As I noted in my last piece, Americans are getting a very raw deal on healthcare. We spend too much and die too early. Here are five possible solutions.
1) We need to address the great disparities in healthcare service costs.
A treatment or surgery can vary by tens of thousands of dollars depending on where it's provided. The key problem is that healthcare consumers do not bear their direct costs. That's because many people receive heavily-subsidized health insurance from their employers. As a result, they have little incentive to take personal responsibility and avoid healthcare treatments unless they are seriously ill.
For example, I used to buy my insurance on the healthcare exchange when I was self-employed. This meant insanely bad coverage for ridiculously high prices and my reluctance to use healthcare services. Today, however, thanks to the Washington Examiner, I pay far less in premiums for far better coverage. And that makes me more predisposed to use healthcare services, because I know I won't personally have to pay as much of the bill.
The problem is that I and others with employer-provided healthcare drive up America's total healthcare costs by being irresponsible consumers.
Luckily, there's a simple way to address this issue. We should tax employer-provided healthcare as income. Doing so will force individuals to judge their healthcare consumption more critically. Employees will also seek cheaper, more efficient plans from our employers.
2) We must reform Medicaid and Medicare.
As I've explained, if we don't restructure these plans, we'll all suffer from the rising national debt. Fortunately, Republicans in Congress seem to at least recognize that Medicaid reform is necessary. Unfortunately, President Trump has ruled out Medicare reform. While pledging to protect current benefits for retirees, those under 55 years old, and the unable-to-work poor, Republicans should work hard to change Trump's mind.
As part of this federal restructuring, we'll also have to cut healthcare grants.
3) We should break the grip of special interest groups like the American Medical Association.
As I've outlined, the AMA has inordinate power to drive up healthcare costs in order to further its members' interests. The AMA and other doctor lobbies also oppose reforms that would reduce costs and improve service. A good example is the AMA's opposition to empowering nurses.
We can also make it easier for qualified foreign doctors to practice in the United States. Doing so would help alleviate our crisis-level shortage of rural and primary care doctors. That shortage feeds local monopolies and causes inordinate suffering for those in rural areas. Challenging special interests could also involve retargeting medical school grants to primary care and rural locality-pledged students.
4) We need to restrict medical liability payments.
Doctors continue to pay ludicrous amounts of money in insurance. President Barack Obama could have included malpractice liability reform in the Affordable Care Act, but he didn't. Any replacement plan must do so. The alternative is to continue allowing trial lawyers and frivolous lawsuits to make money on the backs of the people. After all, doctors must pass off their insurance costs with higher consumer prices.
5) We should tax unhealthy behavior in a way that forces the unhealthy to bear the costs of their choices.
This should mean, for example, federal sugar taxes and allowing health insurers to penalize the obese.
Ultimately, there are many options available. But the basic need is obvious: Americans need a healthcare system that provides good care for affordable costs. As of now, our healthcare trajectory is unsustainable. It's also immoral. Every dollar wasted on healthcare is a dollar that can't be saved or spent on other worthy endeavors, such as improving skills-based education.