On 02/05/2008, I authored a post “Benevolent Dictators Make Good Government”. Examples are King David – Israel – (1010 BC –970 B.C.) in ancient times and General Douglas McArthur – Japan – (1945 –1947) in modern times. I started musing about what I would do if I were absolute dictator of the United States to fast track our country back to a position of greatness and prosperity. Therefore I am submitting a series of posts to PA Pundits (many controversial) about how I would provide solutions to the major issues facing our nation.
I would issue an order to immediately privatize the health care system for everyone, primarily based on a proposal by John Mackey, former CEO of Whole Foods, with modifications.
Some Republican health care proposals are the much demonized plan by Representative Paul Ryan (R – WI), a bicameral coalition of the House and Senate titled “Patients Choice Act of 2009”, a plan by Senator Jim DeMint (R – SC) “Health Care Freedom Plan”, and a plan led by Representative Tom Price (R – GA).
Some of the provisions included in one or more of the bills include investing in preventive medicine, an overhaul of Medicaid, reduction of abuse and fraud in the Medicare program, supplemental health insurance for low-income families, tax credits for health insurance, and a ban on federal funds being used for abortions.
My order would create high-deductible health insurance plans, equalize unfair laws between employer and individually owned insurance, allow insurance companies to compete across state lines, remove mandates regarding what insurance companies must cover, enact stringent tort reform, make all health care costs transparent, and privatize Medicare and Medicaid.
Implementation of the Fair Tax is not considered in any of the proposed reforms, but this is necessary to eliminate any issues of trying to configure plans based on tax deductions or credits. There will be no need for deductions, because income taxes and Federal Insurance Contributions Act (FICA) taxes will no longer exist, and free market forces and competition will determine costs.
The Democrat’s 2,300-page 211,000-word monstrosity health care bill (HR 3200) has created 53 new boards, bureaucracies, commissions, and programs that will control every aspect of our health care system, and destroy the best health car system in the world.
Here is the list: Health Benefits Advisory Committee, Health Choices Administration, Qualified Health Benefits Plan Ombudsman, Program of Administrative Simplification, Retiree Reserve Trust Fund, Health Insurance Exchange, Mechanism for Insurance Risk Pooling, Special Inspector General for the Health Insurance Exchange, Health Insurance Exchange Trust Fund, State-based Health Insurance Exchanges, Public Health Insurance Option, Ombudsman for Public Health Insurance Option, Telehealth Advisory Committee, Demonstration Program Providing Reimbursement for Culturally and Linguistically Appropriate Services, Demonstration Program for Shared Decision Making Using Patient Decision Aids, Accountable Care Organization Pilot Program, Independent Patient-centered Medical Home Pilot Program Under Medicare, Community-based Medical Home Pilot Program Under Medicare, Center for Comparative Effectiveness Research, Comparative Effectiveness Research Commission, Patient Ombudsman for Comparative Effectiveness Research, Quality Assurance and Performance Improvement Program for Nursing Facilities, Special Focus Facility Program for Nursing Facilities, National Independent Monitor Pilot Program for Skilled Nursing Facilities, Demonstration Program for Approved Teaching Health Centers with Respect to Medicare GME, Pilot Program to Develop Anti-fraud Compliance Systems for Medicare Providers, Medical Home Pilot Program Under Medicaid, Comparative Effectiveness Research Trust Funds, Identifiable Office or Program within CMS to Provide for Improved Coordination Between Medicare and Medicaid in the Case of Dual Eligibles, Public Health Investment Fund, Scholarships for Service in Health Professional Needs Areas, Loan Repayment Program for Service in Health Professional Needs Areas, Program for Training Medical Residents in Community-based Settings, Grant Programs for Training in Dentistry, Public Health Workforce Corps, Public Health Workforce Scholarship Program, Public Health Workforce Loan Forgiveness Program, Grant Program for Innovations In Interdisciplinary Care, Advisory Committee on Health Workforce Evaluation and Assessment, Prevention and Wellness Trust, Clinical Prevention Stakeholders Board, Community Prevention Stakeholders Board, Grant Program for Community Prevention and Wellness Research, Grant Program for Community Prevention and Wellness Services, Grant Program for Public Health Infrastructure, Center for Quality Improvement, Assistant Secretary for Health Information, Grant Program to Support the Operation of School-based Health Clinics, National Medical Device Registry, and Grants for Labor-management Programs for Nursing Training.
Remember, HR 3200 has yet to be enacted, and yet these programs are already funded. Democrats are hoping all these bureaucracies will be so entrenched that the bill cannot be repealed.
“The problem with socialism is that eventually you run out of other people’s money.”- Margaret Thatcher.
