1. Healthcare reform should lower costs. Current costs have risen dramatically for many Americans since the implementation of Obama care. In 2017, the nationwide average premium increase was 22%, although some states experienced alarming spikes. For example, Arizona’s average premium rose by 116% [Luhby]. According to the Urban Institute, the 2018 nationwide average premium increase on the Obamacare exchanges was 32% for the cheapest (silver) plans and 19.1% for gold plans [Holahan].
2. Healthcare reform should raise care quality. Under Obamacare, some doctors have either gone to the exclusive “boutique” model or have left the healthcare profession entirely, giving the lie to the infamous “If you like your doctor you can keep your doctor” proclamation we were sold when the plan was first proposed. Choice must be expanded, not restricted.
3. Healthcare reform should ensure basic health services for all Americans. Reform should strive to cover pre-existing conditions and provide options for low-income families.
One of the key reforms is to give states the flexibility to solve local issues. Any meaningful reform must stress the central role of the private sector. It’s been fashionable in the media to bash our healthcare (especially pre-Obamacare). However, the reality is that people around the world with serious health issues (including a few Canadian Members of Parliament) seek treatment in the United States. According to U.S. News and World Report, more Canadians are seeking treatment in the U.S. to avoid long waits—averaging almost 10 weeks for “medically necessary treatment”—and less-than optimal treatment.
The fundamentals of healthcare in America (hospitals, clinics, doctors, nurses, staff, and associated medical technology) are absolutely first-rate. The real issue has to do with costs: costs of services, cost of insurance, and ultimately, who should pay for these services.
The common narrative in the media has been that (a) our pre-Obamacare healthcare was terrible, and (b) the Affordable Care Act would cure everything. Clearly the second assertion didn’t come to pass, but the first statement isn’t true either. Traditional healthcare in the U.S. worked well most of the time, for most Americans, and at a cost that most Americans could afford. Instead of addressing the fairly small gaps in coverage, 90% of the population has been forced to readjust or pay more in order to subsidize the remaining 10%.
The expensive, unfair, and inefficient plan that’s been foisted upon us by the previous administration shows signs of collapse. Instead, we should use the common-sense approach of building on our existing medical infrastructure while removing the burden of making the majority of working Americans pay exorbitant premiums to subsidize the small percentage who lack coverage. Single-payer systems (code for “fully socialized healthcare”) should be avoided at all costs—it’s even more restrictive than Obamacare when it comes to choose of providers, it’s incredibly expensive, and in an open, successful, free-market economy, it would require a huge new layer of government bureaucracy. (Imagine your healthcare administered like the IRS, DMV, and Post Office!) Worse, under a single-payer system, you don’t have the incentive of competition acting as a brake on spiraling costs. Half the insurance companies exited the market when the ACA was implemented and the other half doubled their rates.
Instead, we need to look to options such as healthcare sharing (members share bills, analogous to a credit union), concierge care (flat fee for physician services), insurance availability across state lines, and other emerging free-market alternatives. Several of these options have the potential to reduce cost. Concierge care at one of the largest concierge networks costs approximately $1,650-$1800 annually, while ACA insurance costs an average of $3,600 [Lincoff]. Consumers must be given a choice. Some need full coverage, while some (young, healthy, or solvent, for example) should be able to opt for catastrophic coverage. Under our current system there’s a serious lack of choice. For example, under Obamacare a couple in their sixties are required to pay for maternity coverage. Such mandates are essentially another hidden tax on working Americans.
There are savings available through the elimination of medical device taxes, changing malpractice laws (a huge hidden cost of virtually treatment, from routine dental care to major surgery), and addressing prescription drug costs: often the same drugs are sold overseas for a fraction of their U.S. cost. (This is the unnecessary price for over-regulation and over-taxation for far too long.) We must make fair pricing of drugs a top trade priority to lower U.S. prices.
All of these solutions can be implemented without moving to a draconian system of socialized medicine, where the only actual “equality” is that everyone’s care is equally slow and bad, and everyone’s taxes shoot up to fund an unwieldy bureaucracy. A common-sense approach that builds on our existing, robust medical infrastructure—while leveraging state choice and competition between insurance companies—can accomplish everything we need without heading down the expensive failure-path of single-payer, socialized medicine.