Reforming Health Care

Obamacare has been a disaster for America. It has raised costs, demoralized doctors, and deprived people of the treatments they need. It needs to be repealed.

But the alternatives promoted by Establishment Republicans aren’t much better. In fact, Republican leadership in Congress was in a near panic last year when it looked like the Supreme Court might overturn Obama’s “Affordable Care Act.” They had no idea what to replace it with. This, despite having six years to develop a better approach.

My opponent, Congressman Bill Shuster, has been part of this Establishment. He brags that he has voted 60 times to repeal Obamacare, but these are nothing but show votes. They have had absolutely no effect. Meanwhile, he has voted time and time again to continue Obamacare funding, thereby relinquishing Congress’ most important power – the power of the purse.

Both parties suffer from the same delusion – that a committee in Washington can dictate a “system” of health care that will work for all the American people.

Such a task is impossible for a host of reasons. The most obvious is that such a committee will always be dominated by a health care cartel of special interests. The drug companies, insurance companies, hospital companies, and all the others that make their living in health care will do everything in their power to influence such a committee – their very existence depends on it. The result will be a “system” that enriches each of them at the expense of ordinary Americans – taxpayers and patients.

There are a few fundamental truths about health care that politicians never acknowledge:

  1. Every penny spent on health care comes from us — the citizens and taxpayers of the nation. We may pay for it in the form of taxes, insurance premiums, or lost wages on the job, but it is all our money – there is no other source.
  2. It is all supposed to go to benefit us as patients. The purpose is not to enrich hospitals and insurance companies, the purpose is to provide for our medical needs. We pay the money out when we are well, in the expectation that it will be there when we are sick.
  3. We have trusted other people – government agencies and insurance companies – to manage this money in the belief that they could do a better job than we could. But they have not done a better job of it. They have done a terrible job. They have created a health care system that is unaccountable, inefficient, inconvenient, bureaucratic, of questionable quality, and far too expensive. We could not have done a worse job if we tried.
  4. Not everyone needs, wants, or can manage insurance for all their health care needs. Insurance of any kind is very complicated. Contracts are incomprehensible. The policies and procedures are needlessly complex. Knowing what services are covered under what circumstances by which providers and at what cost is nearly impossible. Plus, in recent years it has become the insurance bureaucrat who has more to say about your treatment than your own doctor. These bureaucrats know nothing about you, they have never met you, they don’t have a clue about your hopes or fears or your physical and emotional resources.

The answer is to gradually roll back this mess, by giving people back their own money and letting them spend it on the services their own families most need. This process has begun in 2003 with the creation of Health Savings Accounts (HSAs), but that was but a small step in the right direction. Even though HSAs were quite limited, they have been a hit in the health care market and have proven that, once people control some of their own resources, they make wise decisions about their own medical care.

HSAs need to be expanded and enlarged so that people will have more control over the whole gamut of health care services. They may use the funds to pay directly for services, or they may decide to buy an insurance policy with the money. If they do the latter, it will be a policy of their choosing, that covers the services they want covered. Since they own the policy, it can go with them as they change jobs or locations.

HSAs can also be used in the Medicare program or with state-run Medicaid programs. HSAs were allowed in Medicare on a limited basis, until Obamacare made them impossible. Pennsylvania was one of the states that had a robust Medicare HSA program, run by Geisinger Health Systems.  This, even while the Medicare program was discouraging people from participating in HSAs (called Medical Savings Accounts under Medicare).

Several states, most notably Indiana, had great success with using HSAs in Medicaid – again, until Obamacare made it all but impossible. Other versions of the concept, like the “Cash and Counseling” program for personal care services under Medicaid, were even more successful and adopted by dozens of states. Under Cash and Counseling, poor, elderly, disabled people were able to use a pool of funds to select and hire their own caregivers.

Programs like these require the bureaucrats and politicians to step back and allow people to make their own decisions – a concept that has become alien in Washington. But this is the only way our health care system can be restored to once again become the envy of the world – efficient, accountable, convenient, or great quality, and at reasonable cost.

It is what I will advocate when I am elected to Congress.

Download this article REFORMING HEALTH CARE.



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