How in the world did we get ourselves into this gigantic healthcare mess? Well, it started following World War II when health insurance was offered by employers as a valuable benefit in lieu of higher wages. Americans quickly became accustomed to having their employer provide for their healthcare, and soon this benefit became a major bargaining chip that management used in every negotiation with labor.
It isn’t just the general public who has been duped. Over the past three decades, physicians have also become dependent on insurance/government based payments. These contractual arrangements use a system whereby allowable charges for their services are established not by the physician, but by the payer. If independent physicians attempt to bargain collectively with an insurance company they risk violating the Federal Sherman Anti-Trust Act. So, as a result, your doctor is compelled to see more patients and spend less time with each one. Some physicians have resorted to offering services that are not covered by insurance, like laser hair removal and botox injections, on a cash basis, just to make a living. I have two friends who are highly skilled and highly trained surgical specialists who have essentially converted their practices into a cash based, cosmetic vein ablation clinic. The effective loss of their talents to the community of medicine is an incredible tragedy for everyone.
If the systematic takeover of American healthcare is allowed to continue unchecked, within just a few years the entire free market system will cease to exist, replaced by “Uncle Barack’s European style healthcare system.” What’s ironic is how most western European countries are actively trying to privatize their existing socialist healthcare programs, because they promote mediocrity and are financially unsustainable.
Everything our government attempts to micromanage becomes more expensive, less available and of poorer quality. Witness the US Postal Service. So, what’s the answer? First, we must repeal The Patient Protection and Affordable Care Act of 2010 (Obamacare). Then, we, the citizens of this country, must emphatically tell our government to stop trying to dictate to us how we can access our own personal healthcare.
While the Republicans have actively called for “Repeal,” they have been quick to add the word “Replace.” But replace with what, more regulations? We must emphatically tell them NO, unless their new laws specifically eliminate existing restrictive regulations and reestablish a free enterprise system. Any new legislation must include the following principles:
- Promote individual, non-employer based Health Savings Accounts that will allow the individual to accumulate funds tax free, allow any unused funds to roll over every year and remain as part of the individuals estate (again free of federal income tax).
- Couple HSAs with high deductible catastrophic insurance which could be provided either by employers or purchased individually.
- Allow individuals to deduct the cost of any health insurance premiums on their personal taxes, the way businesses currently do.
- Allow for any person to buy health insurance from any company, in any state, and carry their policy with them wherever they go.
- Allow insurance companies to offer “good health” incentives similar to “good driver” incentives to encourage healthy behavior that will ultimately lower the overall cost of care.
- Promote “real” health education in our public schools, including specific information about how communicable diseases are transmitted and how specific lifestyles and behaviors lead to costly chronic diseases.
- Encourage insurance companies, through incentives not mandates, to offer high-risk pools, which would include coverage for pre-existing conditions.
- Allow patients and physicians who participate in existing government programs the right to privately contract for services for fees that may differ from the government established payment without penalizing either party. This will ensure access will not be denied based on unreasonably low government payments.
Obviously, the liberal pundits will vehemently object, “Wait! We can’t do that! Who will be in charge of ensuring healthcare for everyone, especially those who can’t afford it?” With those words they actually betray their ultimate objective. “In charge of” can be translated “in control of”, and it is that control that must be vigorously resisted. Healthcare is a personal service and is therefore the responsibility of each individual, even if they are considered “underprivileged.” We have systems in place such as Medicaid and SCHIP that serve as a safety net for the truly impoverished and they should be actively promoted as public assistance for those in need. We also have tax supported county and state hospitals, which were originally built to offer care to those who otherwise couldn’t afford private care. But laws like the Emergency Medical Treatment and Active Labor Act (EMTALA) actually discourage their use by those most in need, and it too should be repealed. We should spend more time. effort and resources educating people who qualify, as to precisely how they can access these existing programs and facilities, instead of trying to convince the entire population of the virtues of a government run system.
Beginning about 65 years ago, Americans started to progressively relinquish many of our rights and our personal liberties to a group of faceless insurance executives who promised us financial security. By allowing the government to complete the take over of the healthcare system we are simply exchanging one set of controls and restrictions for another.
The time has come to break our dependence on “the system” and regain control of this most personal of all human services. Eleanor Roosevelt once said, “With freedom comes responsibility.” That has never been more true than it is today with healthcare. Both patients and physicians must exercise personal responsibility by breaking our unhealthy dependence on the current third party payment system and regain our freedom, lest we will forever become wards and agents of the state.
The opinions expressed herein are my own and do not necessarily reflect or represent the policies or opinions of any medical organization or group.
Check out my web site at www.robertsewellmd.com