Health care challenges for American families are real and need to be addressed. These include access, portability, quality, and growing concerns over rising healthcare costs. President Obama, in the effort to begin to address these challenges, decided to grow government and limit freedom and choice rather than empower the American people. Health care challenges need to be addressed, but there is a better way, the American way.
The first step toward improving health care is to repeal ObamaCare and its Big Government mandates. Then we need to replace it with a Health Care Freedom Agenda which addresses the needs of families in a manner which embraces freedom, opportunity, innovation, and choice. This is a better prescription for America’s health.
Every American should have access to high-quality, affordable health care, with health care decisions made by patients and their doctors, not government bureaucrats. America needs targeted, market-driven, patient centered solutions to address the costs and underlying causes of barriers to access rather than a one-size fits all, government run health care system. We need solutions that freedom lovers and problems solvers such as John Adams would sign into law, not solutions that might be imposed on subjects by King George.
Health Care Freedom Agenda
· Unleash the power of competition and choice: Reduce costs and increase access with robust free-market competition and patient choice by repealing ObamaCare and reducing over-regulation that distorts and stifles free-market competition of health coverage markets. We need to let patients and their doctors make choices about their health care. ObamaCare does little to nothing to reduce costs. It is packed full of policies that increase costs, shift them to others, and reduce choices. Patients should decide what type of coverage meets their needs, not be told what they must purchase by government bureaucrats.
o Reducing mandates and onerous regulations will increase competition, reduce costs and increase access. A one-size-fits-all, government approach to health care is not popular with Americans. Health care insurers should attract consumers through price and service, just as with other forms of insurance. The government should not use mandates and regulations as an excuse to increase costs and deny access.
o Patients should be allowed to purchase health insurance across state lines to gain access to the best insurance coverage to fit their individual needs. Patients should not be required to pay for (and subsidize for others) coverage for services they don’t want or need. Current state licensing monopolies require consumers to purchase coverage for a long list of specific services, whether the consumer wants that coverage or not. By some estimates, breaking the current state licensing monopolies would result in one third of the uninsured being covered (with no new taxes or government subsidies).
· Health coverage that you own and control: Strengthen and expand access to health coverage options, with patients and doctors making health care decisions, not government bureaucrats or insurance companies. Empower patients with Health Savings Accounts, to give them the power to shop around for low-cost services and keep what is left over for themselves. Combined with other incentives such as High Deductible Plans, HSAs would put insurance within reach for more low and middle income Americans and address concerns about serious or catastrophic illnesses. HSAs are banned from the state exchanges under ObamaCare, because they do not meet the definition of a qualified benefit plan, effectively gutting them.
o Increase HSA contribution limits to keep pace with medical inflation.
o Implement “Large” HSAs, through changes to current law that would allow most workers to receive the full amount that they and their employer spend on their health benefits as a tax-free cash contribution to the worker’s health savings account.
o HSAs should be open to those covered by any type of insurance, as well as the uninsured. Remove the requirement that HSA holders be covered by a qualified high-deductible health plan but encourage additional high deductible and/or catastrophic plan options. This will also allow individuals to plan and save for future health care expenses including long-term care.
o Allow HSA holders to purchase health insurance, of any type and from any source, tax-free with HSA funds.
o Create expanded savings options for health and support needs of parents and families of those with special needs. Enact 529-like accounts that can be used for services and medical expenses. Let parents plan and save for the futures of their most vulnerable children, just as we do for their children attending college.
· Promote portability and reduce punitive tax DIS-incentives on individuals and families: Current tax treatment of health insurance penalizes individuals who purchase their own coverage and favors those with employer-sponsored coverage. Allow those who purchase their own health care coverage to do so with pre-tax dollars. This empowers individuals in a mobile society and changing economy so that individuals are not tied to jobs solely for health coverage, but have portability of affordable coverage.
· Increase affordability: Provide a refundable, income-related tax-credit for the purchase of health coverage for struggling families. Target resources to those most in need (sliding scale with more robust credit for lower-income families). Empower choice rather than government mandates. This has the added benefit of strengthening Medicaid by allowing lower-income families, not the government, to choose their coverage, and change it as they see fit.
· Combat costs of defensive medicine and excessive regulation on providers: Enact meaningful medical liability reform to increase access, and reduce added costs and inefficiencies from defensive medicine. Reduce and streamline government regulations and programs that force valuable resources to be spent on managing red tape rather than patient care.
· Help families with the challenges of pre-existing conditions through state risk pools: About 2 million to 4 million people a year have uninsurable conditions—approximately one to two percent of the U.S. population of 313 million. In order to enable insurance companies to be able to offer low-cost premiums to Americans, those with severe illness need to be offered the option of special health insurance programs through the state, known as risk pools. States are laboratories of innovation and have different needs in their populations. They can also learn from each other as to what works best and what does not. I’m also in favor of the federal government helping states set up risk pools if that’s how they want to address this challenge. This would be dramatically less expensive than the impositions of ObamaCare and provide more choice for those who really need extra help with difficult to insure conditions. Those with pre-existing conditions would receive health insurance, subsidized by the state, through regular insurance companies. They would be able to choose their health insurance, with the price of the premiums depending on income. Alternatively, states might select one insurance company to insure all those with uninsurable conditions.
· Reform and strengthen Medicaid: Implement the successful aspects of welfare reform to reform and strengthen Medicaid by block-granting Medicaid so that states have the flexibility to effectively manage their programs and are not burdened by one-size-fits-all federal mandates. In exchange for taxpayers’ investment of block-grants, we will require accountability and responsibility from states and beneficiaries. Taxpayers should feel certain that every dollar is spent efficiently (i.e., no fraud, waste or abuse) and effectively (i.e., benchmarks for success) – currently the program is neither. This will return Medicaid to its original purpose – to be temporary assistance to our able-bodied citizens who, due to unfortunate circumstances, find themselves in need of transition assistance, not create generations of able- bodied individuals dependent on government from cradle-to-grave.
· Reform and strengthen Medicare: Medicare must be made financially solvent and sustainable, to strengthen the program for current and future generations. Modernize Medicare from a program run by government bureaucrats to a premium-support model that empowers seniors, not government bureaucrats. Every dollar saved through Medicare reforms is used towards the solvency of the program and not raided to fund such things as new entitlements like ObamaCare or more government spending.
· Incentivize medical innovation: With increased medical innovation patients will have more choices for managing their health and combating diseases. Research and development has moved overseas due to increasing uncertainty and government over-regulation. Reform the FDA so that medical innovation research and development has transparent and predictable regulations regarding approval and safety. Repeal ObamaCare and its onerous taxes and regulations on medical innovation (medical device tax, biopharmaceutical tax, government-run Independent Payment Advisory Board, etc.). Government should not decide what services are covered and how they are reimbursed.