Wednesday, December 14, 2016
By Elizabeth Lee Vliet, M.D., guest blogger*
Congratulations to President-elect Donald Trump for a common-sense and much needed approach to selecting the new Secretary of Health and Human Services (HHS): Instead of a lawyer or another bureaucrat, President-elect Trump selected a competent, knowledgeable physician and surgeon, Dr. Tom Price
HHS is the third largest federal agency, often described as a moribund, over-budget, bloated bureaucracy rife with waste and fraud, that controls Medicare and Medicaid, on which millions of Americans depend. HHS itself is desperately in need of strong medicine.
Dr. Price, a long standing member of the Association of American Physicians and Surgeons (AAPS), is well known to the medical community as a physician who has been a proponent of sound medical practice, has fought for common-sense reforms and market-based solutions on rising medical costs, and has worked to reduce the escalating government interference in medical decision-making. Dr. Price has also worked to improve access to medical care and specialists for patients in the government-run programs.
As physician himself, Dr. Price understands that patients need care tailored to their individual needs of patients without government bureaucrats dictating what must be done. Secretary Sebelius, a lawyer by profession, imposed thousands of pages of new and onerous regulations during her tenure at HHS, strangling the practice of medicine and causing increased costs and confusion in medical practice across America.
Democrats constantly claim that “Free-markets didn’t work; we can’t go back to what was, even if ObamaCare has problems.” But “free markets” in medical care and health insurance have not been allowed to operate in the U.S. since the 1940s, when employer-owned health insurance arose because of government wage and price controls.
“Free markets” in medical services were further destroyed with the 1965 passage of Medicare and Medicaid. President Johnson caused insurers to cancel the private insurance that millions of senior citizens liked and wanted to keep, wiping out competition. Costs exploded, followed by more and more government controls on doctors and hospitals in a futile effort to contain runaway spending.
State governments piled on with insurance mandates, “certificate-of-need” legislation, and other restrictions on competition.
The political elites have “disconnected” the natural regulatory mechanism of price signals and consumers making voluntary decisions about the use of their own money, so politicians keep compounding the problems they created by creating more and more regulations in an effort to fix them. The key problem is NOT failures of free markets, but rather government control of markets.
Despite the government’s restrictions, the remnants of a free market managed to keep the U.S. at the top in the world for quality, accessibility, innovation, variety of medications, diagnostic and treatment procedures available, and longevity for the major diseases we face. Then came ObamaCare, forced on America by Democrats on a 100% partisan vote, that drove many private insurers out of business, and caused further consolidation of hospitals into megasystems, and destruction of small, independent medical practices. Costs rose exponentially as a result.
There is practically NO true health insurance available, just managed-care plans. Americans prepay their premiums, and someone else (government or insurance company) decides what services they are allowed to have, and which doctors and hospitals they can use.
President-elect Trump has proposed reforms that would pair catastrophic medical insurance with individually owned Health Savings Accounts (HSAs). Patients themselves would then control most medical spending. This would provide more medical freedom that we have seen over the course of my whole career.
To be affordable, health insurance must be like casualty insurance (such as automobile and fire insurance), reimbursing us only for unpredictable expenses that would wipe us out, and leaving the free market to work to determine prices and allocation of resources. True insurance is voluntary, portable throughout the nation, and owned by the subscriber rather than employers. It is only about the contractually agreed amount of payment, not about dictating one’s choice of body shop, mechanic, contractor, type of repair, or medical treatment.
“Reforms” like ObamaCare or many proposed “replacements” are about redistribution of money. Huge premiums are collected from all Americans, placed in the coffers of government-preferred “plans,” and doled out to preferred “providers” according to the “values” of decision-makers working for the plan or the government, regardless of the individual needs and desires of patients. After the huge premium, often as large as a mortgage payment, Americans have little money left, and little choice about how to spend it. They are forced to pay for overpriced care for those preferred by the policymakers, and less and less able to provide for their own needs.
If we “reformed” what is actually “broken” in the medical payment system—the distortions put in place by state and federal governments, then all Americans would pay less and get more value. With a physician who believes in medical freedom and free markets at the head of HHS, perhaps patients will finally be free of government and third-party control.
*Dr. Vliet is an Independent physician with an active US medical practice in Tucson AZ and Dallas TX, specializing in preventive and climacteric medicine with an integrated approach to evaluation and treatment of women and men with complex medical and hormonal problems. Dr. Vliet is also Chief Medical Officer of Med Expert Chile SpA, connecting patients to top tier, lower cost medical care in Latin America, focused on medical freedom, patient-centered, individualized care preserving the Oath of Hippocrates. Dr. Vliet is a past Director of the Association of American Physicians and Surgeons (AAPS).