Commentary

Doctor-Politicians Treat Sick Health Care Poorly: Time to Kick Washington Out of the Doctor's Chair

Deane Waldman | February 10, 2017 | 10:27am EST
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Obamacare is not working. It's time to kick Washington out of the doctor's chair and repeal Obamacare. (AP Photo)

Experienced clinical physicians, even though they become politicians, ought to remember how to treat a critically ill patient. You don’t negotiate with pneumonia or compromise with cancer. If a patient is dying, you don’t take the patient’s political temperature and then apply a poultice.

Our health care system has a highly malignant tumor. The cancer that is consuming health care is a control-everything, intentionally complex—therefore inefficient and unsustainably expensive, federal bureaucracy.

Former liver specialist, now-Senator Bill Cassidy (R-LA) and former eye specialist, now-Senator Rand Paul (R-KY) have each suggested “treatments” for sick health care. Unfortunately, both leave the malignant bureaucracy in place.

Hopefully, another doctor-turned-politician, Tom Price (R-GA), the soon-to-be Secretary for Health and Human Services, will remember his surgical training and excise the cancer.

Senator-MD Cassidy wants to repeal Title I of ObamaCare, but “allow [any] State to reinstate Title I of the ACA” if they wish because, “states should have the right to choose” their own health care. Yet the Senator-doctor plans to keep Titles (sections) II through VII—the bulk of ObamaCare’s ten million words of federal mandates and requirements. This will leave the cancer in place and belies the claim to “return it [power over health care] to state capitols.” Frankly, the promise of giving power to the states is as realistic as ObamaCare’s promise of $2,500 in family savings, which in fact was a wage reduction of $1,200/year according to a recent study.

Despite knowing that government control is the reason health care is “sick,” the doctor-Senator increases government involvement with: price controls, even more government spending, and automatic enrollment in government-approved health plans.

Politician-physician Cassidy offers two options besides keeping ObamaCare that reputedly allow the states to enact market-based reforms. However, with Titles II-VII still in force, there are no free market forces.

When the federal government controls both supply (for example, by dictating payments to doctors and hospitals) and demand (by dictating benefits insurance must provide), the market is not free. And dire fiscal consequences follow.

With government supports for the insurance industry gone along with Title I but keeping all the mandates in the other six Titles, the few insurance companies still selling insurance will also exit the market.

As a result of ObamaCare, UnitedHealth, Aetna, and Humana lost over $1 billion in 2015 and stopped selling health insurance. At present, one third of all U.S. counties have either one or two companies willing to sell health insurance, and many have none, such as southeast Phoenix with a population over 400,000.

The CBO has estimated that repeal of ACA without compensating replacement, as suggested by the Senator-doctor, will double insurance premiums. Before the ACA, the average cost for a family of four was slightly more than $12,000. The present cost is more than $18,000, but with Cassidy-Collins, the lucky Americans who can even find an insurance seller could be charged $36,000! Who among us can afford that?

By leaving the federal bureaucracy in control of health care, the cancer continues to grow unchecked.

Another senator-doctor, Rand Paul of Kentucky, says he has a different approach but he too repeals only a part of the ACA while leaving most of the ObamaCare regulatory monster intact. So the cancer thrives while We the Patients can’t find a doctor.

Senator-doctor Paul plans to make some reasonable adjustments to flaws in the system but does not fix the system itself. He is like a doctor who gives painkillers to a patient with a malignant tumor. Eventually, the pain returns. Meanwhile, the cancer continues to eat away at the patient, who in this case is the health care system.

Isn’t it time for our doctor-politicians to remember their medical training? Isn’t it time for them to face the fact that our health care system is failing because of federal control of health care.

Be a real doctor. Do what patient health care desperately needs. Kick Washington out of the doctor’s chair.

Doing what patient health care needs is possible: politically hard because of powerful vested interests but relatively straightforward.

  1. Repeal ALL federal mandates relating to health care such as Medicaid, EMTALA, HIPAA, UMRA, plus all of ObamaCare. Also repeal the federal prohibition against selling insurance across state lines. (To be fair, Rand Paul wants to do this.)
  2. Allow states to design whatever health care plans they think is best for their residents. States may create interstate health care compacts as they choose. If Vermont wants single payer and Texas wants free market, so be it. That is their choice.
  3. Continue federal support for health care to the states based on percentage of tax revenue the state contributes to Washington that was used in the past to pay for all federal health care programs. If some other formula is better, use that.
  4. No federal support for any specific parts of the health care market such as insurance carriers. When Washington tries to pick winners in the market, it invariably finds the loser. Recall Solyndra? A free market means everyone competes on a level playing field.

Don’t start fussing over the details. There it is – a simple workable U.S. health care system, understandable by anyone, fiscally sustainable, responsive to local needs, that restores “power to the people,” as the new president promised in his Inaugural speech.

Dr. Deane Waldman, MD MBA, is Emeritus Professor of Pediatrics, Pathology and Decision Science, and Director of the Center for Health Care Policy at the Texas Public Policy Foundation as well as the author of The Cancer in the American Healthcare System. He can be reached at dwaldman@texaspolicy.com.

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