Guest opinion: Heatlh Care RX – common sense reform
August 7, 2010
Our health care delivery system is the envy of the world, attracting patients from around the globe searching for the best care. Dedicated, entrepreneurial American health care providers and scientists built this system. Advancement and innovation require an environment of healthy competition and reward for excellence. Yet the health care legislation enacted by Congress stifles these principles. Instead of affording more Americans access to quality care at reasonable cost, the legislation actually undermines the doctor-patient relationship and exacerbates escalating health care costs and premiums.
Our health care system suffers from a lack of incentives for cost containment. Employers buy coverage or the government provides it, while consumers rarely pay doctors and hospitals directly. This obscures the true costs of health care and leads to overuse. Competition is replaced by government and insurance complexity, leading to inefficiency and fraud. The result is rapid cost escalation with millions unable to afford insurance.
Health care reform was supposed to address these two flaws in our system – escalating costs and access to insurance. But the politicians’ response is to have more costs paid by third-parties. The new law expands rather than reforms this unsustainable system.
Returning control of the health care system to patients and their providers is the key to true health care reform, not ceding that control to bureaucrats in government or the insurance industry. The following principles outline major components of this approach, advanced by Republican members of Congress throughout the health care debate:
1. First, do no harm: Do not limit patient choice; do not put the government between patients and their health care providers; and do not raise taxes, as the new law does.
2. Reduce costs: Advance the use of health savings accounts (HSAs) to encourage long-term savings for health care needs, and cost effective and consumer directed health care choices.
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3. Improve patient control and portability: Give purchasers of individual plans the same tax advantage as employees in employer-sponsored plans, by providing tax credits to purchase insurance. Increase consumer choice, access, portability, and competition by allowing the purchase of insurance across state lines. Enable people to buy affordable insurance if they do not earn enough to make a tax credit meaningful or if they have pre-existing conditions.
4. Improve quality and lower costs: Provide incentives for preventative care and hold patients accountable for unhealthy lifestyle choices.
Very few of these principles were incorporated in the new health care law. Americans continue to oppose the law in overwhelming numbers because they realize that it puts the government in the middle of the doctor-patient relationship, reduces access to quality care and moves us toward a single-payer system – the kind that foreign patients flee when they come to America for care.
Central to practitioners, the new law presents the following concerns:
No malpractice reform: This is one of the keys to reducing health care costs and continuing to attract talented people to the field of medicine. Most doctors and hospitals practice “defensive medicine” by ordering too many tests in an attempt to avoid malpractice claims. Additionally, the cost of malpractice insurance has for some specialties become prohibitive. Qualified, caring, and dedicated medical providers who are unable to afford malpractice premiums and can’t justify living with the stress and uncertainty of potential litigation unrelated to the quality of care they provide, have already begun to abandon the practice of medicine. The new legislation does nothing to stem this tide.
Health insurance without access: The law requires everyone to have health insurance. Yet nothing in the law addresses the problem of retaining enough medical professionals to meet the current unmet demand, let alone serve the millions more who will be covered by the new law. The legislation throws more than half of these Americans into the Medicaid system, which already is notorious for low reimbursement rates for health care providers. In the case of Medicaid for low-income children, for example, the reimbursement structure is so deficient that it doesn’t cover most practitioners’ overhead. Many doctors must limit or refuse to accept these patients or go out of business. In other words, the new law provides “coverage” for many more people without ensuring their access to care. Inevitably, emergency rooms will continue to be utilized for non-urgent matters, care will be fragmented, an individual’s primary care home will be disrupted, medical errors will increase, and health care costs will continue to escalate.
Patient accountability: The most efficient utilization of resources occurs when patients have financial accountability for their health care decisions. Without such accountability, patients seek unnecessary medical services, over-utilize congested emergency rooms, and make unhealthy lifestyle choices. The new law further distances patients from accountability by increasing health care entitlements and decreasing patients’ ownership of their care.
Government intervention in medical decisions: The health care legislation creates 150 new agencies and interposes thousands of unelected, non-medically trained bureaucrats into the health care decisions of individuals and their health care providers.
Despite increases in taxes of $669 billion, Medicare cuts of $417 billion, and an increase in the federal deficit of at least $352 billion, the new legislation is estimated to leave 23 million people uninsured by 2019. If we are to make real reforms in our health care system, we must repeal the health care law and replace it with measures that lower costs and assist those who lack affordable coverage options. Please consider these points as you approach the upcoming November elections.
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