President Barack Obama consistently accuses Americans who are skeptical about his health care plan of supporting the stats quo. Like much of what Obama says about health care, this simply isn’t true. Louisana Gov. Bobby Jindal has an op-ed in the Washington Post identifying 10 ideas to increase the affordability and quality of health care:
- Voluntary purchasing pools: Give individuals and small businesses the opportunities that large businesses and the government have to seek lower insurance costs.
- Portability: As people change jobs or move across state lines, they change insurance plans. By allowing consumers to “own” their policies, insurers would have incentive to make more investments in prevention and in managing chronic conditions.
- Lawsuit reform: It makes no sense to ignore one of the biggest cost drivers in the system — the cost of defensive medicine, largely driven by lawsuits. Worse, many doctors have stopped performing high-risk procedures for fear of liability.
- Require coverage of preexisting conditions: Insurance should not be least accessible when it is needed most. Companies should be incentivized to focus on delivering high-quality effective care, not to avoid covering the sick.
- Transparency and payment reform: Consumers have more information when choosing a car or restaurant than when selecting a health-care provider. Provider quality and cost should be plainly available to consumers, and payment systems should be based on outcomes, not volume. Today’s system results in wide variations in treatment instead of the consistent application of best practices. We must reward efficiency and quality.
- Electronic medical records: The current system of paper records threatens patient privacy and leads to bad outcomes and higher costs.
- Tax-free health savings accounts: HSAs have helped reduce costs for employers and consumers. Some businesses have seen their costs decrease by double-digit percentages. But current regulations discourage individuals and small businesses from utilizing HSAs.
- Reward healthy lifestyle choices: Providing premium rebates and other incentives to people who make healthy choices or participate in management of their chronic diseases has been shown to reduce costs and improve health.
- Cover young adults: A large portion of the uninsured are people who cannot afford coverage after they have “aged out” of their parents’ policies. Permitting young people to stay on their parents’ plans longer would reduce the number of uninsured and keep healthy people in insurance risk pools — helping to lower premiums for everyone.
- Refundable tax credits (for the uninsured and those who would benefit from greater flexibility of coverage): Redirecting some of the billions already spent on the uninsured will help make non-emergency care outside the emergency room affordable for millions and will provide choices of coverage through the private market rather than forcing people into a government-run system. We should trust American families to make choices for themselves while we ensure they have access to quality, affordable health care.
These are all great ideas, many of which are incorporated into the Ryan-Coburn Patients Choice Act. Heritage scholar Ed Haislmaier has also detailed six key principles of reform that will bring sanity to our nation’s health care system:
- Individuals are the key decision makers in the health care system. This would be a major departure from conventional third-party payment arrangements that dominate today’s health care financing in both the public and the private sectors. In a normal market based on personal choice and free-market competition, consumers drive the system.
- Individuals buy and own their own health insurance coverage. In a normal market, when individuals exchange money for a good or service, they acquire a property right in that good or service, but in today’s system, individuals and families rarely have property rights in their health insurance coverage. The policy is owned and controlled by a third party, either their employers or government officials. In a reformed system, individuals would own their health insurance, just as they own virtually every other type of insurance in virtually every other sector of the economy.
- Individuals choose their own health insurance coverage. Individuals, not employers or government officials, would choose the health care coverage and level of coverage that they think best. In a normal market, the primacy of consumer choice is the rule, not the exception.
- Individuals have a wide range of coverage choices. Suppliers of medical goods and services, including health plans, could freely enter and exit the health care market.
- Prices are transparent. As in a normal market, individuals as consumers would actually know the prices of the health insurance plan or the medical goods and services that they are buying. This would help them to compare the value that they receive for their money.
- Individuals have the periodic opportunity to change health coverage. In a consumer-driven health insurance market, individuals would have the ability to pick a new health plan on predictable terms. They would not be locked into past decisions and deprived of the opportunity to make future choices.