In the emergency department of Grady Memorial Hospital in Atlanta, where — as in many US hospitals — patients are forced to wait for treatment in corridors due to lack of space and overcrowding. (Photo by Jonathan Torgovnik/Getty Images)
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Washington’s political class continues to insist that our health care problems can be solved with more regulations, more dictates, and more red tape. The results of this command-and-control mentality speak for themselves: skyrocketing premiums, shrinking options, and an increasingly unresponsive, unaccountable, and unaffordable health care system.
We don’t need more government engineering. we need more freedom. When individuals, not bureaucrats, control health care dollars, innovation flourishes, costs fall, and patients receive better care. This is the same formula that has made the US a world leader in technology, finance and consumer products. There is no reason why healthcare should be any different.
Here is a plan for reform based on common sense and economic reality.
• Empower Americans with true Universal Health Savings Accounts
Health Savings Accounts (HSAs) embody a basic truth: When people spend their own money, they demand better value. However, today’s HSAs are weighed down by limitations that undermine their potential.
There are ways to fix it:
1. Make HSAs universal, available to everyone
2. Increase or abolition of maximum contribution limits
3. Allow HSA dollars to be used for a wide range of services, from telemedicine to mental health to preventive and wellness
4. Allow HSAs to be used to purchase health insurance
Put consumers in control and providers will have to compete like any other industry offering quality and innovation.
• Bringing back reality to Health Insurance
One of the great absurdities in health care today is the attempt to pretend that everyone presents the same risks. This is a financial fantasy and drives premiums through the roof.
The reform should allow:
1. Larger age ranges and reasonable health assessments
2. Premium discounts or HSA bonuses for healthy behavior
Rewarding healthier choices reduces costs and improves outcomes. Only in Washington is this controversial.
• Make Catastrophic Coverage the Foundation of Health Insurance again
Insurance was never meant for micromanaging colds, regular check-ups and basic prescriptions. No other form of insurance attempts this.
We need:
1. Affordable catastrophic plans that cover large, unexpected expenses
2. The ability of these plans to compete across state lines
3. Ability to use HSA and pay directly for regular care
This simple structure will immediately eliminate mountains of waste and administrative bloat.
• Give Americans the flexibility they deserve, including access to the Federal Employee Health Benefits Plan
Consumers should be able to adjust coverage as they adjust their investment portfolios—a catastrophic plan here, a direct primary care subscription there, and telehealth and chronic care add-ons.
One of the best reforms available is also one of the simplest: Open the Federal Health Benefits (FEHB) program to everyone.
For decades federal workers have enjoyed a plethora of private insurance options competing for their business. It works. The rest of America deserves the same. This reform alone would create a national, transparent and competitive market that empowers families instead of bureaucracies.
• Requirement of transparency of real prices
Health care invoices that read like ancient cuneiform tablets must become relics of the past. The only way to lower prices is to shine a light on them.
We need:
1. Package, advance prices that break down costs, such as the anesthesiologist
2. Strict enforcement of transparency rules
3. Freedom for cash-based and subscription-based providers to compete openly
When prices are visible, competition follows. When competition follows, costs go down. Always.
• A safety net that lifts, doesn’t trap
Those who need help should get it — but in a form that maximizes dignity and choice. Vouchers would give low-income Americans the ability to buy into the same innovative private programs as anyone else.
The bottom line is that the health crisis is not the markets fault. it is the result of market strangulation. Free up choice, empower consumers, and unleash competition, and U.S. health care will become more affordable, more accessible, and far more innovative.
Freedom works. It’s time to let it work in healthcare.
