Focus health care reform on patients, not government

By The Honorable Arlene Wohlgemuth, Guest Columnist

In August, the Texas Public Policy Foundation released a report by internationally renowned economist Dr. Arthur Laffer which concluded that health care reforms based on President Barack Obama’s agenda would lead to much higher health-care inflation and slower economic growth; cost every Texas resident an additional $4,265; and still leave roughly 30 million Americans uninsured.

But if not the Obama plan, or one of the similar proposals pending in the U.S. Congress, then what? Our research establishes that a patient-centered approach to health care reform would build on America’s world-leading quality and high patient satisfaction in a way that extends those benefits to even more people and empowers all patients to make their own medical decisions.

Government health care programs were created with the intention to help the needy, but the transition out of government assistance has presented severe problems. Medicaid and the Children’s Health Insurance Program (CHIP) are means-tested, and no matter where the income eligibility level is set, families just above that level suffer a triple whammy. They are not eligible for the government benefit, they must obtain private insurance which has been made more expensive because of government programs, and their taxes increase to pay for the health insurance of families that may only make slightly less than they do.

It should not be surprising that many of these families living on the edge of self-sufficiency wind up among the uninsured.

Instead, provide families eligible for Medicaid and CHIP with vouchers that they could use to purchase private insurance. The amount of the voucher would be on a sliding scale — government support would taper off as family incomes increase. Such an approach would assist those who are unable to help themselves, while providing a pathway for those families to become self-sufficient and giving them a greater voice in their own health care decisions.

Those who currently have health coverage would also benefit from a patient-centered approach that reduces the size, scope, and complexity of government intrusion.

Today’s employer-based health insurance system is a relic of the 1940’s that has proven to be unsuitable for a much more fluid 21st century workforce. Providing the health-insurance tax deduction to individuals instead of employers would allow people to truly own their insurance, carry it from job to job, and resolve many of the issues surrounding pre-existing conditions.

We should encourage greater use of proven cost-saving tools such as health savings accounts (HSAs), which pair high-deductible, catastrophic insurance protection with tax-exempt savings to cover routine medical expenses. When compared to traditional insurance plans, HSAs have reduced health care costs by 12 to 20 percent the first year, and halved thereafter the rate of increase in health care costs.

Consumers should be free to shop across state lines for policies that meet their requirements rather than those arbitrarily set by their state government.

Antiquated scope of practice laws prohibit non-physician health professionals from practicing to the extent of their education and training. Eliminating such artificial restrictions would increase the supply of quality medical providers and provide more choices to the consumer.

Finally, Texas-style medical liability reform would better balance the needs of those patients who have suffered wrongly at the hands of bad medical providers with those of good providers who deserve protection from frivolous lawsuits and exorbitant medical malpractice insurance premiums.

Proposals such as these would reduce the role of third-party payers — especially the government — and increase personal responsibility for one’s own health care. The financial relationship between the health care provider and the patient would be restored, and the free-market forces that have delivered more innovation, higher quality, and lower costs in most other sectors of our economy would be unleashed.

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The Honorable Arlene Wohlgemuth is a Senior Fellow at the Texas Public Policy Foundation, a non-profit, free-market research institute based in Austin. She served 10 years in the Texas House of Representatives, specializing in health care issues.