The difference between health and auto insurance is so obvious that we often miss it. Auto insurance is, well, actually insurance, a protection against an unexpected but known risk. We don’t use our car insurance - or worse yet, government - to fill our gas tanks, change our oil or replace our windshield wipers. The health care fantasy world of avoiding “out-of-pocket” expenses simply means your money will be taken out of your tax pocket and your insurance premium pocket, and usually a lot more of it. Does anyone believe that oil changes will become cheaper if our government declares them to be a fundamental right and takes them over?
What’s more, because you buy it yourself, your car insurance belongs to you. Your boss can’t take it away from you. You will never be stuck in a bad job because you’re afraid of losing your car insurance. And best of all, if your car insurance company fails to treat you right, you can simply fire them and hire someone else.
As we envision a health care system in post-Obamacare America, surely we can agree that patients deserve to be treated at least as well as car owners. What follows are straightforward steps that make the patient, rather than government, the priority in health care. Additional details of these substantial but solvable problems can be found in my book, “First, Do No Harm” (Broadside e-books, 2011).
Tax fairness: Under current law, individuals face unfair tax penalties for daring to purchase their own insurance. These laws coerce Americans into accepting employer-based policies, which often trap poor souls in bad jobs and even make some productive workers unemployable simply because they got sick. Tax fairness would level the playing field so families could choose for themselves how to purchase insurance.
End state insurance monopolies:State governments have a long history of mandating that you purchase whatever services they declare you need - coincidentally provided by those who have the best lobbyists. Not only does this practice raise insurance premiums, it is responsible for a quarter of the uninsured in America. What’s more, these mandates create the artificial state boundaries that have the perverted effect of protecting insurance companies from competition in the other 49 states. End them, either by allowing states to do so voluntarily or by employing the power of the Constitution’s Commerce Clause, if necessary.
End state licensing monopolies: Physicians, like insurance companies, are also the beneficiaries of artificial state boundaries that protect them from competition from each other. Our system should be centered around patients, not doctors. As with the state insurance monopolies, the licensing monopolies should be ended voluntarily, if possible, or using the Commerce Clause.
Health savings accounts: HSAs and other consumer-directed health plans empower patients to be consumers and have been shown to save money without sacrificing health care outcomes. Our current third-party-payer health care system is like a grocery store without price tags, where customers fill their carts with “free” steaks whether they need them or not. Since patients are blind to prices, the government has only one way to reduce health care costs: provide less of it. This is accomplished with reduced reimbursements and outright rationing. HSAs, on the other hand, would turn 310 million Americans into an army of watchdogs who are incentivized to avoid unnecessary medical expenses but are still able to get the care they need.
End frivolous lawsuits: It’s estimated that nearly $50 billion a year is wasted on “defensive” medicine that could otherwise be used to provide care for the needy. Furthermore, the sky-high malpractice insurance costs are unavoidably passed on to patients. If an obstetrician is charged $100,000 per year for malpractice insurance and she delivers 100 babies, you’re paying a $1,000 “lawsuit tax” to welcome your bundle of joy into the world. Limits on pain and suffering - but not actual damages - have been shown to reduce health care costs and improve access. For the most egregious cases, forcing losers to pay the winners’ court costs would end the lottery-ticket mentality of trial lawyers.
WOLF: After Obamacare - Washington Times
