Patient-Oriented Healthcare?

President Obama said last week that competition with a public health insurance "option" will be good for private sector health insurers because the competition will keep them honest. But who will keep the government provider honest?

Two conservative senators, Richard Burr (R-NC) and Dr. Tom Coburn (R-Okla) believe that healthcare reform can only come about through free market competition. Their new Patient Choice Act intends to make good on that belief.
In a Manhattan Institute panel on June 11th discussing the bill, Douglass Holtz-Eakin said “There is no problem so big to which a government solution is the answer.” In support of the Patient Choice Act, he elaborated upon the flaws of the government solution..

The government, not close enough to have a personal understanding of individual health needs, lacks both an incentive to care about the quality of the care (or the effectiveness of the treatment) or the cost of the care.

Supporters of the “government option” the president favors promise to provide more healthcare at less cost.  But — as the experiences of Britain, Canada and so many other nations proves — more care costs more money. There’s no way to get around that.

The results of market based reform, as designed in The Patient Choice Act, brings back choice and responsibility to all consumers permitting individuals the chance to work in their own best interests. The Patient Choice Act supports ultimate decentralization, putting the individual patient in control.

This act removes the WWII “employer exclusion” system which subsidized employer provided insurance. It replaces this antiquated system with a tax rebate system of $2,200 for individual and $5,700 for families to offsets the costs of private healthcare insurance. Most importantly this plan benefits everyone and anyone who is buying healthcare unlike the employer exclusion system which is only benefitting a few.

This plan opens the market to the 45 million uninsured citizens in the United States, but does not force those who are happy with their healthcare to change it. This act supports true equal opportunity health care, supported by the government but not mandated by it.  With this bill the government is allowing the self-interest of the consumers to direct spending, price, cost, and supply.

Putting the two actors of the exchange, the consumer and the producer, directly responsibility to each other ends the wasteful government spending that is occurring as a result of fraud. Private insurance providers, with the aim to profit, do not waste money. They have an incentive to search out and stop fraud. This natural reform will immediately clean up 1/6th of our economy, benefitting the tax payer.

This plan also supports the federalist principles of this nation. This act provides a base plan that the states can alter as they see fit. The tax rebate comes with a minimal requirement on the state for certain services from the insurer.

This act would put the state in the position to work with private insurers to provide transparency about cost and quality for the consumer. This easily permits individuals, and small business owners to shop around.

By providing transparency about price and product, competition within and between state will be furthered. This plan will engage private employers in every state, putting them in the position to provide the best coverage.

Speaker Pelosi has said that the healthcare reform bill will not come out of the House without the government option President Obama favors.  But the opposition to that is growing.

Most significantly, the American Medical Association told a Senate panel last week, “The A.M.A. does not believe that creating a public health insurance option for non-disabled individuals under age 65 is the best way to expand health insurance coverage and lower costs. The introduction of a new public plan threatens to restrict patient choice by driving out private insurers, which currently provide coverage for nearly 70 percent of Americans.”

The government knows how to ration care. But it does not, and cannot, grasp the art of giving care. Health care is 40% art and 60% science. The art arises within the individual case. With heart disease, there are 9 science determined solutions, yet it is the art of the care which knows which solution to use. The government though would have to ration one solution, as opposed to leaving the choice up to doctors. This is part of the problem other nations have recognized with government provided universal healthcare.

Throughout the world people are living with the failures of universal healthcare. In Canada patients regularly come to the US for healthcare not just because they will die waiting in lines, but sometimes – as in the case of neurosurgery- they do not have the skilled doctors to perform the required health care. Yet, as Tom Colburn mockingly observed “we think we are smart enough in Washington to manage it.”

He has a point.