Tuesday, May 20, 2014

Real Health Care Reforms

From a critic regrading my stance on government run health care (specifically Obamacare)

The HealthSource RI app was humorous marketing. It's sad to see you lack a sense of humor, or at least the ability to detect when something is done in jest. Yes, the Exchanges are not working as hoped, and obviously that could have been a far better process. That said, millions of people now have coverage who didn't before. They're going to seek care, many who will get preventive care as opposed to waiting for something to get so serious that they wind up incredibly ill, and ultimately much more expensive. Yes, young and healties were needed - you know, because it's insurance. Any type of insurance works that way. Do you think everyone who gets car insurance gets in an accident that year? You need all the people not getting in accidents to adjust for the people who do. That's how health insurance works, and without healthy people, it just doesn't. But you can sit there complaining without offering any actual alternatives for people who need care. That's incredibly productive.

The person who offered me this extended comment suggested that I have been nothing but negative about the current health care "reforms" offered by President Barack Obama. To be precise, President Obama has not offered anything, but has in fact forced a terrible, government driven model which will increase costs and rationing while diminishing access and efficiency.

More importantly, however, I have indeed in the past and now offered solutions and health care reforms which will work, as opposed to granting more power to the government.

1. Health Savings Accounts (HSA). Dr. Ben Carson suggested permitting individuals from birth receive the opportunity to own and invest in an HSA, so that in the event of an emergency, the child can resort to the account for major expenses. Furthermore, HSAs should be tax deductible, thus increasing the incentive for individuals to invest in them.

2. Health Insurance Across State Lines. Currently, individuals seeking health care plans must resort to the limited market within their respective states. Car owners are permitted to purchase car insurance from any firm in the country, a market mechanism which has helped drive down the costs of car insurance. Such a simple reform as permitting the purchase of health insurance across state lines expand access as well as options, the reform would increase competition, accountability, and affordability.

3. Remove sclerotic licensure laws. While this reform sounds counterintuitive at first, the fact that physicians  must seek a medical license in every state has actually made it more difficult for professionals to practice medicine, yet has not done as much to prevent misconduct, incompetence, or abuse. License laws are unnecessary when the dimensions of supply and demand, reputation and expectations factor more largely in whether a physician retains a practice or not. Medical firms which wish to remain in business must practice good medicine, or get used to being out of business. Once a doctor has passed all required courses and residencies, has obtained his degree and earned a basic license demonstrating competence, there is no need to require that person to relicense himself every time he or she seeks to establish a practice in a different state.

4.  End the arbitrary barriers which prevent doctors from forming limited co-ops. Currently, doctors must either set up an individual practice, or they must work in a hospital. It is very difficult and rare indeed for a group of physicians to create a set medical status which exceeds one individual yet does not entail all the comprehensive care of a hospital. By removing such arbitrary restrictions to private group medicine, patients will have access to more opportunities to seek medical care.

5. Allow more people to become doctors. The American Medical Association has fashioned a guild-like cabal which severely restricts the number of individuals who can graduate from medical school and become MDs. These arbitrary limits were designed to drive up the cost, er salaries of medical professionals, which is wrong. The demand for quality health care from individual citizens should inform medical costs, not arbitrary unions or unaccountable government bureaucrats.

6. Restore  a trade-oriented, cash-cost direct relationship between doctor and patient as much as possible. Government controlled health care is bad health care, where third-party agents engage in arbitrary decisions, all of which betray the best interests of the patient as well as undermine the authority and integrity of the doctor. By eliminating health insurance as a the customary means of payment, beyond catastrophic needs (as car insurance operates), clearly indicated prices for health care will drive down costs while increasing competition and efficiency.

7. Tort Reform. Aside from suing for damages, patients (and by extension lawyers) should not be allowed to sue doctors, hospitals, and other medical-related firms for exorbitant punitive damages, which discourage the practice of medicine altogether. In nations like France, an independent attorney reviews the claims of both parties in a civil suit and arrives at a settlement which often pleases neither party. In Great Britain, the losing side in a civil case must pay the attorney's fees for the winning side. These legal reforms would discourage court-mandated outcomes and discourage frivolous (i.e. fraudulent) lawsuits, thus eliminating a number of the ancillary costs which doctors are compelled to accrue, whether in paying for liability insurance or in completing simple medical tests.

Most of these reforms strike liberals as either uninformed, unfair, or unrealistic. Yet for decades, if not centuries, health care was not viewed as a right, but as a commodity to be purchased, and health was a responsibility which every individual invested in. Free market reforms, not government-driven mandates, will ensure efficient as well as effective health care which encourages healthful habits as well as medical interventions when needed.


  1. The Affordable Care Act is NOT "government run health care". I suggest you lean about an issue before reflexively attacking it. You haven't got a clue.

  2. With what is happening at the VA we know what the end result of Obamacare will lead to. Over 6 million people lost the insurance they liked. Apparently about 8 million signed up on the exchanges and how many of those paid their first month of premiums there are no numbers. So we turned our healthcare system on its head for a small gain at best and a loss of the total number insured at best. I guess David also believes that people who like their insurance can keep them and you can also keep your doctor. Isn't it shocking how many people drink the Obama Kool Aid and don't realize they have just been screwed.