A alternative to the Dem’s health care reform

Joseph Coletti of the John Locke Foundation in Raleigh, offers up ways health care reform can empower patients without requiring a public option. The Mint Hill Times ran an editorial this week pushing for more compromise and bipartisanship in passing health care reform. Dem’s could take note of Coletti’s ideas. Read his full article after the break.

Health Care Reforms Should Empower Patients
By Joseph Coletti

Why not base health care reform on policies that work? Consumer-driven health care has a proven ability to reduce costs while maintaining or improving the care received by patients. Studies have found that people with consumer-driven plans are more likely than those with more traditional insurance to listen to their doctors, purchase generic medications, improve their health habits, and use online tools to find quality and cost information on doctors.

Patients with consumer-driven health plans become their own advocates (PDF link). They do not have someone from an insurance company, government agency, or independent commission of experts second-guessing the decisions they make with their doctors or pharmacists. Instead of fighting insurance company red tape, people can choose to pay more for the branded medicine. They can, and often do, ask their doctor for the generic alternative.

For all their promise, though, consumer-driven health plans are just a first step toward a fully functioning health care market. Health care is nowhere near being a market. Americans pay on average just 13 percent of health costs from their own pockets. Government and insurance companies pay the rest, so they make many of the decisions about care, too. Among those not enrolled in Medicare, Medicaid, TriCare, or one of the other government programs, most have their insurance chosen for them by their employers.

Five other reforms, none of which requires 1,000 pages of legislation, are also needed.

Tax Equity: Eliminate the tax penalty for not getting insurance through an employer. Tax credits or exemptions are one way to achieve this. Congress could also expand health savings accounts (HSAs) and ease the rules on them so individuals can put more money in the accounts and use them for all their health expenses, including insurance premiums.

Tax equity alone, over time, can go a long way to accomplishing the goals of lowering costs and expanding access. Health insurers may not advertise, but car insurers do. Car insurance is subject to varying state regulations, but insurers sell coverage one policy at a time. There are no self-insured companies that avoid most regulations, and no agents can make a sale to the human resources department of a company.

Fewer mandates: Allow consumers to purchase only the insurance benefits they want, not the ones they don’t. Many mandated types of coverage that state governments impose would be offered anyway, but other mandates add cost with no benefit. At least a fifth of people without health insurance can afford it but choose not to purchase it. The reason many give is that it is too expensive. States should reduce the number of mandates they impose, which in North Carolina include marriage therapists and pastoral counseling.

Interstate purchases: Allow consumers to purchase insurance from any state in the country. Someone like me purchasing the lowest cost insurance option in St. Louis could save $504 a year in premiums over the lowest cost insurance in Cary. Purchasing insurance in St. Louis for an entire family like mine could save $1,320 a year. The coverage might not be exactly the same, and doctors in North Carolina would be out-of-network, but the annual savings are hard to ignore.

More providers: Allow providers to do what they are trained to do without arbitrary limits such as scope of practice regulations within state licensing and certificates of need for capital investment.

Tort reform: Allow prices to signal quality. Doctors with strong records may be willing to provide large monetary guarantees against harm that is a result of their mistakes. Less skilled doctors or those with less experience may not be able to offer the same guarantees, but may be willing to provide care at a lower price. This depends again on having consumers making decisions instead of insurance companies or the government setting prices.

Companies and individuals already have the ability to reform health care for themselves. Some small changes, none of which would require anywhere near 1,000 pages of legislation, could have transformative effects while recognizing that no person or group of people is going to have all the answers for everyone.

Joseph D. Coletti is fiscal and health care policy analyst at the John Locke Foundation in Raleigh (johnlocke.org).

2 comments on “A alternative to the Dem’s health care reform
  1. The other day, I received an interesting and very instructive e-mail from my brother Jeff who lives in France. He asked me to share it with the readers of my blog. I think I will share it with you also.

    “As an American who has been living in Europe for most of the last 20 years, one who has visited doctors numerous times in four different countries, whose two children were brought into this world in European hospitals (France and England), who has himself spent a week in a public British hospital, and who underwent an operation in a private British clinic, I think I can say a thing or two about health care in Europe.

    “Our out of pocket expenses for the births? Zero, even though in France my wife spent 5 days in the hospital after the birth, which is standard, by the way.

    “During the three years we lived in England, we never once paid for medicine for our children. Children get drugs for free in the UK. Visits to the GP are free for everybody.

    “My expenses for the week in the NHS hospital? Zero.

    “The cost of the operation in the private clinic? Zero, it was covered by my work insurance, as was the post-op physical therapy I needed.

    “In Western Europe you would never be forced to sell your home in order to pay for your medical bills, as happens all too often in America when catastrophic illness strikes and the insurance company decides that your condition was ‘pre-existing’.

    “The quality of the care? Mostly good. French hospitals are excellent, even the food is decent. The food at the NHS hospital was beyond awful, but then again most English food is pretty bad (though they do have great Indian food). At night, they were understaffed, but I am guessing that, apart from that place where Dr. House works, most American hospitals are understaffed at night, too.

    “In short, in the US, you pay more, get less, and die younger than we do in Europe. What part of that don’t you understand?

    “My fellow Americans, you have nothing to fear except those who would use fear to keep you enslaved to the myth of the might of the American health care system.”

    Jeff Degan

    What can I tell you? The guy is a Communist. Not only does he live in France, he actually likes it there. An eternal shame to our family’s good name. Let us boil down his seven paragraphs to their juicy essentials, shall we?


    Here is (Excuse me, I meant to say, “Here was“) a golden opportunity for real reform and the idiotic Americans are screaming about socialism. Is it any wonder that we have become the laughingstock of the Western world?


    Tom Degan
    Goshen, NY

    PS – I love English food!

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