With COVID-19 receding, we the patients must fix health care

With COVID-19 receding, we the patients must fix health care

With the COVID-19 danger possibly receding, the U.S. economy is beginning to return to its pre-COVID-19 health and vigor. The U.S. health care system remains dysfunctional and massively wasteful, diverting more than 1 trillion "health care" dollars from patient care to pay for federal bureaucracy.

For years, polls have consistently shown that Americans' top concern is our sick health care system, with affordable insurance and inaccessible care. It is time to turn the national focus from viral response back to our collapsing system, 

This year, the average American family of four will expend $28,653 on health care, making it the most expensive item on household budgets, more costly than a home mortgage. As for getting care when you need it, wait times to see a primary doctor for a non-COVID-19 problem now exceed the pre-COVID-19 delay of more than four months. For Medicaid patients, the wait maybe forever as only 68 percent of U.S. family physicians accept new Medicaid patients.

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With a presidential election less than two months away, what proposals are being offered that will make care affordable and accessible to Americans?

Even though federal control of health care via the ACA doubled insurance premium costs and reduced the pool of available medical caregivers, Democrats say the cure is more regulation and greater spending on bureaucracy, as envisioned in their "Medicare for All" bill, H.R. 1384. This proposal institutes total federal control of health care, eliminates private insurance, imposes both price and wage controls, and the price tag is 32.6 to 40 trillion taxpayer dollars over ten years. ObamaCare cost only $1.76 trillion.

Republicans tout their admittedly valid objections to the ACA but offer no proposals that will get people the care they need when they need it. Republicans recommend small changes in financing and eligibility standards when health care needs a total overhaul.

The White House has provided a mixed bag of fixes for health care, some good and some bad. On the positive side, there has been considerable deregulation by the Centers for Medicare and Medicaid Services that has reduced bureaucratic inefficiency and has increased access to medical care. The unfortunate actions include price controls and ill-conceived price transparency.

The history of price controls shows increased costs to patients along with shortages and suppression of innovation and new drugs. Transparency — giving consumers cost information — without allowing them to control their spending will fail to reduce health care spending.  

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In summary, there is nothing new or helpful, coming from Washington. Meanwhile, increasing numbers of Americans can't afford insurance, and fewer can find a doctor to care for them.

There is a workable answer for health care, one that will never come from Washington. Why? Because the "cure" for health care is to remove Washington. Federal control of health care is cancer destroying the system.

There are numerous reasons why Washington is the disease and not the cure. First, there is a 50-year track record of failure. Federal fixes have repeatedly backfired, making health care more expensive and less available. One size most definitely does not fit all 330 million Americans spread over 3.8 million square miles. Though only physicians are legally allowed to practice medicine, in fact, the government, as well as insurance bureaucrats, practice more medicine on you than your doctor does. Washington diverts more than 1.4 trillion "health care" dollars away from patient care to pay itself. Finally, according to the Tenth Amendment, Washington is prohibited from health care, which is "reserved to the states, respectively, or the people."

Most Americans cannot imagine a health care system not run by Washington. Their only experience is with health care that is centrally controlled. However, a decentralized, free-market system can supply affordable, timely care provided by the doctor of your choice. health care without Washington can reconnect patients directly with the physician, without a third-party decision-maker disrupting the doctor-patient relationship.

Health care without Washington returns both medical and financial control where it belongs–in the hands of We the People, also known as We the Patients. If families put the $28,000 they spent on health care in 2018, 2019, and 2020 into an unlimited Health Savings Account, and purchased high deductible, catastrophic insurance for, say, $5000 a year, they would have $69,000 in the HSA. 

Next, imagine a medical marketplace where sellers of goods and services compete for consumer dollars, not for contracts with health plans. Consumer prices would plummet due to seller competition as well as the elimination of the cost of the federal bureaucracy. The $69,000 would easily pay for routine care activities and even common procedures such as the delivery of babies, appendectomy, hernia repair, and cataract surgery.

Market-based health care will offer the care Americans want, when they need it, from someone they choose, at prices they can afford. Add state-based safety nets for the medically vulnerable, and that is an effective health care system without Washington.

The real problem is that Washington would vehemently oppose giving up control of one-sixth of our economy and all the votes associated with bureaucrats who are dependent on their jobs on taxpayer dollars doled out by the federal government. Americans have to decide whether they are willing to fight for a health care system that works for them or one that works for Washington?

Deane Waldman, M.D. MBA, is an emeritus professor of Pediatrics, Pathology, and Decision Science; former Director of Center for health care Policy at Texas Public Policy Foundation; and author of multi-award-winning, "Curing the Cancer in U.S. health care: StatesCare and Market-Based Medicine."