Guest Post from Nick Pandelidis, MD:
We, physicians, are at a uniquely opportune time to offer an alternative health care reform to ObamaCare. First and foremost, people have come to see that the Affordable Care Act has made insurance unaffordable for many people. The individuals/families in the individual insurance market learned firsthand that the President’s promise that “If you like your insurance you can keep your insurance” was a blatant lie. The American people more generally have witnessed the incompetence of government in the inept rolling out of ObamaCare and in the care of our military veterans.
We are at a uniquely necessary time to offer an alternative health care reform to ObamaCare. The Republicans who are poised to take control of Congress must demonstrate they are not the party of no but rather are able to offer a credible, coherent, and specific health care reform alternative. The upcoming Supreme Court challenge of federal funding of federal exchanges makes promoting an alternative even more pressing.
Unfortunately, politics and politicians regardless of party primarily serve self and special interest and will not come up with a credible and coherent proposal. Those of who believe in individual and economic freedom need to persuade/help the Republican Congress a put forth alternative reform based in those principle of individual and economic freedom.
As has been stated previously, physicians are uniquely positioned to champion health-care reform because we are correctly perceived as patient advocates and as experts in health-care delivery. Physician support for a specific reform policy could provide legitimacy, credibility, and impetus for moving forward with reform.
We all know the frustration of trying to get our colleagues to join such an effort. There are at least 2 reasons for this failure of most physicians to become engaged. First, they are woefully ignorant of the policies and fundamental economics that drive unsustainable health care cost growth and the ever increasing infringement of patient-physician medical decision-making freedom. Secondly, even if they were to have such an understanding, they have not seen a credible, coherent, and specific alternative reform proposal to get behind and promote. Without a clear vision of pathway for physician involvement to make a difference, many physicians remain disengaged fearing active involvement would only lead to frustration.
So too move forward to grow the critical physician engagement and influence on the reform process requires 2 components: First developing a relatively simple and logical basic health care economics and policies education module outlining the consequence of economic mal-incentives created by 3rd party payment and unwise government intervention, e.g. tax policy promoting employer ownership of health-care insurance, mandated coverages, cost controls, etc. Part of the education component should also be expose to Medicaid for the for the 3rd rate health care that it is. We must denounce the poor access, high expense, and poor outcome the patients enrolled in the government provided indigent health care system are forced to endure.
The second component to engage physicians in this reform is development and promotion of a coherent, credible, and easily understood alternative reform proposal. The reform proposal should not try to fix everything at once: The more “comprehensive” the reform, the greater the unintended consequences. Reform should not be judged by whether or not it addresses all of the shortcomings of our present health care system but rather by whether or not it moves us in the direction of lower costs and of increased patient-physician medical decision-making freedom.
Viable reform must move health care financing from a 3rd party payer system to a more patient-centered system.
The two critical components of such reform are:
- Health care insurance freedom: Senator Gramm outline this simple reform in a July WSJ opinion piece. His proposal is very simple. It addresses critical flaws in our present system. Its message of freedom will resonate with most Americans. And it is politically brilliant. His proposal does not repeal ObamaCare but rather would give Americans the freedom to opt out of ObamaCare and instead to have the freedom to buy a policy that best fits their needs, choosing the coverages they want and can afford. The proposal would also give insurance companies the freedom to sell (actuarially sound) policies that individuals want to buy. Part and parcel to such a policy would be allowing insurers to sell policies across state lines.
- Giving all Americans, including the poor, the same tax advantage when buying a health insurance policy whether in the employer-provided insurance or in the individual-purchased insurance market. It has been estimated that providing a tax credit of $2500/individual and $8000/family would be revenue neutral with the current employer-provided insurance tax advantage. Such a policy would also give the working poor the freedom to opt out of a 2nd rate Medicaid system and allow them to have private insurance like the rest of us enjoy.
The first reform – health care insurance freedom – does not need to be tied to repealing ObamaCare. The reality is it completely undermines ObamaCare without the political demagoguery of being accused of repealing The Patient Care and Affordability Care Act.
Again this is vision for a pathway to enlist physician support and to leverage the public’s trust in physician as patient advocates and experts in health care delivery to influence politicians to promote the necessary legislative free market reforms that lower costs and protects patient-physician medical decision-making freedom. The plan for educating and engaging physicians is sound. Leveraging physician credibility would be powerful.
Promoting only the 1st reform initially would still be very powerful.
The key to moving forward at this point is to get a large political action group, respected policy center, or influential politician on board with this vision.
I have reached out to Heritage Action and to Senator Gramm but have not gotten any support for moving forward. If anyone else has thoughts or influence to get such support, let’s make a plan to move forward. Otherwise it is just talk.