Here are a few conservative ideas regarding health care.
1. First, I propose two basic premises:
a. Health care is not a right in the political sense of the term as defined in the Bill of Rights. However, throughout my career, we have always treated patients regardless of their means. Government has taken over and even, in many cases, criminalized charitable care.
b. Government does not run anything wisely and efficiently. This doesn’t necessarily mean the government shouldn’t do anything, but health care is too important for any further government intrusion.
2. The ideas:
a. Malpractice and the patient’s right to sue must remain in place, although with some limits. As much as I don’t like malpractice suits, they have shown to be the best guarantee of the quality of medical care in the long run.
b. Remove most of the costly government controls and regulations, which add billions to the cost of health care annually.
c. Providers should be given tax incentives for charity care.
d. The Food and Drug Administration is costly and often times ineffective largely due to intense lobbying and incompetency in the agency. The FDA creates excessive costs in getting new drugs on the market.
e. To reduce cost of new drugs, suggestions would be to reduce the patent period for new drugs, allow the purchase of medications from foreign suppliers, more over-the-counter drugs available (like epipen) and more prescription writers such as pharmacists.
f. Besides the elimination of most governmental regulations and rules, promote reduction and elimination of certifications, licensing, oversight, etc. All create huge costs and diminish competition.
g. More providers practicing independently are needed. Nurse practitioners and physicians have a huge monopoly on who gets to deliver care. More competition does reduce costs. This loosening of restriction, however, does create a “buyer beware” mentality and responsibility of the patient. This should be very acceptable, since we have an extremely educated public.
h. More technology most often does lower costs over the long haul with some exceptions. Let the marketplace decide if a new technology is worth it.
i. All pricing must be made public, and variable pricing must be posted and the reasons for varying costs for different patient groups. This really is about unfair and unprincipled discrimination. If private citizens became aware of the various pricing schemes, they would not tolerate it.
j. More competition among insurance companies. One way to do this is to eliminate state line barriers for insurance companies entering a larger market. Another way is to mandate that all medical bills be transacted between patient and insurance company, only. In other words, a provider can no longer bill the insurance company for the patient. This sounds harsh but would simplify and reduce costs and end medical billing gaming.
k. Preventive care is important, but it is not new information that one shouldn’t be an alcoholic, a glutton, a drug abuser, a smoker or a sex-aholic. OK, eat well, reduce stress and get plenty of rest and exercise are also good ideas, but not new.
l. No more employer health care insurance. The employer being responsible for providing this makes no sense. After all, your employer doesn’t buy your life insurance, car insurance, home insurance, etc. Instead, do not restrict but in fact encourage and allow other large buyer groups to form, such as all nurses, CPAs, plumbers, single moms or you name it. The bigger the group, the more dicker power they would have with insurance companies.
m. HSA, HSA, HSA, HSA and more HSAs — enough said. (Editor's note: HSA are health savings accounts.)
n. Maintain a safety net for those who cannot pay for a more streamlined, efficient system. The safety net should emphasize that local control is more ideal, somewhat like medicine in the “old days” with county health clinics and hospitals.
o. Medicare is the giant monster in the closet (but real). The reasons it’s the monster entails a very lengthy discussion, but in the meantime seniors should be able to opt out. I’m afraid that “Medicare for all” would translate to “VA medicine for all.” Although I know many fine providers in the VA system, it is plagued with endless problems that systematically seem unsolvable.
p. One final thought. Whatever scheme the politicians and regulators come up with, they themselves must live (or die) within their scheme. No special medical care systems for the “special people.”
These ideas are not likely to happen since we are far along the path to the alligator pit already, but it doesn’t hurt to look at the “what could have been.”