Column: The biggest threat to health care
Politicians and bureaucrats interfering in our relationship with patients and dictating care in the name of controlling costs is by far the greatest threat to health care.
The federal government has spent decades trying to micromanage the finances of the health care world, always with unintended consequences that do more harm than good. Yet rather than recognize their mistake, those responsible almost always point to the problems they created as proof that even greater intervention is needed. What they should be doing is giving patients more control of their own health care dollars, which is the only proven way to lower costs and improve outcomes.
One of the most blatant examples of federal folly was the so called “Sustainable Growth Rate.” From the late 1990s until last year, federal law required that doctors’ Medicare reimbursements be cut if per-patient spending increased faster than the economy. Thanks to life-saving medical innovations and other factors, this happened every single year.
Congress stepped in to prevent the cuts from taking place, recognizing the obvious harm annual reimbursement cuts would have caused. They would have driven doctors from practice and left patients with nowhere to turn.
Looking elsewhere in medicine, we can also see the huge bureaucracy that runs Medicare. It is often quite tardy in the funding of newer drugs and devices. This coupled with archaic Food and Drug Administration approval policies has increased costs for patients and decreased access to potentially life-saving treatments.
And then there’s the president’s signature health care law, Obamacare. It dictates to patients what health insurance companies can and can’t provide in their products and how much specific age demographics can be charged in premiums. It also created a vast apparatus of federal agencies — 159 at last count. Ostensibly, this convoluted, regulation-driven system is supposed to keep costs down.
The result has been the opposite. When Obamacare went into effect in 2014, it immediately spiked insurance premiums in Michigan between 52 and 107 percent. The young saw the highest spikes of all, even though they’re the least able to afford them.
Now Michiganders are looking at premium hikes of between 20 and 40 percent heading into next year. While for some, these increases will be covered by subsidies, that just means that taxpayers are footing the bill.
The simple fact is that Obamacare is dramatically increasing the cost of health insurance premiums. And it has also led to higher deductibles, higher co-pays, and smaller networks for tens of thousands of Michiganians. The law has created a new class of patients, those “insured, but unable to pay.”
These are only a few examples of how government attempts to control health care costs have harmed the people they were supposed to help. Yet as I said before, the only proven way to keep costs down — while also increasing access and quality — is to empower patients to make their own choices.
The government-first crowd will claim that individual freedom is what got us into this mess in the first place, but that simply isn’t true. It’s been over fifty years since patients had the same level of freedom with health care that we have in other parts of our market based economy. We need to allow those who wish to do so to have more control of their personal care via tax credits, health savings accounts and high deductible insurance plans.
Every time these policies have been tried on a limited basis, they have had positive outcomes for cost and quality. Freedom works. As long as the federal government tries to call all the shots, pull all the strings, and come between the patient and doctor, health care costs will continue to increase.
Kenneth Fisher, M.D. is the author of “Understanding Healthcare: A Historical Perspective.”