Health Care

In the United States, working and middle class people, people of average health and not on Medicaid, spend between 11% and 24% of their income on health care; this doesn’t include any employer paid premiums or taxes. Explore the variations yourself at the Peterson–KFF Household Health Spending Calculator.

I affirm that access to reasonable health care is a human right, and that no one should have to declare bankruptcy because of an illness or injury. I also support  a single payer system. Though my policy proposal is different (and will be released in several weeks), I share presidential candidate Elizabeth Warren’s assessment of our health care system:

• Her 2007 study found that “the number one reason families were going broke was health care — and three quarters of those who declared bankruptcy after an illness were people who already had health insurance.” Ending the Stranglehold of Health Care Costs
• “Today, in 2019, in the United States of America, the wealthiest nation in the history of the world, inadequate health coverage is crushing the finances and ruining the lives of tens of millions of American families.” Ending the Stranglehold of Health Care Costs
• “The need is clear. Last year, 37 million American adults didn’t fill a prescription because of costs. 36 million people skipped a recommended test, treatment, or follow-up because of costs. 40 million people didn’t go to a doctor to check out a health problem because of costs. 57 million people had trouble covering their medical bills. An average family of four with employer-sponsored insurance spent $12,378 on employee premium contributions and out-of-pocket costs in 2018. And 87 million Americans are either uninsured or underinsured.” Reducing Health Care Costs in America

I will work in good faith with all representatives in the House to put together a solution that, unlike the Affordable Care Act, doesn’t result in more expensive premiums or higher out-of-pocket costs. There are six standards I will use in evaluating any health care legislation:

• Uncouple Health Care from Employment
• Provide a Catastrophic Backstop
• Improve Preventive Care and Counseling
• Insure Against Complications
• Reform Barriers to Entry
• Enable Charitable Care

Uncouple Health Care from Employment

The solution here is simple; we need a single payer system.

Provide a Catastrophic Backstop

Nobody should be bankrupted by health care bills. Health care spending as a percentage of GDP may continue to rise, or it may decrease; that is immaterial. What we need to do as a nation is insure against the catastrophic.

Improve Preventive Care and Counseling

An annual exam and counseling should be available to anyone, free of charge.

Insure Against Complications

One market necessity that is conspicuously missing in the healthcare market is upfront pricing. To be fair, it is not as easy for a clinic to set a price for a service as it is for a restaurant. Complications can and do arise. Addressing those complications can be costly, and that cost is currently passed on to the patient.

Insurance is meant to cover unexpected costs. What is more unexpected than a complication. What we need is a requirement that practitioners address all complications during a procedure at no additional cost to the patient. We need to set up the legal structure that will allow companies to insure doctors against complications. Premiums for such insurance would be based on that clinic’s track record.

Reform Barriers to Entry

Medicine is a tightly controlled occupation. Only the brightest and the most dedicated complete the rigorous training and vetting required to become a doctor. This high standard is requisite in areas such as diagnostics, trauma care, intensive care, prescribing medication, surgery, and the cutting edge of medical science. But the complicated procedures of decades past are now the routine of today. It used to be that only highly educated professionals built computers, but now a child can build a custom computer from components in an afternoon. We need to allow certified, skilled workers to take some of the busy work from doctors, not merely as assistants, but as independently capable individuals.

By lowering the barrier to entry we can bring more competition, more personalized care, and lower prices into the health care market. We need to allow certified, skilled workers to independently practice simple and safe medicine.

Enable Charitable Care

Free clinics should be legally encouraged, and given reasonable protections against litigation. Health care payments on behalf of someone else should be tax free and tax deductible.