Column by Norman Leahy
Primum non nocere, a Latin phrase meaning “First, do no harm,” is the first principle in the provision of health care. It should also be a first principle in health-care reform. Of course, this assumes the debate is truly about health care and not just another excuse to further expand the reach and control of government.
In an interview with Doc Thompson on WRVA radio in Richmond, Sen. Mark Warner assured listeners that he was deeply concerned about health-care reform and was eager to work on a plan that would make the system more efficient and equitable.
The House just passed a bill that costs around a trillion dollars and imposes any number of restraints and mandates. It’s been the focus of debate, shouting, and a lot of YouTube moments.
Yet what’s really needed to improve health care is a program that looks forward and embraces both the marketplace and individual choice, rather than more government mandates which end up costing taxpayers more money and giving them less insurance choices year after year.
A new Virginia Institute for Public Policy report, The Prognosis for National Health Insurance: A Virginia Perspective, looks at the current proposals floating around Congress and finds that while they promise much, they will end up costing Virginians dearly.
By 2019, the Commonwealth’s economic growth will be reduced by 4.5 percent. The already creaking state budget will take an additional hit as health costs rise $500 million per year, and to pay for it, tax receipts will have to rise nearly one percentage point.
In other words, the budget problems we face today will look like the good old days if one of Congress’s current bills actually gets passed.
What’s the alternative? The report’s authors, Arduin, Laffer & Moore Econometrics, lay out seven broad principles:
1. Individual ownership of insurance policies. Employers own your insurance now, not you. And they get a tax break for their trouble. To kick-start reform, that equation needs to be reversed, with you getting the tax break for a policy you own.
2. Wider access to Health Savings Accounts. Under the House bill, these high-deductible policies coupled with tax-favored savings accounts would vanish. That’s exactly wrong. Instead, we should encourage more people to establish these accounts so they can take greater charge of, and responsibility for, their own health care.
3. Cutting the number of mandated benefits. Virginia mandates that insurance companies cover services from marriage counselors, licensed acupuncturists, certified nurse midwives, clinical social workers and more. Health-care consumers should be able to decide which types of care they want to pay for, not the General Assembly and certainly not the federal government.
4. Allowing interstate purchasing of insurance. Virginians routinely cross the state’s borders for deals on goods and services. They should be allowed to do the same for health care.
5. Giving Medicaid recipients vouchers to purchase their own insurance. An income-based voucher program would slash overhead costs, save taxpayers money and give Medicaid users the same level of health choice as other private insurance owners.
6. Ending the health-care guild system and allowing non-physician health-care practitioners to deliver care to the extent of their training. Restricting who can deliver even the most mundane and routine health care drives up cost and restricts choice.
7. Tort reform. Congress and the White House have put this off-limits, in spite of the President’s tepid acknowledgement that maybe, perhaps, it might be worth considering. Tort reform will help end the practice of defensive medicine and reduce costs for health-care professionals and recipients.
Giving patients and providers more choices, and more freedom, directly addresses the problems Congress and the White House say they want to fix. Costs would come down, health outcomes would improve, and those who lack coverage would be able to get it. Plus, the state and federal budgets won’t be drowned in the red ink of good intentions.
Can the mess be fixed? Absolutely. However, the answers lie not in more government control, but in greater individual freedom.
Norman Leahy is the vice president for public affairs of Tertium Quids, a 501(c)4 issue-advocacy organization headquartered in Gainesville.