PrintThe latest wrong-headed ‘fixes’ for healthcare
Recent proposed solutions for healthcare are what systems thinkers call fixes that fail or backfire. They are like a doctor giving opioids to a cancer patient. Painkillers mask the symptoms but never get at the root cause of illness: the malignancy that is making health care unaffordable and unavailable.
Following are some recently touted healthcare fixes followed by why they won’t work.
o AI cannot replace human clinicians, who are in very short supply
- California passes $25/hour for healthcare workers
o Safety-net hospitals say they will close because they cannot afford $25/hour
- Expanding care for homeless, called a “gamechanger”
o Who will provide the care?
- Individual coverage health reimbursement arrangements (ICHRA)
o Won’t lower costs or make care more available
- Expand time for insurance enrollment
o Will provide more people with insurance -- will not make care more accessible
- Stop-loss insurance for employers
o Won’t affect care
o Physician shortage will limit effectiveness of virtual medical care
These solutions ignore the root cause of healthcare system failure. In fact, they compound that failure. The root cause is lack of freedom: people are denied decision-making authority. Washington takes away their right to choose.
Patients cannot decide what care is imposed on them, government does, as in mandatory COVID shots. Doctors don’t decide what medications a patient should take, a pharmacy benefits manager does. Neither doctors nor patients choose procedures to be performed: an insurance company does. And all of the third-party decision makers follow rules and regulations established by Washington.
Instead of having the personal freedom guaranteed by the Tenth Amendment to the Constitution, Americans live under federal tyranny by proxy. Washington controls healthcare, the system, as well as individual health care through bureaucratic power over insurance companies, medical facilities and organizations, social media and news outlets, and even individual physicians. Agencies like the FDA, CDC, and NIH decide what information Americans are allowed to have, what care they get, when and if.
With freedom comes responsibility. Yet many people believe health care is a human right. If so, government is responsible to provide that “right,” meaning that government chooses, thus taking away the individual’s ability and responsibility to choose. The logic is unescapable, yet many continue to believe one can be free and still have a right to medical care, the personal service or work product of another person.
When viewed through the lens of denial of health care freedom, the proposed solutions throw gasoline on a fire. Mandating care for homeless, increasing minimum wages, expanding insurance procedures, or implementing care-by-computer all further reduce individuals’ right to choose and thus make healthcare sicker, not better.
Then, there is the money. Not only are Americans not free to choose their care, they are also not free to choose how to spend their money. Two fiscal facts explain why health care is unaffordable.
The average American family will expend $32,065 on healthcare costs this year. More than 80 percent will go to insurance companies. They decide where that money goes, not the individuals.
Between 31 percent and 50 percent of healthcare spending is diverted away from payments to healers or hospitals. That money goes to pay for healthcare BARRCOME: bureaucracy, administration, rules, regulations, compliance, oversight, mandates, and enforcement. As much as half of all U.S. healthcare spending -- more than $2 trillion -- produces no care!
Federal government and insurance companies decide where healthcare dollars go, not the individuals who produced those dollars. Thus, the usual market forces -- buyers’ need to economize and inter-seller competition -- are distorted and suppressed. This explains why costs keep rising without limit and service is so delayed that Americans die waiting in line for care that never comes.
The recently proposed fixes for healthcare will fail to fix. In fact, they will backfire by adding more federal BARRCOME and taking more money away from care. An effective solution addresses the root cause. Curing patient Healthcare requires restoring individuals’ right to choose and getting federal government out of healthcare.
Deane Waldman, M.D., MBA is Professor Emeritus of Pediatrics, Pathology, and Decision Science; former Director of the Center for Healthcare Policy at Texas Public Policy Foundation; and author of the multi-award winning book Curing the Cancer in U.S. Healthcare: StatesCare and Market-Based Medicine.
Image: OpenClipArt
