Health care costs are spiraling out of control. On this point, there is universal, bipartisan agreement. One of the perceived villains is insurance companies. People see their premiums soaring without a concomitant increase in value. We find ourselves in this predicament partly because of the insurance companies but more so as a sequela of government interference into the healthcare arena.
Healthcare does not operate in a free market system in America. The creation of Medicare and Medicaid in the 1960s put an end to that, with government involvement in medical decisions and artificial price fixing for medical services. Over the past 50 years, individuals have become increasingly disconnected from the true costs of their medical care. Patients now feel that they pay such an exorbitant amount of money for insurance, that they have no desire to pay any more out of their own pocket. They consider their health insurance plan to be the equivalent of a “pre-paid” health plan, and demand the highest level of care, utilizing the latest and most expensive treatments, and they want it immediately.
We have reached a tipping point and those who demagogued insurance companies, physicians, and all other parts of the healthcare system prevailed when they succeeded in getting the Affordable Care Act (ACA, Obamacare) passed. Their solution was to centralize all healthcare decisions in Washington, and it was guaranteed that by doing so, costs would be contained. What has occurred is a shift in the control of medical decisions and their financial ramifications away from patients/consumers, putting them instead in the hands of bureaucrats in Washington. Instead of decisions being made on the basis of medical issues, they will be made on the basis of politics and lobbying. And the costs are escalating, not decreasing.
The sad irony is that we did not need to take this path towards a socialized healthcare system where the government takes over the responsibility of “paying” for healthcare, although in reality, everyone is already paying at some point through the tax system. Control over paying for healthcare services at the point of service could have been left in the hands of patients, which would have ultimately given them more control over every aspect of the healthcare that they receive.
The solution would have entailed health insurance reform. The “black eye” that insurance companies currently have would disappear if patients had more control over the financial aspects of receiving medical services. If health insurance could be treated more like true “insurance”, instead of pre-paid healthcare, costs would plummet and patients would be more secure.
In order for this to occur, it would require restructuring of state and federal laws to establish a true, free market. Consistent healthcare laws are needed on a national or regional level. This would entail removing unnecessary mandates that insurance companies are required to have in healthcare policies and which differ in every state. The tax treatment for health insurance policies should be the same whether the policy is purchased by an employer or by an individual. Health Savings Accounts and high deductible insurance policies would make individuals better consumers because the financial implications of healthcare would be transparent and become their direct responsibility.
Free market ideas and products currently exist. One solution to the many problems facing healthcare is to seriously tackle the healthcare insurance problem as is currently occurring in Georgia (www.georgiahealthreform.com). A team was created consisting of concerned private citizens who worked with state legislators, grassroots organizations, and academic centers to produce a comprehensive, consumer driven healthcare system based upon competition, patient choice, transparency of cost and care, and a level playing field for consumers. This concept could and should become a pillar upon which real healthcare reform is built.
Contrary to the rhetoric from those who have a different view on the role of government in healthcare, we have the best healthcare system in the world. It does not need to be dismantled. It needs to be adapted to meet the challenges of the 21st century. We do not need a government run healthcare system. We need 300 million Americans who are empowered to direct how healthcare products and services will be allocated through the power of their purses, which they control.
Hal C. Scherz, MD is the Founder and President of Docs4PatientCare, VP of Georgia Urology, and Associate Clinical Professor Urology- Emory University.
Jeffrey B. English, MD is the Docs4PatientCare, Georgia Chapter President and the Director of Clinical Research at the MS Center of Atlanta