Source of health care’s re­cent tra­vails is Wash­ing­ton it­self.

The source of health care’s re­cent tra­vails is Wash­ing­ton it­self

The Washington Times Daily - - FRONT PAGE - By Deane Wald­man Deane Wald­man, a physi­cian, is the direc­tor of the Cen­ter for Health Care Pol­icy at the Texas Public Pol­icy Foun­da­tion. He is the au­thor of “The Can­cer in the Amer­i­can Health­care Sys­tem” (Sbpra, 2015).

There are two ways to achieve suc­cess. The best way is to make the right choice. A sec­ond way is to avoid the wrong choice. Wash­ing­ton avoided dis­as­ter by with­draw­ing the hastily con­structed, ill-con­ceived Amer­i­can Health Care Act (AHCA).

One pun­dit ex­plained away this Repub­li­can po­lit­i­cal set­back writ­ing, “Oba­macare is more pop­u­lar than the GOP al­ter­na­tive.” Some will sit back and watch Amer­ica’s fa­vorite spec­ta­tor blood-sport, the blame game. Or, we might learn the right les­son, make the right choice, and ac­tu­ally fix our col­laps­ing health care sys­tem.

U.S. health care has been fail­ing for decades: it is a plat­form on fire. Early at­tempts by Wash­ing­ton to put the fire out — EMTALA (Emer­gency Medical Trans­port and La­bor Act), UMRA (Un­funded Man­date Re­form Act), HIPAA (Health In­sur­ance Porta­bil­ity and Ac­count­abil­ity Act), SGR (Sus­tained Growth Ra­tio) — only made the flames go higher. Oba­macare poured gaso­line on the plat­form. AHCA would have been a fur­ther ac­cel­er­ant.

It is time to lis­ten to man­age­ment gu­rus and make the right choice. “When you’re stand­ing on a burn­ing plat­form, get off it!”

The burn­ing plat­form that is con­sum­ing health care is not made of ve­nal in­sur­ance ex­ec­u­tives, un­car­ing doc­tors, or goug­ing phar­ma­ceu­ti­cal com­pa­nies. The burn­ing plat­form is fed­eral con­trol — Wash­ing­ton it­self.

Man­dated in­sur­ance pack­ages, stan­dard­ized el­i­gi­bil­ity, un­re­spon­sive pay­ment schemes, and gov­ern­ment prac­tic­ing medicine are ways the fed­eral gov­ern­ment dic­tates where tax­payer dol­lars go in­stead of where they should go: to pay for care.

The real les­son from the demise of AHCA is that any an­swer for health care em­a­nat­ing from Wash­ing­ton is doomed to fail­ure. We need a non-Wash­ing­ton so­lu­tion, one that starts with full re­peal of Oba­macare and con­tin­ues by re­peal­ing other fed­eral health­care man­dates.

A “non-Wash­ing­ton” health care sys­tem means that the states de­cide what health­care sys­tem works for its res­i­dents. If Cal­i­for­nia thinks sin­gle payer sys­tem is best, give the Golden State a block grant for health care and let them build the sys­tem they want. If Texas wants a free mar­ket, give them their block grant, and step aside.

The health care needs of in­di­vid­u­als in Cal­i­for­nia’s Im­pe­rial Val­ley are quite dif­fer­ent from what peo­ple need on the Texas Pan­han­dle. State gov­ern­ments are much more at­tuned to the di­verse in medical needs of their peo­ple, much more ef­fec­tive in al­lo­cat­ing scarce re­sources, and much more re­spon­sive to its cit­i­zens than the fed­eral gov­ern­ment.

Care across state bor­ders could eas­ily be part of in­ter­state com­pacts, es­pe­cially if the fed­eral gov­ern­ment al­lows in­sur­ance com­pa­nies to sell across state lines.

Costs will plum­met when the fed­eral health care bureau­cracy is out of the pic­ture. In­sur­ers such as Aetna, An­them, Hu­mana, and Unit­edHealth will re-en­ter the mar­ket. With­out fed­eral man­dates, they can com­pete suc­cess­fully and sell poli­cies we want. The prices will fall fur­ther.

As a di­rect re­sult of Oba­macare’s in­sur­ance man­dates, an­nual health care costs for a fam­ily of four have reached $25,826 a year. This is slightly less than half of all that fam­ily’s in­come. When re­lieved of the cost of bureau­cracy and with in­sur­ers com­pet­ing, in­sur­ance costs will cer­tainly also fall, prob­a­bly to less than $10,000.

Us­ing a stick — Oba­macare’s penalty tax — to get “young in­vin­ci­bles” to pur­chase in­sur­ance hasn’t worked. The car­rot works bet­ter: let the free mar­ket drive the cost down to where the young and healthy see in­sur­ance as both af­ford­able and valu­able.

Un­like Wash­ing­ton, states can­not print money. State spend­ing on health care can­not add to a na­tional debt, that has dou­bled to $19 tril­lion with Oba­macare in place. In fact, the Obama ad­min­is­tra­tion es­tab­lished a new and un­en­vi­able record. For the first time in U.S. his­tory start­ing in 2012 and con­tin­u­ing to date, our na­tional debt is greater than U.S. GDP. Be­fore Pres­i­dent Obama, GDP was 35 per­cent greater than na­tional debt.

Peo­ple tend to fo­cus on in­sur­ance cov­er­age when dis­cussing health care. They lose sight of the rea­son for hav­ing a sys­tem: care. It may sound like a won­der­ful achieve­ment that 16.9 mil­lion Amer­i­cans gained in­sur­ance who did not have it be­fore. The vast ma­jor­ity, some say as much as 97 per­cent, oc­curred through Med­i­caid ex­pan­sion. Un­for­tu­nately, while more peo­ple were in­sured, ac­cess to care went down. Al­most half (47 per­cent) of U.S. physi­cians can no longer af­ford to see new Med­i­caid pa­tients. Wait time to see a fam­ily prac­ti­tioner in Al­bany is now av­er­ag­ing more than four months.

Health care is stand­ing on a burn­ing plat­form. The plat­form is named Wash­ing­ton. It is time to get off. Whether you call the so­lu­tion StatesCare, Fifty Plan, or sim­ply states’ rights health­care, Wash­ing­ton needs to with­draw from health care and let the states take over. Then, we can get the care we need, when and when we need it, for a price we can all af­ford.

As a di­rect re­sult of Oba­macare’s in­sur­ance man­dates, an­nual health care costs for a fam­ily of four have reached $25,826 a year. This is slightly less than half of all that fam­ily’s in­come.


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