Our Political Process Will Not Repair the Healthcare System

Stanley Feld M.D.,FACP,MACE

The Presidential election is just 18 month away. During every political season interesting things happen in America. On January 19th the WSJ had an article entitled “Health-Insurance Gap Surges as Political Issue.”

“Suddenly, the long-festering issue of providing health coverage to the one in six Americans who lack it seems to have leapt to the top of the national to-do list.” The Journal reviewed all various politicians’ proposals to repair the system.”

.” However, “[t]here’s nothing approaching a consensus on what to do.” Some see “the current turmoil and dissatisfaction with job-linked insurance as hastening a single-payer national system,” while others “would let individuals shop for health care much as they do for other things.” Meanwhile, a “third camp, borrowing from what’s going on at the state level, essentially would widen existing sources of health insurance — government, employers and individual policies — so that they cover everyone.”

President Bush had distinct proposals in his State of the Union. The lead article in the NY Times did not report all his proposals. President Bush’s entire proposal was defective in that it gave lip service to price transparency. A system without price transparency is a system that does not generate competition. I feel his outline was too brief and the implications incomprehensible to the average citizen. It may have been incomprehensible to the average congressman and senator.

“In effect, the president is proposing a new standard deduction for health insurance — $15,000 for families and $7,500 for individuals. That would mean lower taxes for more than 100 million Americans with employer-provided coverage worth less than the standard deduction, Mr. Bush said. But it would raise taxes for about 30 million people with more expensive plans, unless they switched to less costly alternatives, White House officials said.”


Does everyone understand the above??

“Mr. Bush said the tax proposal was an effort to “level the playing field” between Americans buying insurance on their own and those who get it through their employers.”
“For the millions of other Americans who have no health insurance at all, this deduction would help put a basic private health insurance plan within their reach,” he said. “Changing the tax code is a vital and necessary step to making health care affordable for more Americans.”

The ability to deduct health insurance premiums by the uninsured is vital to solving the uninsured problem. However, it is only one initiative in a dysfunctional healthcare system. The system needs many sound structural changes introduced simultaneously to be repaired to a truly market driven competitive system.

A little step here and a little step there will only make the system more dysfunctional. These small steps will only be to the advantage of the insurance industry and hospitals. The cost of care will go up with more money in the system. CEOs of insurance companies will get richer while access to care and quality of care will go down.

“Democrats, labor unions and some consumer advocates said the proposal would shake the foundations of the nation’s health insurance system, still largely built around the workplace.”

This quoted statement shows me the profound lack of understanding of the problem the healthcare system faces.

This is precisely the reason that the consumer and not our government needs to lead the change.

The patient needs to control his own healthcare dollar in a totally price transparent environment. Some entrepreneur or some financial services organization is going to provide this option to the consumer. The result will be the all that financial gains through inefficiency and rising premiums will be toppled. I have in mind some entrepreneurs who I think could do it.