Patient Based Health Care Reform

“Obamacare is not just a battle in a cultural war being waged in America it is a battle  between the American value system and Leftism.  Lovers of America as an abstraction may be found on both sides, but it truly is a war for the real soul of our country. It’s not about policy and whether the individual mandate should be instituted or not. It’s about who we are as a people.”  Howard Sachs, MDTell-a-Lie

The Patient Protection and Affordable Care Act, which is neither protective of doctor/patient relationships nor affordable, moves health care in the wrong direction.

True health care reform would empower individuals to make their own health care decisions free from government interference, not saddled  with coverage they don’t want or need, premiums and deductibles they can’t afford, and the loss of personal choice in their health care decisions..

True health reform should promote personal ownership of health insurance, encouraging Americans to purchase insurance policies they can take with them from job to job and into retirement in a competitive, free market.

Portability:   Individuals should be able to purchase an insurance policy when they are young and carry that policy with them throughout their working lives into retirement.

Equal Tax Relief.  ObamaCare contains 18 separate tax increases which, according to the Congressional Budget Office and the Joint Committee on Taxation, will raise $771 billion in new revenue from 2013 to 2022.   A better approach would equalize the tax treatment of health insurance without new taxes.  That could be done through replacing the existing deduction for employer-provided health coverage with a flat tax credit that individuals could use to purchase a policy of their own or by giving everyone a standard deduction for health insurance whether it was obtained through their employer or on their own.

Providing equal tax treatment removes  the  obstacle that discourages individuals from buying and holding a health insurance policy that they could carry from job to job.  Tax equity would also encourage firms either to provide direct contributions toward their workers’ health coverage or to increase wages in place of health benefits.

Encouraging Personal Savings:  Since 2004, health savings accounts (HSAs) have been a popular way for millions of families to build savings for needed health care expenses.  Eliminating the restriction on HSAs that prevents its use for insurance premiums and increasing HSA contribution limits would enhance both personal savings and personal ownership of health insurance.

Coverage for Pre-Existing Conditions:  Obama claimed that as many as 129 million Americas with pre-existing conditions could not obtain health coverage.  That claim was wildly untrue.  Pre ObamaCare,  individuals with employer-sponsored coverage, which is about 90% of the private market, could not be subjected to pre-existing condition exclusions.   In fact, prior to Obamacare, the number of individuals with pre-existing conditions who truly could not obtain health coverage was vastly smaller, and existed only in the individual market.  According to the most recent data,  only an estimated 134,708 individuals have enrolled in the supplemental federal high-risk pool program since it was created under Obamacare to cover individuals with pre-existing conditions, far less than the government’s projected lies.

States could use a variety of approaches to provide coverage to individuals who are unable to purchase insurance. 35 states already operate high-risk pools with a collective current enrollment of 227,000.  Alternatively, states could establish reinsurance or risk transfer mechanisms under which insurance companies would reimburse each other for the cost of treating individuals with high medical expenses without added funding from state or federal taxpayers. Either approach would be far preferable to the massive amounts of regulation, taxation, and government spending under Obamacare.

Cross-State Purchasing:  State insurance markets are uncompetitive and highly concentrated and their cost benefit mandates raise premiums by an average of $20 to $40 a month.  Individuals should have the ability to purchase insurance products across state lines, choosing the health plan that best meets their needs regardless of the location of its issuer.

Pooling Mechanisms:  Allowing  small businesses, membership associations, religious groups and fraternal organizations to sell health insurance through new group purchasing arrangements would extend the benefits of  group coverage beyond the workplace, encourage portability of health insurance coverage and allow consumers to choose their plan from a trusted source.

Medicare Private Contracting:   Seniors could  benefit from patient-centered Medicare reforms to help restore  the doctor–patient relationship.  Congress should eliminate the anti-competitive restrictions that prevent doctors and patients from contracting privately for  services outside of traditional Medicare as well as modernize the program, that has remained largely unchanged since its creation nearly 50 years ago, to enhance patient choice and hopefully preserve its solvency for future generations.

Medicare Reform:  Regrettably, Obamacare imposes many its most harmful effects on senior citizens.  According to the Medicare actuary, the Medicare reimbursement reductions in Obamacare will make 15%  of all hospitals unprofitable within the decade and 40%  unprofitable by 2055.   Congress should provide Seniors with a subsidy to purchase a Medicare plan of their own choice.   Those chosing a plan costing more than the subsidy would pay the difference out of their own pockets.

Consumer Choice and Competition:  Obamacare hinders patients’ ability to choose their own health plan.   Expanding competition and choice could reduce  health care costs and spending, the exact opposite of Obamacare which restricts choice and increases costs and spending.

Medicaid Premium Assistance:  Medicaid, the “not real insurance,”  is known for its poor quality and patient outcome.  A recent study from Oregon concluded that after two years, patients in Medicaid did not achieve measurable health benefits from their “not real insurance” coverage.  Many doctors, because of the program’s low reimbursement rate, will not even treat Medicaid patients.   Obamacare makes  the  problem worse  by consigning millions more Americans to this poor government-run program.  True reform would subsidize private health insurance for low-income Medicaid beneficiaries, providing not only better care but a substantial savings to taxpayers.

Not only does ObamaCare raise health costs,  it creates new bureaucracies that will erode the doctor–patient relationship and places a massive fiscal burden on future generations.   It must be repealed.  Then, and only then, Congress must advance true reform, not some socialist based agenda,  that moves toward patient centered, market-based health care promoting personal choice and ownership that responds to consumer demands and helps reduce health care costs.


Source:  Heritage Foundation

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