through a group purchasing program – then we can change jobs without fear of losing coverage or of not being able to get coverage because of a pre-existing condition. It is our coverage. This leads to more freedom and better results.

Tort Reform 

We know this works. It has here in Texas and it will in the United States as a whole. It drives down costs for everyone by lowering insurance premiums and, more importantly, by reducing the amount of defensive medicine that is practiced. Defensive medicine is projected to account for around $210 billion per year, or about 10% of the total medical bill for America (Source: PricewaterhouseCoopers).

Allow More Competition

We need to responsibly remove the government-imposed barriers to free-market competition among hospitals and between insurance companies. For instance, why is it that the federal government, the entity that is supposed to facilitate interstate commerce, doesn’t allow that competition for insurance companies? Correcting this would be the kind of health care “change you can believe in”!

Second, the federal government should remove any restrictions on how individuals can group together to purchase insurance. We should be able to gather with whomever we want. If we want to organize our church, community group, fitness club, extended family, other small business owners, whatever! Why should there be any restrictions on this?

If we are allowed to gather together to purchase insurance in whatever group we want and our insurance is not tied to our place of employment we have more freedom.

Get the Government out of Healthcare:

As I brought up earlier: Should the federal government be providing healthcare services at all? I think, other than services for military personnel, the answer is no. It is not part of the Constitution. It certainly was not a part of the founder’s vision in the “General Welfare” clause.

Government-Imposed Free Care Must be Eliminated 

Today, in too many cases, people that cant’ or don’t want to pay for care go to emergency rooms, (the most expensive place you can go for medical assistance.) They go to get free services for many things that could be treated more efficiently in other settings. They can do this, in large part, because of federal EMTALA law (Emergency Medical Treatment and Active Labor Act). This well intentioned law has been abused by many, including illegal immigrants. It has also contributed to a culture of entitlement that is costing us all each year through higher insurance premiums and medical costs. This law should, at least, be revised by Congress to take into account the many ways in which it is abused each year.

The core question regarding this law is whether or not healthcare is a right. I don’t believe that it is. If it was a right then I would be able to demand service for no compensation because it is my right. That is not how healthcare should work. That is not how any service provided by one person to another should work.

I agree that these last two points, discussing the government’s proper role in healthcare and re-evaluating or eliminating EMTALA, are big steps. However, that does not mean that we don’t need to work towards resolving these questions in a way that strengthens our nation and our core values. Socializing our medical industry certainly will not build a stronger America.

My Frustration:

Obviously none of the above points are on the Democrat’s agenda. That is understandable. Too many Democrats seem to think that government is the answer and that they can create “rights” out of thin air. Hence, their attitude is not a source of frustration to me. It is what I expect of them.

The frustrating thing is that these issues and goals have not been on the Republican agenda either! They had the power to get these things, or something like them, done and didn’t. That is the lack of leadership that caused me to run for this office. I believe we can do better if we will just stick to our conservative principles and lead from them.

As with all my proposals, I would appreciate your feedback and suggestions on this solution. Thanks.