When President-elect Joe Biden assumes office, he’ll have to contend with the worst healthcare crisis in a hundred years. If Biden’s track record is any indication, he will lead the charge for increased government control of our healthcare choices.
Yet, for the sake of millions of patients across the country, Biden should push for greater choice in medical decisions and fight against arbitrary price controls. The only prescription for the dire healthcare problems facing millions of people is a robust free market.
Despite the resilience and resolve of the U.S. healthcare system, hospitals are still struggling to cope with new coronavirus cases. The country is now routinely reporting 100,000-plus daily cases of the coronavirus, while new patients crowd emergency rooms. Doctors are now far better equipped to treat patients than they were at the beginning of the crisis, and daily death counts are now only a quarter of what they were at the height of the crisis. But nearly 1,000 daily fatalities is far too high, and this figure could easily increase if the wrong policies are pursued at the national level.
On the campaign trail, Biden advocated for a beefed-up version of the Obamacare in which the government increases subsidies for health insurance plans on private, individual insurance markets (as opposed to employer-based coverage) and creates a public option for those who cannot afford private insurance.
By all indications, a public option will lead to worse healthcare outcomes than private insurance due to lackluster doctor reimbursement rates and out-of-control bureaucracy. Reputable doctors simply don’t want to participate in plans that pay them less and require more paperwork than private insurance networks.
Scholars examining the impact of the expansion of Medicaid under Obamacare have found maddeningly mixed results on healthcare outcomes. One recently released cross-sectional study of more than 500,000 patients diagnosed with breast, colorectal, and lung cancer found that only the lung cancer patients fared better in Medicaid expansion states than nonexpansion states.
Frustratingly, it found that “there were no differences in mortality changes among at-risk populations, including among Black patients and among those living in areas with the lowest quartile of income.” One 2018 analysis using hospital registry data to track the outcomes of patients admitted with congestive heart failure found no mortality improvement associated with Medicaid improvement.
The lack of improvement in critical outcomes, especially for the at-risk populations targeted by Medicaid expansion, should give Biden pause before further expanding federal insurance programs. Surely, part of the $70 billion that the federal government spends annually on Medicaid expansion could be given directly to low-income people via tax credits to purchase the healthcare of their choice. Unfortunately, Biden has dismissed this tax credit approach in favor of bloated government programs.
The president-elect’s misguided faith in government control has also led him to embrace the price-fixing of certain healthcare services. This is especially problematic, given that lawmakers have repeatedly pushed for a rate-setting system in which doctors will be forced to take a large pay cut overnight.
Some members of Congress have insisted that the only way to rein in the pressing problem of surprise medical bills is to force doctors to accept deeply discounted insurance reimbursement rates. Republican Sen. Lamar Alexander has been trying to institute price-fixing and is currently working on a “compromise” with Republican Sen. Bill Cassidy. Any compromise that institutes price controls would be devastating to patients and doctors.
Look at what happened when California embraced a price-fixing approach for surprise medical bills. Complaints about access to care skyrocketed, and medical practices consolidated across the Golden State. Some doctors even considered leaving California altogether. Now would be the worst possible time to export that failed model nationwide.
Clearly, big government healthcare “solutions” such as Medicaid expansion and rate-setting would break the bank and lead to a range of unintended consequences without improving care. Biden should work to increase patients’ choices in healthcare rather than doubling down on failed ideas that will only worsen the coronavirus crisis.
Ross Marchand is a senior fellow for the Taxpayers Protection Alliance and a Young Voices contributor.