With a projected $1.8 trillion deficit for 2011, several trillions more in deficits projected over the next decade, and with both Medicare and Social Security entitlement spending about to ratchet up several notches over the next 15 years as baby boomers become eligible for both, we are rapidly running out of other people’s money. These deficits are simply not sustainable. They are either going to result in unprecedented new taxes and inflation, or they will bankrupt us. While we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead, we should be trying to achieve reforms by moving in the opposite direction—toward less government control and more individual empowerment. Here are reforms that would greatly lower the cost of health care for everyone:
Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs). The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems. For example, high-deductible health-insurance plans, and use of additional health-care dollars through deposits into employees’ Personal Wellness Accounts to spend as they choose on their own health and wellness will create incentives to spend their health dollars. Money not spent in one year rolls over to the next and grows over time. Individuals could therefore spend their own health-care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in. This creates incentives to spend the first $2,500 more carefully. Costs would be much lower than typical health insurance, while providing a very high degree of worker satisfaction.
Repeal all state laws that prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable. There is a barrage of television ads from automobile insurance companies touting their advantage over competitors because there is a free market to compete in any state, but a dearth of such ads for health care because of individual state regulations about coverage. Government mandates regarding what insurance companies must cover must be repealed. These mandates have increased the cost of health insurance by billions of dollars. What is insured and what is not insured should be determined by individual customer preferences and not through special-interest lobbying.
Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. These costs are passed back to us through much higher prices for health care. I would also issue an order that attorneys will not be allowed to advertise on television, radio, internet, or newspapers. No class action lawsuits will be permitted, and lawyers will not be involved in any medical malpractice, product liability, or accident suits. There will be panels of doctors and/or qualified “experts” in each city and jurisdiction who will determine malpractice or damage awards, with national caps of $500,000. for pain and suffering. Who do you trust most, a panel of doctors or a panel of trial lawyers? I will also institute a loser pay system as they have in all of Europe and most other nations. Finally, I will issue an order that the maximum contingency fee that a lawyer may charge a client is 10% of the monies awarded the client when winning a suit. This will prevent most frivolous lawsuits. These are true tort reforms that will save Americans hundreds of billions of dollars each year.
Make costs transparent so that consumers understand what health-care treatments cost. How many people know the total cost of their last doctor’s visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost us? Virtually everything we buy has a published price except for health care. We would not buy a car from a dealer and wait a week for a statement to see how much we paid, hoping someone else will pay the bill and expressing outrage about the price. Health care should also have predetermined published prices, with each doctor and dentist office having a price for the visit and a large billboard with the price for each procedure. Hospitals should provide the same information. It is understood that health care is different than any other service, because many times the visit is an emergency and dealing with life and death does not lend itself to asking how much it will cost.
Many promoters of health-care reform believe that people have an intrinsic ethical right to health care—to equal access to doctors, medicines and hospitals. While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter? Health care is a service that we all need, but just like food and shelter it is best provided through voluntary and mutually beneficial market exchanges. A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That’s because there isn’t any. This “right” has never existed in America Even in countries like Canada and the U.K., there is no intrinsic right to health care. Rather, citizens in these countries are told by government bureaucrats what health-care treatments they are eligible to receive and when they can receive them. All countries with socialized medicine ration health care by forcing their citizens to wait in lines to receive scarce treatments. Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment, according to a report last month in Investor’s Business Daily. In England, the waiting list is 1.8 million. Employees of a company should be able to vote on what benefits they most want. Subsidiaries of Canadian and British companies usually express their benefit preferences very clearly – they want supplemental health-care dollars that they can control and spend themselves without permission from their governments. Why would they want such additional health-care benefit dollars if they already have an “intrinsic right to health care”? The answer is clear – no such right truly exists in either Canada or the U.K. or any other country. Rather than increase government spending and control, we need to address the root causes of poor health. This begins with the realization that every American adult is responsible for his or her own health.
Unfortunately many of our health-care problems are self-inflicted: Two-thirds of Americans are now overweight and one-third are obese. Most of the diseases that kill us and account for about 70% of all health-care spending—heart disease, cancer, stroke, diabetes and obesity—are mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption and other healthy lifestyle choices. Recent scientific and medical evidence shows that a diet consisting of foods that are plant-based, nutrient dense and low-fat will help prevent and often reverse most degenerative diseases that kill us and are expensive to treat. We should be able to live largely disease-free lives until we are well into our 90s and even past 100 years of age. Health-care reform is very important. Whatever reforms are enacted it is essential that they be financially responsible, and that we have the freedom to choose doctors and the health-care services that best suit our own unique set of lifestyle choices. We are all responsible for our own lives and our own health. We should take that responsibility very seriously and use our freedom to make wise lifestyle choices that will protect our health. Doing so will enrich our lives and will help create a vibrant and sustainable American society.
Credits – John Mackey