We have a few weeks before Congress will pass a healthcare bill. This is the time to take a fresh look at the healthcare industry, and discuss possible solutions to the problems it has.
Washington politicians are telling us that the status-quo is not an option, that it’s time for a change, and we should speak if we have a proposal to improve the healthcare. So here it is. This proposal is not as radical as the bill proposed in the Congress, but it’s the only proposal I am aware of that when implemented, will really reduce the price, will really increase the choice and the competition, will really be deficit neutral, will really provide free or almost free cover for all uninsured and all people with preexisting conditions, and will really not raise a penny in taxes on anybody.
The US healthcare is the envy of the world. Most advances in medical technology are made in the US. Most people with the serious illness, if they have a choice and the means, would come to this country for cure. Most Americans are satisfied with the system we have.
Yet, our healthcare has some undeniable problems.
The price of the health insurance is too high and rising too fast.
Tens of millions of people are uninsured. For some people it’s a choice, but many are not able to afford the cost of insurance.
Fear of losing insurance. Many millions of people are fearful of losing their insurance because of the job loss.
Preexistent conditions. It’s hard to get insurance for people with preexistent conditions for a reasonable cost.
Deterioration of services. It’s undeniable that over the years the medical service deteriorated despite the enormous advance of medical technology and computers. Where are the house calls? Where are the family doctors?
Here is a comprehensive plan on how to fix all of these problems.
1. Dump the FDA.
Because of the FDA the cost of bringing a new drug is about half -a-billion dollars and the time to bring it to the patient is about 8 years. If, as often proclaimed, hundreds of thousands of people save their lives every year with a new miracle drug, it stands to reason that hundreds of thousands people die each year while the FDA keep the drug off the market. And it’s just for one drug, for one year. So it’s not an exaggeration to say that millions of people die because of the FDA.
This cost and this waiting period have the chilling effect on the development of new drugs. We are probably hundreds years behind in development of new drugs only because of this.
The argument that people would not know which drug to use without the FDA is ridiculous. To get the drug recommended by the doctors, the manufactures would pay a small part of the half-a billion for the drug to be reviewed by the reputable experts.
2. End the war on drugs.
Alcohol prohibition resulted in the same violence as the war on drugs. Any drug should be available at the drug store. It’s absurd to wait for an appointment, pay for a visit to a doctor a few hundred dollars, to get antibiotics at the pharmacy (and to sign that “yes, I know what to do with these pills” form) before you get them. Making any drug available to anybody will bring the cost of the drugs and the entire medical care down.
It also happens to be a moral and practical decision as well. It’s immoral to prevent people from buying any chemical substance that want for their own consumption. After all, we do own our bodies, don’t we? It’s also impractical. Do we want to restrict access to perfume, gasoline, and other substances that could cause harm if swallowed? Do we want doctors to write prescriptions for anything but organic vegetable? There are cases when people dye after drinking a lot of water. Should we regulate the amount of water bought by an individual as well?
3. Abolish Medicare and Medicaid.
Not only it’ll cut about 20% of federal spending, it’ll stop the inflow of extra money and that will cut the cost of the healthcare dramatically. Seniors will get their insurance the same way as everybody else, through private contracts or charity.
4. Remove the doctors/government monopoly on medical services and medical education.
There’s a myth deeply penetrated into the American psyche that doctors and the government should be responsible for the healthcare design of the nation. We all know that most politicians are corrupt and they look for their own interest not for the interest of the people. Yet, the doctor’s profession is so respectful, that it’s not widely understood that they also look for their interest first.
By the way, as opposed to the politicians, I think that’s the way it should be – the doctors should look for their interest first. I want my doctor to be motivated by a good outcome when he is treating me. I want him to know that he might lose his practice if his patients are not happy with his treatments. I would try to avoid a doctor who does not really care about his interest and therefore doesn’t care about success of his practice, which is the case of all government-run and many of not-for-profit companies.
I am also not afraid of a doctor who prescribes me a treatment or surgery that I don’t feel I should have. I can deal with that. People deal with pushy marketers all the time in all other spheres of life. We can consult with others, but it’s up to us to decide what product or service to buy. I’d rather have this problem of making a choice than a system when I am not offered a certain treatment because somebody else made a decision that people of my age or my condition don’t need it. Just tell me all the options that are out there, make the recommendation and let me make the decision.
What I am against is the notion that the doctors should be in charge of our healthcare – we should be in charge.
The American Medical Association was established in 1847. Almost immediately it merged with the government through establishing medical boards at each state. And then the doctors use the government force to fight the market forces: to make sure to kill all the competition and to keep their salaries high. It was done by achieving two goals.
One, through these boards, doctors made sure that only individual licensed by these boards could deliver medical care. If Jesus shows up now and starts curing people, he would be taken to jail because he doesn’t have the license.
Two, American Medical Association has been able to restrict the number of medical schools. Did you know that because of the AMA we have fewer medical schools in the U.S. now than 1oo years ago even though the U.S. population tripled in size?
Anybody should be able to give a medical advice. If I want you to pay you for your medical advice, why anybody on Earth should prevent you from giving me the advice? And any university should be able to hire experts and offer medical degrees. If there’s enough demand for qualified students who want to became doctors, why anybody on Earth should prevent a university to help them achieve their dream?
5. Stop government regulation of health insurance industry.
Some modest proposals of restrainging certain aspects of government regulations are discussed in Congress once in a while. For example, letting people ability to buy out-of-state insurance, or offering multiple year insurances, and so on. Why don’t we let the market come up with whatever product people want? Why do we want to create artificial barriers and then have lengthy discussion which of the thousands of constrains may be released?
And there should be many different options, for a different price of course, from accidental and basic insurances to the most advanced covering everything plans. It’s absurd to think that a single plan should cover everybody. What about organ transplants? What about treatments that cost millions?
Also, a single, universal health insurance plan will stiffen medical advance. Who eill be interested in developing new and expensive treatments if there’s no chance for them to became a part of the universal plan?
And any new treatment is expensive at the beginning.
Uh, but what about preexisting conditions and uninsured… That brings us to the last step of this program.
6. Make medical insurance charity 100% deductible.
The effect will be immediate. People will gladly allocate their taxes to private charity. It’ll be enough money to provide basic insurance to those who need it and to the people with preexisting condition.