Healthcare

The great disruptor can fix healthcare

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Ronald Reagan liked his nickname, the Great Communicator. For the president-elect, there is a moniker he might relish: the Great Disruptor. He has said he will repeal Obamacare and replace it.

There is general agreement that the ACA should be repealed but people are fearful of losing insurance and access to care. The big question is, replace with what?”

{mosads}The Great Disruptor has an opportunity to actually fix healthcare. That starts with making a root cause diagnosis: understanding the reason why healthcare is sick and has been that way for six decades.

Keep in mind that Congress, as the treating physicians for our sick healthcare system, has spent billions of man-hours and trillions of dollars to fix healthcare. All they have done is make it sicker and the reason is simple: they refuse to accept the diagnosis.

Healthcare has cancer. A necessary part of the system, that used to be benign, has stopped doing its job, turned malignant, and now just keeps growing. That part is the federal bureaucracy. Instead of helping all the other parts of a system do their functions, what a bureaucracy is supposed to do, the federal bureaucracy has started to grow and expand apparently without any limit.

The cancerous bureaucracy steals energy, i.e., money and time, from the rest of healthcare—doctors, nurses, hospitals, wheelchair manufacturers, etc. — and uses that energy to grow bigger and Bigger and bigger. Instead of living for others, the bureaucracy is living off of others. For example, the Affordable Care Act (ACA) takes $716 billion from services to Medicare patients to pay for all six new government agencies, 23 (mostly failed) Co-Ops, bailouts for insurance companies, tens of thousands of bureaucrats, and the implementation of more than ten million words of rules and regulations.

Obamacare was designed to aid the malignant federal bureaucracy in its relentless drive to expand.  To fix healthcare, we need to stop the ACA’s sapping effect not only on healthcare, but on the economy, education, the military, and even our infrastructure.

Repealing the ACA will only stop its poison. The patient — healthcare — will still have a malignant bureaucracy inside. To cure our sick healthcare system, we must kill the cancer without killing the patient. (Always a complex balance for the doctor).

Politicians on both sides of the aisle in Congress tell us it can’t be done. They say: negotiate with the cancer; seek a compromise; take baby steps; do things slowly. This is code for “stall.” After all, the establishment does not want to tear down the establishment.

That is precisely what Donald Trump wants to do and why the American people elected him. The Great Disruptor can break the logjam we call Congress. He promised to disrupt the status quo.

If the cancer in healthcare is due to government’s power of the purse and its regulatory control, the cure is to put the money back into the hands of the people and to release the health care providers from Washington’s regulatory shackles.

How? Take a fraction of the money we now spend on healthcare, approximately four trillion dollars per year, and give it to the people into HSAs. Let them shop for and buy their health care. Let them purchase catastrophic insurance for the surprise big ticket items. For the Medicare crowd, pay them back what they put in to the Medicare Trust with some nominal growth factor.

Watch the Great Disruptor enjoin Congress to repeal Medicare, Medicaid, EMTALA, HIPAA, UMRA, and the ACA. Then marvel as the cost of health care plummets for three reasons.

First, the malignant bureaucracy will no longer take half of our healthcare spending. Second, There will be a good reason to economize, as people will be spending their own money. Third, sellers of goods and services will have to compete for consumers’ dollars. If they refuse to compete and stand on ceremony or say the consumers can’t possibly understand what they are buying, you know what will happen. They will quickly go out of business.

Don’t let anyone tell you the free market can’t work in healthcare. We haven’t had a free market for fifty-one years. The market in healthcare has been under strict government control since the Medicare Act of 1965.   

It is time to restore the free market to healthcare. The Great Disruptor may be the right man for the job.

Dr. Deane Waldman, MD MBA, is Director of the Center for Health Care Policy at the Texas Public Policy Foundation and author of The Cancer in the American Healthcare System. He can be reached at dwaldman@texaspolicy.com.


The views expressed by contributors are their own and not the views of The Hill. 

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