Repeal Obamacare – Real Health Care Reform

Health Care reform was born of the desire for this country to provide those segments of our population who can least afford it equal access to high quality health care. Unfortunately, the models used to design Obamacare (the Patient Protection and Affordable Care Act) have already failed, such as Massachusetts’ affordable health care and socialized medicine throughout Europe. Instead of supplying access to health care for small segments of our population such as those who are uninsured and those with pre-existing conditions Obamacare has sought to diminish the success of private sector health care in favor of more government control, less competition, and interference with the patient-doctor relationship.

Private sector health care is faced with ever-increasing costs compounded by a poor economy, driving more people to become uninsured. Rather than adversely affect our existing private-sector healthcare, we should focus our attention upon those segments of the population who can least afford health care by specifically addressing their problems. We must first address the issues driving up healthcare costs such as abuse, fraud, and fraudulent litigation. Rather than follow failed models, we should follow models that have succeeded. States that have already implemented “loser pays” have reduced frivolous lawsuits and therefore reduced the cost of insurance.

Restoring interstate competition and access to group insurance benefits like that once offered by the chamber of commerce will reduce costs by normalizing the risk pool. This can be done in conjunction with products for private plans that would offer an individual health savings account and a rate based on the universal risk pool across the company, and would follow the individual regardless of employment. Measures similar to these would better adapt to the demographic variations that exist from state to state or city to city. More densely populated states and cities would have a wider variety of risk pools, allowing for better competition, and would better address local health and health needs, in addition to allowing for a much more personal relationship between health care providers and their patients. By lowering the cost of private health care insurance we will have more people contributing lower amounts of their income toward health care insurance, while simultaneously decreasing the segment of the population that cannot afford health insurance – that segment of the population that will ultimately require coverage due to federal or state programs, effectively paid for by the taxpayer. In contrast, Obamacare will greatly increase the number of people requiring government provided health care at low or no contribution, decreasing the private risk pool size, driving up both the cost of private health care and the cost to taxpayers. Socialized health care has always decreased the quality of health care, the number of health care providers, and resulted in higher, unsustainable costs.

More on Obamacare

Obamacare  was started as an attempt to socialize medicine and ended up, after all the arm-twisting and vote buying in Congress, as nothing more than a massive tax levied on the American people through insurance companies. Its model was based in error, copying that of European nations who have cut their defense to the bone and still cannot afford their health care programs, and its implementation was entirely partisan and wrongheaded, so much so that our own citizens of Massachusetts sent Senator Brown explicitly to be the 41st vote against it.

Unfortunately the Supreme Court rendered a ruling that defied Constitutional principles, as they have done on rare occasion, in deferring to Congress that legislation passed by it reflected the will of the people. The Supreme Court was two years behind the times – at the time of Obamacare’s passage a majority of Americans opposed it, a majority of Americans still oppose it, and in 2010 that majority elected new officials in massive numbers to make that point clear. The onus is now on the American people to act where the Supreme Court did not.

More on the Patient-Doctor Relationship and Specific Reforms

Real health care reform starts at the patient-doctor relationship. As a health care provider, the first thing I do is take a patient history, then analyze their needs and offer treatment plans that fit within their budget. I will take this same approach down to Washington to fix this, one of our most pressing issues. Our society needs to get back to that model, because health care is individual. My patients come to me from all backgrounds, all income levels, all life styles, and every other variety you can imagine. Solutions that may work for one patient may not be reasonable for another, even if the problem is similar.

A key problem is that health insurance does not follow an insurance model. Traditionally understood, insurance is a contract where one party pays a premium over time in exchange for financial protection from unlikely, but possible events. It was never designed to pay for routine examinations or common health concerns. One of the great new innovations in health care is Health Savings Accounts, which allow for pretax dollars to be allocated toward expected health expenses.  This is a great start to a model that cuts costs by bringing healthcare back to its source – a patient and their doctor.

More on Individualized Insurance and the Risk Pool

Insurance should be individualized, Health Savings Accounts should be individualized. Insurance companies as they exist and states are nothing more than third and fourth parties whose introduction increases costs. Our healthcare system in Massachusetts is being crippled by minimum mandates, which drive up costs by enriching companies that lobby for those covered products, invariably making health insurance a product no young person would ever voluntarily buy. Doing this nationally, as Obamacare intended, will have the same results. The reason to have young people buy insurance is to reduce the risk pool, but young people rarely need more than catastrophic coverage. The best state solution to health care is to get the state out – it is creating an inferior product that benefits politicians, not the sick.

Two things can be done to address the risk pool. First, allow insurance companies to compete across state lines so that consumers can find products specific to their needs regardless of their location. Second, require insurance companies to have a single price from their universal risk pool of all policy holders, rather than the current system where they have a risk pool for each employer, and employers are prohibited from banding together to reduce costs by expanding their risk pool over more individuals, thereby normalizing the risk. It also makes insurance companies want to entice young people onto their plans, as larger groups of young people have a greater marginal effect on their risk pool and therefore the price they can offer to all consumers.

The larger problem is job-lock and pre-existing conditions. Employer-based healthcare made sense when a person could reasonably expect to be working for the same company for decades. Our economy has changed from that model dramatically, where people can change jobs multiple times in the same year. Instead, move insurance down to the individual level, and make a health savings account like an individual bank account. Allow parents and family to invest in the health of their children, and create a system that obviates the problem of pre-existing conditions by making insurance independent from employment. An interim solution would be necessary for people alive today, but ultimately shifting health care back to the responsibility of the individual and giving them control over their health care outcomes and health care savings will dramatically reduce costs by removing needless middle men.