The Need for Reform

The current state of health insurance in the United States leaves much to be desired.  Sweeping reforms are needed if we are to ensure that the citizens of this great nation have access to quality, affordable medical coverage.  However, it is of equal importance that the right kinds of reforms take place.

First and foremost, we need to enable citizens to purchase health insurance across state lines.  It is absurd that the federal government mandates restrictions on the ability of citizens to purchase better health insurance packages in other states.  Such restrictions on consumer choices are a blatant overreach of the powers granted to Congress by the Commerce Clause and should be repealed.  Congress needs to pass the Health Care Choice Act overturning the interstate restriction, which has already been proposed in the House of Representatives on three separate occasions (2005, 2007, and 2009).  The fact that this bill has not already passed is disheartening.

In addition, we must find ways to cut back on the negative effects of medical liability suits.  Such effects include doctors being forced to practice defensive medicine and made to purchase expensive liability insurance, the cost of which is then passed on to the consumer.  To do this, we must pass sweeping tort reform that limits liability damages to the amount of economic loss incurred from the injury plus non-economic losses incurred based on scheduled caps.  We must also fight the ever persistent problem of frivolous law suits by implementing a loser-pays system, wherein the loser in a medical liability case would be responsible for his or her legal expenses plus the legal expenses of the winner.  This would help to weed out the more frivolous suits by placing greater financial risk on the person considering the suit.

Price transparency is another major problem.  In any free market system, it is imperative that people be given as many options as possible.  This means that they need to be aware of opportunity costs when purchasing goods and services.  In the case of medicine, the opportunity cost of a visit to the doctor’s office or to the hospital is the amount of money that could be saved by going to another medical provider.  What is disconcerting is that patients are largely unaware of these opportunity costs, as most medical firms do not reveal their prices upfront to customers.  As such, it is imperative that states pass laws mandating medical price transparency.  This would enable consumers to be more aware of such costs, making it easier for them to choose between various doctors and hospitals.  This would force medical firms to compete like firms in almost all other industries in the United States, which would in turn lower the prices for consumers.

The use of tax-free health savings accounts (HSAs) must also be promoted.  It is time that access to these accounts be expanded to enable more people to save-up for their own medical expenses.  Much like Social Security, we need to begin weaning people off of Medicare all together so that we can move to a more privatized system of medical and health savings, wherein individuals will have greater control over the allotment of their financial resources rather than the government.

While on the subject of Medicare, it is important that the issue of cost shifting be addressed.  Cost shifting takes place because both Medicare and Medicaid do not cover the full costs of medical services in many instances.  In these cases, the unpaid costs of medical visits are shifted to consumers on private insurance plans in the form of higher prices.  To lessen this effect, we should begin to eliminate Medicare, slowly but surely, all together (as described above).  There does not seem to be a lot that can be done in regards to the cost shift caused by Medicaid, but there is something that could be done to lower its burden on the national debt.  Basically, the federal government could opt to replace Medicaid all together with an inexpensive public option for the same brackets of low income individuals and families who currently received Medicaid benefits.  This would still enable low income citizens to afford medical costs, but would also help to generate a great deal of the revenue that is lost under the current system.

On a final note, for far too long the government has maintained policies that tax individual health insurance plans and forbid employers from buying individual plans for their employees.  Such has lead to widespread utilization of group insurance plans purchased by employers for their employees as collective wholes.  This system, combined with the soaring unemployment caused by America’s current economic recession, has led to a situation in which millions of citizens have lost coverage.  To combat this, the federal government must encourage the purchase of individual health insurance plans, which remain with a person regardless of his or her employment status, by ending all forms of taxation on individual plans and enabling employers to purchase individual plans for their employees.

Reforming our nation’s system of medical coverage is of vital importance, as is ensuring that we implement the right kinds of reforms.  Such reforms should expand personal choice, enhance affordability, and promote fiscal sustainability.  The types of reforms described in this article certainly meet such criteria, which is why we as citizens must demand their implementation at both the federal and state levels.  Otherwise, we will remain on the road to economic ruin that we are already on.

About Zachary Cady

Zachary Cady is a freshman at American University’s School of Public Affairs, where he is pursuing a major in Political Science. Born and raised in North Carolina, Cady has been active in politics for several years. He served as a page in the North Carolina House of Representatives in 2007, worked as an intern for the Victory Program of the North Carolina Republican Party in 2008 and 2010, and served as a delegate to the United States Senate Youth Program in 2009. Cady is also a member of the School of Public Affairs Leadership Program.
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