Over the past several weeks I have introduced to you various new options and choices that are necessary for creating a vibrant, free market system in health care – some of which are non-negotiable for creating a better America. To summarize what those recommendations are, they are as follows:

1. End the government sponsorship and protection of the insurance industry by removing the anti-trust exemption on the insurance industry forcing them to compete based on products, prices and services

2. Encourage and bring to an equal level Health Shares and non-profit Co-ops to provide additional options and alternatives for Americans to choose from

3. End the dominance of the employer sponsored health care plan which would promote private health insurance for all – the unemployed, the employed but with no insurance, the employed, and the retired

4. Introduce health care vouchers for employees rather than health care plans

5. Reform tax treatment of health care related expenses so they are all treated equally and do not favor one type of plan over another or one type of provider over another

6. Reform and increase the use of HSAs

7. Create a maximum on the amount the uninsured can be charged relative to the insured

8. Freeze Medicare & Medicaid at their current levels

9. Have the government provide vouchers for the low income and retired to purchase private health coverage that fits their needs

10. Introduce an increased tax deduction or credit for assisting family members with their health care expenses

11. Introduce a truly free and open health insurance exchange for all people and all health care related products

12. Pre-existing condition reform

13. Allow insurance plans written in one state to be sold in another state

14. Pay doctors for results and not only for services including the amount charged and warranties

These proposed reforms are not all inclusive. Some others that I have not focused on include:

1. Encouraging wider user of Health Savings Accounts for retirement health care. Health Savings Account contributions by any source would be tax deductible and never taxed upon withdrawal ensuring that health care expenses come first. If each American put aside between 2-4% of their income annually into an interest bearing account, they would be able to pay for most, if not all, of their health care related expenses after retirement (Footnote 1).

2. Freeing up doctors to be able to dictate their prices rather than the insurance companies. This would obviously create a market that truly competes based on price (Footnote 1).
Requiring, similar to our regulations on public companies, that doctors and hospitals disclose their success and failure rate. Patients have a right to know the quality of care they will be receiving. Furthermore, this reform, combined with #2 above, would truly help to create a marketplace that competes on value – quality and price (Footnote 1).

3. Encouraging more direct interaction between doctors and patients through phone and e-mail consultations. Because insurance companies don’t reimburse for this kind of care, doctors don’t provide it. If doctors are freed in their ability to determine prices and services, the market can better take care of the needs of the people in it (Footnote 1).

4. Electronic Record Keeping to build an infrastructure wherein information is more easily passed, efficiently maintained and more productively used for the care of the patient
A free market agency that rates providers based on quality of care and value of services. Such an agency would be similar to the “Energy Star” rating on electronic products. The value of this is obvious.

To sum up the whole of this kind of reform, if all of these reforms were enacted, American health care would be entirely different. All citizens would be able to have health care tailored to their needs and desires – the young invincibles to the aged and infirm, the employed and unemployed or retired. Insurance companies would not only be forced to compete with each other for the first time in modern history, but they would also have to compete for customers with health shares, co-ops, and self insurance. Small businesses are able to help provide care to their staff through vouchers. There are incentives for private plans to emerge. Employers would still be able to compete for top talent by the amount they contribute to private plans through vouchers. The government’s funding crisis becomes minimized by freezing the number of enrolled members in Medicare and Medicaid and simultaneously stimulates the free market by providing vouchers for eligible Americans to purchase private health care based on their needs. Americans have sufficient funds at retirement to pay for their health care and the costs for everyone have been lowered by competition, electronic records, diverse products and options, individual policies written to their needs, public disclosures of performance levels, and “Energy Star” type ratings.

Essentially, the rich and poor, healthy and infirm, employed and unemployed, could all be provided for. Not only that, they would be more effectively and efficiently provided for than had the government done it. Future generations are not taxed to provide for our care today, our reforms bless untold millions of unborn and future generations, government credit is increased and the National character becomes a light of what free will, Justice and the American spirit intended. True reform would bring about true blessings that could benefit everyone.

Compare this kind of reform to that being debated in Congress. Insurance Companies keep their anti-trust exemption, Medicare, Medicaid and the employer sponsored health plan are further entrenched, choice and freedom is not expanded - on the contrary, it is contracted - government growth goes up, quality eventually goes down, government is forced into an unethical situation of injustice and inequity, certain levels and powers to ration care, ourselves and the future are burdened with an unbearable level of greater and greater debt, the family is weakened, the health care industry is crippled by certain elements of central planning, costs for everyone with insurance go up, and the people in the long run are the ones who are hurt. The future is not all dark with the government health care reform, however. There are still some bright spots such as greater access to health care, some insurance reform, and some efficiency and cost improvements which would be blessings for many. However, it isn’t as bright as they would like us to believe it is either.

In essence, the government would not be able to fulfill its role to promote and protect the unalienable rights it was chartered with protecting: Life, Liberty and the Pursuit of Happiness through the protection of Property. Its good intentions would cripple its abilities to deliver the expected outcomes on every front - not just health care.

Freedom and Justice as the means leads to Freedom and Justice as the destination. Free market reform isn’t perfect but it is the only way for us to get as close to perfection as we can. The People can do that. The government can’t.

The possibilities of free market reform are as numerous as are individuals. That is the beauty of the market – we all work together, as free Americans, to fill and meet the various needs of every individual in the manner that is best - providing the best service at the best price. It is the invisible hand that moves to fill needs, provides opportunities, sparks ideas, enhances quality, removes barriers, and, where coupled with proper oversight, blesses the whole society. Some would say it is even guided by Providence – after all, free will was given by Him. The proper exercise of agency is a blessing to us all.

This is the best way for America to proceed. If we had no alternative then I would not be nearly so adamant about this kind of True Reform. However, we have an alternative to the status quo that works better than direction we are going in. Why then is it not going in this direction?

To answer that question, we will next briefly address the various forces and players influencing the health care reform debate.


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Footnotes

1. John C Goodman, “A Prescription for Americans Health Care” Imprimis, March 2009, Volume 38, Number 3