Health care has long been the third rail of politics, and once again, it has been so for the Democrats. Dissatisfaction with Obamacare premium rises and their effects appeared to have coalesced into a Trump victory.
We must get rid of the waste, fraud, and abuse in our crony-capitalist health care system — immediately.
The problem isn’t the defense budget or Social Security; the problem resides in Medicare and Medicaid.
Last year, the federal government spent $1.4 billion out of $3.85 billion — or 37 percent of every dollar — on Medicare and Medicaid. This was a 9.3-percent increase over last year’s expenditure of $1.3 billion. At this rate, within the next four years, Medicare and Medicaid will consume just over $2 trillion — an increase of $600 billion a year in spending.
Hillary planned to tax the middle class to pay this cost. Economists knew this would exacerbate the current deflationary spiral of this economy.
The problem isn’t the defense budget or Social Security; the problem resides in Medicare and Medicaid.
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Donald Trump has promised to repeal and replace the Affordable Care Act as his first act in office. These five positive steps could fulfill the promises originally made to the American people and make health care once again solvent, affordable, and accessible in the U.S.:
1.) Stop subsidizing other countries’ health care systems by overpaying for drug prices.
This is critical — it will save our government hundreds of billions of dollars and make health care accessible to all Americans regardless of insurance. Drug companies should not be permitted to charge a higher price to privately insured Americans (or to Medicare and Medicaid) than the lowest price charged to any of the “developed” countries in the Organization for Economic Cooperation and Development (OECD).
Perhaps we should even get a discount for buying as much as we do. Americans should not have to pay the lion’s share of the costs of drug research and development while some foreigners pay only the incremental costs of manufacturing the pills. Others, including myself, have advocated a more drastic approach — 15 U.S.C. Chapter 1 should be applied to all parts of the health care industry. These consumer protection acts allow the executives of drug companies to be criminally prosecuted and fined if they charge Americans five to 10 times what our Western European allies and Canadian neighbors pay. Once a few senior drug company executives do the perp walk, I would expect costs to drop pretty quickly. We don’t need any new laws.
2.) Take out the frills that Obamacare forces health insurers to include as a giveaway to special interests.
If a service cannot meet a cost-benefit test, and consumers won’t pay even a fraction of the true costs through meaningful copays, don’t force those services into basic insurance packages. If any private company did that, it would be a violation of the anti-trust laws. Remember Microsoft?
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3.) Require true price transparency and neutrality.
Post the price for each procedure and service, plus the best information on its utility, or benefits, and restore price competition to the health care sector so that consumers can make informed decisions.
4.) Allow insurance companies to compete across state lines.
Any policy that qualifies under federal standards — and qualifies under the laws of at least one state or Washington, D.C. — should be available for purchase in every state the company wishes to offer it. Interstate commerce and a huge market is what made America an economic behemoth, able to bring down prices and raise living standards. Why should health insurance be run like the Department of Motor Vehicles, with different rules in every state?
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5.) Fulfill President Obama’s earlier promise: If you like your doctor, you can keep your doctor — period.
A simple rule will just about get us there: Require any insurance company to compensate out-of-network physicians and providers with at least 80 percent of the amount they pay in-network physicians. That may not cover the full costs of going out of network in many cases, and the patient will have to make up the difference — but your insurance plan will no longer be a “closed shop” where your insurance is worthless unless you use the physicians or hospitals they tell you to.
Martin Luther King Jr. once observed, “Capitalism does not permit an even flow of economic resources. With this system, a small privileged few are rich beyond conscience, and almost all others are doomed to be poor at some level. That’s the way the system works. And since we know that the system will not change the rules, we are going to have to change the system.”
President-Elect Trump must now radically change the system — or he will be the Herbert Hoover of the 21st century.
Dr. Ramin Oskoui, a cardiologist in the Washington, D.C., area, is CEO of Foxhall Cardiology PC and a regular contributor to LifeZette.
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