Home inFocus American Policy at a Crossroads (Fall 2012) A Principled Health Care Plan to Empower Patients

A Principled Health Care Plan to Empower Patients

Representative Tom Price Fall 2012

hen President Obama and Democrats in control of Congress set out to draft, debate, and pass health care reform, they fundamentally ignored one simple and powerful truth: health care decisions ought to rest with patients, families, and doctors. Any third party—whether it is an insurance company or the federal government—should not be the final arbiter of what constitutes quality, affordable, and accessible health care in this country. Due to their insistence on creating a stronger more invasive governmental role in health care, Democrats lost the trust of the American people and with it the opportunity to truly fix what ails America’s health care system.

Following the Supreme Court’s decision to uphold, for the most part, President Obama’s health care law, those who would defend the law in Washington have declared the health care reform debate all but over. Just like they did when putting the legislation together, they have shut out the voices of those who disagree with their approach, and they have attempted to perpetuate the myth that their ideas are the only relevant ones in town.

The fact of the matter is Republicans not only offered alternative legislative proposals during the debate over the president’s health care law, but also certainly have not given up the fight in the wake of its passage or the Supreme Court’s decision. In addition, it is important to note that while the Supreme Court did rule that almost all of the law could stand, it did not rule on the wisdom of the law itself. The Court’s decision was in no way a confirmation of the approach to health care reform.

A Different Approach

Congressmen who believe there is a more positive way to cure what ails America’s health care system have made a commitment to not only repeal the president’s health care law but also to bring forth ideas and specific solutions to address a broken status quo. These lawmakers acknowledge that millions of Americans without access to affordable, accessible health care is unacceptable. But rather than putting Washington in charge, they propose a patient-centered approach to health care reform that will actually deliver the level of quality care the American people expect.

It begins with repealing the president’s health care law. Repeal is the first step to replace. With repeal, the imposition of over 20 new taxes—including a number on middle class families—can be stopped. Repeal means avoiding the new mandates on employee-provided health care coverage that could result in over 50 percent of Americans losing the health care plan they currently have, getting rid of the individual mandate that—whether you call it a penalty or a tax—still forces every American to purchase health care coverage that is defined by Washington, and stopping the $716 billion in cuts to Medicare that the Obama administration took to help pay for its new health care plan. For all these reasons and others, replacing the president’s health care law must start with repealing it.

Following repeal, lawmakers need to ensure they embrace and apply the key principles of health care to a new plan. Those are: affordability, accessibility, choices, innovation, responsiveness, and quality. Adhering to those principles will ensure a patient-centered health care system is created.

To keep individuals in charge of their health care decisions, lawmakers need to make sure everyone can own their health care coverage and take it with them whether they lose a job or change a job. There’s no reason one should have to choose between their career and their health care, so portability of coverage is a necessity.

It is imperative that lawmakers tackle the challenges in the American health care system related to folks with pre-existing conditions. No one should lose access to health care coverage if they are diagnosed with a bad injury or illness. But government mandates and dictates are not the way to solve this problem. Instead, those in the small group and individual health insurance markets—the ones who are sometimes priced out of the market—must be allowed to pool together to create the purchasing power that large groups and companies have.

Lawmakers can aid in that endeavor by allowing the purchase of health care insurance across state lines so more insurers compete against each other for the opportunity to serve individuals and families with higher quality coverage. With a robust pooling mechanism in place, there will be greater access to more affordable choices.

To bring costs down further, there is a tremendous need for medical liability reform so the practice of defensive medicine in this country is eliminated. That would save hundreds of billions of dollars according to a national physician survey conducted by Jackson Healthcare. It would allow physicians to practice their trade without fear of unreasonable litigation.

The Empowering Patients First Act

All of these concepts have been put forth for years now and they were, for the most part, entirely ignored when President Obama and Washington Democrats drafted their health care reform law. One such proposal is the Empowering Patients First Act (H.R. 3000). This legislation introduced by this author reforms America’s health care system in a way that abides by the principles of health care to solve its challenges.

At its core, the Empowering Patients First Act seeks to defend and secure the doctor-patient relationship. It pledges to reform the health care system by empowering individuals and their families and leaving government as far out of the decision-making process as possible.

To that end, it fully repeals the president’s health care law. It takes it off the books entirely. Not simply because the president’s health care law is unaffordable and loaded with spending and taxes the American people cannot afford. But even more so because the president’s health care law is built around a fundamentally flawed premise that greater authority vested in Washington will result in a stronger health care system. That is simply not true, and it is objectionable to Americans’ belief in individual freedom. As a free people, Americans ought to be able to choose the health care coverage that they want for their families and themselves, not the coverage Washington says they need.

That is why simply making small changes to tweak the law does not work. The very foundation of the president’s health care law is antithetical to the concept of individual freedom. Only by bringing the American people out from under the mandates and dictates of the president’s health care law can lawmakers begin to reform the system in a way that protects Americans’ rights and Americans’ health care.

First and foremost, health care must be made financially feasible for all Americans. The Empowering Patients First Act does so through a system of tax deductions and tax credits that will make it affordable for individuals—wherever they may be on the economic ladder—to purchase health care coverage. Depending on one’s station in life, the act provides a flexible system within the tax code to ensure one has the financial wherewithal to purchase health care coverage.

To address the challenges of portability and pre-existing conditions the act adopts robust pooling mechanisms and ensures folks can take their health care with them wherever they live and wherever they work. Portability and pre-existing conditions are by far two of the biggest health care challenges, and this act shows that they can be addressed without putting the government in charge. The law just has to have respect for individuals and give them the purchasing power already afforded to large businesses and groups.

By creating a system where patients and physicians can adjudicate disputes through a health care tribunal system, the law would cut down on the runaway costs created by the practice of defensive medicine. While allowing for an informed ruling on the merits of any case, this system would not in any way take away or jeopardize anyone’s access to the traditional legal system.

Additionally, the Empowering Patients First Act encourages wellness and prevention programs and establishes quality care measures built around the needs of patients and with the input of physicians, not bureaucrats. Again, there’s an inherent respect built into this approach for the unique needs and interests of individuals—one that is severely lacking in the president’s health care law.

A Need for Reform

Those who fought for and to this day defend the president’s health care law will do all they can to perpetuate the false narrative that health care reform has been accomplished. But truly, as more and more broken promises that will come with this new law are brought to light, Americans know that the health care system is still badly broken. The failings of the American health care system are in many ways made worse by the new law, and its foundation is one that seeks to empower the government over the individual.

Having spent nearly 20 years caring for patients as an orthopaedic surgeon, this author served on the frontlines of America’s health care system. It can be tremendously successful in discovering new and innovative treatments and advancing the cause of compassionate, quality care, but it also has tremendous failings in expanding access and making that care affordable.

It is clear that there are few decisions more personal and more important than those related to one’s health care. Health care, more than most any issue bandied about in the political arena, is going to elicit—appropriately—deep convictions and concerns among the American people.

That is why America needs positive, patient-centered health care solutions that respect the needs of individuals, families, and their doctor. There are ways to solve these challenges without putting government in charge, without further bankrupting the nation, and without surrendering decision-making to Washington. Reform built around the principles in health care outlined here will ensure this country has a system that is responsive to the needs of patients and accessible to all Americans.

Representative Tom Price, M.D. (R-GA) is an orthopaedic surgeon representing the Sixth District of Georgia. He serves as Chairman of the Republican Policy Committee in the House of Representatives.