Opinion | Healthcare

The ongoing collapse of US health care

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

While national attention is focused exclusively on COVID-19 and Supreme Court appointment maneuverings, U.S. health care continues its slide into oblivion. Washington is doing nothing to get Americans desperately needed medical care.

With his typical hyperbole, President Trump has promised his "terrific," "phenomenal," and "fantastic" new health care plan that will replace the ACA. He has yet to produce the said plan. Republicans want to tweak financing and eligibility rules that do nothing to improve access. Candidate Biden wants to expand the ACA law that reduced the availability of care, by passing "Medicare for All" that could seemingly take away our right to choose. With a price tag cost of $32.6 to $40 trillion, Biden's (really Bernie Sanders') plan will, at a minimum, double Americans' tax burden and simultaneously cut access to care.

While our political leaders play power politics with health care, the system is collapsing. Spending goes up and care goes down. Health care costs for the average American family in 2020 have reached an unaffordable $28,653; the number of uninsured Americans has risen; mental health continues to decline; the doctor shortage deepens; and worst of all, care that was insufficient as well as delayed before COVID is now put off by patients as simply not available.

U.S. health care is not a broken machine. It cannot be fixed by spending or replacing a damaged part, such as adding a public option. Health care is a critically ill patient in the ICU on a ventilator.

The attending physicians, Congress, or collectively Washington, refuse to acknowledge what is truly wrong with health care-the-patient. Lacking a precise diagnosis, their treatments have been ill-conceived and have made patient health care worse. Every day, Americans experience the result of five decades of Washington fixes: unaffordable insurance and inaccessible care.

Health care needs a clinically experienced physician who will identify the underlying reason why health care is sick, the diagnosis or what doctors call the etiology, and treat that cause of sickness, not merely the symptoms. 

In 2013, I accepted a new patient named health care in my practice. The first order of business was to uncover the etiology of illness and dysfunction. Instead of using a physical exam, blood tests, and x-rays for a sick human, I applied systems thinking and other diagnostic managerial tools such as queueing analysis, learning curve theory, and quantitative strategic matrix. Within three years, the diagnosis was established. Health care has cancer. A malignancy has spread throughout the system, from Congress's halls and its bloated bureaucracies down to your general practitioner's office.

All the evidence was compiled in a 2016 book titled, "The Cancer in the American Health Care System: How Washington Controls and Destroys Our Health Care." A cure was implied in that book, but not delineated. It required three additional years to develop the models to prove that a financially viable and medically effective cure. The evidence and proofs were placed in a short, 86-page book written for the general public, titled, "Curing the Cancer in U.S. Health Care: StatesCare and Market-Based Medicine."

The cure for cancer, any cancer, is to cut it out, whether one uses a scalpel, drugs such as chemotherapy, biologic treatment, radiation, or a combination. As Washington is the primary and its regulatory bureaucracy are the metastases - cancer spread to other places - the cure is to cut Washington and its minions out of the health care system. 

Washington politicians, both Democrat and Republican, agree on one thing: they never have enough power and always want more. Health care represents control of nearly one-fifth of our entire economy and tens of millions of voters beholden to federally funded bureaucratic jobs. The swamp residents of Washington, both elected and bureaucratic appointments, will never voluntarily return the right to choose where it belongs - in the hands of We the People, or as I like to call us, "We the Patients."

Many people I respect say it is impossible to remove Washington's tentacles from our health care system. If you agree, you will create a self-fulfilling prophecy. "It can't happen. Therefore, I won't bother trying." As a result, change won't happen.

The pessimists are wrong. The true power in the U.S. rests with We the Patients at the ballot box. If Americans want affordable, timely, high-quality medical care, Wethe Patients - that's you and me - need to act. If we keep waiting for Washington to cure patient health care, we wait for what will never come.

We need to regain control of our own lives and our money. That means removing Washington and its insurance minions from making decisions for us. We want our freedom back. We demand the right to choose our health care, as guaranteed by no less than the Constitution. According to the 10th Amendment, the federal government is prohibited from authority (power) over health care. "The powers not delegated to the United States [federal government] by the Constitution, nor prohibited by it to the states, are reserved to the States respectively, or to the people."

We should only elect people to Congress who pledge to repeal all the Washington-generated health care rules, regulations, and mandates and leave health care structure up to the people in their states.

At present, more than $1 trillion of the $3.6 trillion spent last year on health care went to federal advisories, administration, bureaucracy, guidelines, mandates, rules, regulations, and oversight. Texas has 50,000 licensed physicians. The Texas Health and Human Services Commission, which oversees physicians' compliance with federal regulations, employs 62,000 health care bureaucrats. With Washington removed from health care, all that wasted money can be recouped and used for patient care or left in our pockets. Your choice.

Who knows what's best for California, Texas, Oregon, or New York: Washington with one-size-fits-all solutions or each state's residents? If 39 million Californians want single-payer, 29 million Texans want market-based health care, 4.2 million Oregonians want universal health care, and 6.9 million people in Massachusetts want to keep Commonwealth Care, by what authority does Washington deny 79.1 million Americans the right of self-determination?

You can have the health care you want by following Nancy Reagan's famous admonition. Though she talked about the war on drugs, "Just Say No" applies to health care. To cure our sick system, We the Patients should say no to anyone seeking congressional office who will preserve Washington's tyranny over U.S. health care.  

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." 

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