Editor’s note: This column was co-authored by Jennifer Minjarez
Suppose you have a broken machine. You hire an engineer to fix it. He changes several parts of the machine, evaluates the changes, and finds that the changes did not fix the problem. Should he try to sell you a machine that doesn’t work?
Paraphrase the previous paragraph for healthcare. Democrats changed the way healthcare was financed by Obamacare. We the People have discovered that our costs went up while our access to care went down. Should the Republicans try to fix a system that doesn’t work? Would you want to pay for a system that is a proven failure?
The collapse of Obamacare
Obamacare is collapsing. It has achieved the opposite of what was promised. President Obama’s namesake law has doubled the cost of insurance, contributed to doubling the national debt, and worst of all, it has reduced our access to health care.
A recent report from Kaiser Family Foundation was reported as showing that the healthcare insurance market was “not collapsing.” Even if this is true, the market has stabilized where premium costs are unaffordable. Much more important is this: while the health insurance market may be temporarily stable, our healthcare system continues its slide toward total failure.
Obamacare has forced companies such as UnitedHealth, Humana, Aetna, and Anthem to stop selling health insurance. As a result, nearly one third of all U.S. counties have only one insurance company. By driving insurance sellers out of the market, Obamacare has eliminated consumer choice.
Obamacare reduced our access to care. Medicaid reimbursement schedules have become so low that almost half of U.S. doctors cannot afford to accept new Medicaid patients. As a result, the 11 million Americans who received “free” insurance through Medicaid expansion can’t get care.
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What should not be done?
The collapse of Obamacare proves that Republicans were right to oppose it. So, what is the GOP doing? They are propping up Obamacare, delaying its inevitable collapse.
We should not “prop it [Obamacare] up.” No amount of adjustment will save healthcare from Obamacare’s inherent design flaws, systemic contradictions, and constant revisions.
We must not accept the mainstream media’s contention that single payer is the only remaining option.
Single payer is not the answer
Single payer is shorthand for total control of healthcare by the government. In single payer, government decides if you get care, what kind, where and when. The government decides how much to pay providers, and how much money to allocate for burn units, MRI scanners, and operating rooms. Since paying the bureaucracy is the federal government’s highest priority, care for We the People gets the leftovers.
The U.S. has extensive experience with single payer in our Veterans Administration system. A 2015 internal audit of the VA showed that “307,000 veterans may have died waiting” for medical care. This is called death by queueing and is a common phenomenon in other single payers, such as Great Britain and Canada.
It is particularly ironic that talking heads on TV say a new single payer will save us from our currently imploding one—the ACA.
What should be done?
Washington should break with tradition and do what is right instead of what is expedient.
Congress starts all discussions with a vote count and end with what can’t be done. They should start by identifying the root cause of our healthcare system’s failure. Then, Congress should eliminate that root cause.
We read about subsidizing insurance companies and “ensuring cost-sharing payments…are permanent.” Instead, Congress should be discussing ways to take dollars away from the healthcare bureaucracy, so we can pay our doctors and hospitals to provide the care we need when we need it.
Obamacare did not start the decline of the U.S. healthcare system, though it is hastening the system’s demise. Our system was sick long before 2010. The cancer in healthcare is Washington control.
When a patient has cancer, you don’t negotiate with the tumor to cut out just a small piece, and then walk away saying, “That’s all I can do today. I’ll come back another day and cut some more out.”
The U.S. spends more on healthcare than any other nation. Yet we don’t have enough money to pay our providers and hospitals. That is why Americans cannot get timely care. Where are the healthcare dollars going that aren’t being used for care?
The federal bureaucracy consumes more than forty percent of all healthcare spending, much of which pays for Obamacare regulations and administration. In 2015, the U.S. spent approximately $4 trillion on healthcare. That means more than $1.6 trillion was taken from care services to pay Washington. Imagine how much health care doctors and hospitals could provide for $1.6 trillion!
The federal bureaucracy is malignant. Expecting Washington to fix healthcare is like hoping cancer will cure cancer.
The way to cure our ailing healthcare system is clear: cut Washington out.
StatesCare
If Washington does not control healthcare, who should? The immediate answer is the patient, though having 320 million individual healthcare systems does seem a bit far-fetched. Having the states determine their own systems does not. In fact, healthcare decided by the states—"StatesCare"—is the cure for sick healthcare.
California wants to have its own single payer system. Oregon wants universal health care. Texas wants a free-market system. Why should they not be allowed to chart their own courses? If smaller, cash-strapped states want to get together and create their own multi-state system, they should be free to do so.
State representatives are more responsive to their constituents and have a better understanding of their specific medical needs than someone in a Washington cubicle with a standardized, a one-size-fits-all approach.
Not only can the states do a better job than Washington, the states have a constitutional right to decide their own fate.
StatesCare—getting Washington out of healthcare—is the right thing to do. Republicans in Congress and President Trump will fulfill their promise to repeal Obamacare in full. StatesCare would give the people what they want, state by state.
Most important by far, StatesCare will allow Americans to get the care they need, when they need it without going broke in the process.
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Dr. Deane Waldman, MD MBA, is Director of the Center for Health Care Policy at the Texas Public Policy Foundation. He is Professor Emeritus of Pediatrics, Pathology, and Decision Science, and the author of “The Cancer in the American Healthcare System.” Dr. Deane can be reached at dwaldman@texaspolicy.com.
Jennifer Minjarez is a staff analyst in the Center for Health Care Policy at the Texas Public Policy Foundation. She can be reached at jminjarez@texaspolicy.com.
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