The Healthcare Rhetoric vs The Reality

Everyone can agree that this political season has been different. The candidates and their “win at all cost“ campaigns have unwittingly uncovered what has been lurking under the surface. It is what voters have known, but have been unable to put their fingers on or wrap their brains around – the feeling that there is something wrong with the direction in which the country has been moving.

The rise of the ‘outsiders’ attests to this. However, what has become increasingly confusing to wade through is the exponential rise in the rhetoric which is designed to keep the status quo in place. How else can one explain the fact that on one hand some conservatives have been advocating policies that work against the conservative principles of free market and the rule of law, while actually funding and perpetuating big government policies that centralize power at the expense of individual rights; and on the other hand liberals have been advocating policies that abrogate free speech, restrict the freedom to associate with whom and how you see fit, while championing cronyism in the form of Medicare for all, and taxing the middle class out of existence in the name of the nanny state wrapped in the guise of social justice.

This political season has managed to out both the Republicans and Democrats as two sides of the same coin. How else can one reconcile establishment conservatives stating that they will vote for Hillary Clinton? It is clear they would rather turn over the board instead of lose the structure that has made the controlled opposition the only game in town. The truth is apparent for anyone willing to get off of the divide and conquer merry-go-round of identity politics. A growing number of people are coming to understand the most important axiom – whoever controls the money has the power. Understanding this principle allows one to understand how the levers of power have worked against all of us to push Common Core, decide elections, empower crony capitalism, along with the corporatization and centralization of healthcare.

The healthcare system has been dismantled under ObamaCare. Repeal and replace no longer matters because the corporate players have seized control of the delivery of healthcare with the blessing of the government. Any practicing physician if asked would have been able to predict that the cost of healthcare would go up without price transparency and access would fall. You can’t go from dozens of medical insurance companies to five (soon to be three), create large hospital systems at the expense of rural and community hospitals, and have independent physicians become employees of hospitals at increasing rates and not expect problems. ObamaCare has empowered and institutionalized the most expensive aspects of healthcare. Because of this, patients have been forced through the mandate to pay arbitrary and inflated costs of healthcare driven by these players.

With the patients now locked in by the mandate. It is becoming increasingly obvious that physicians are next to be locked into this toxic system. Although payments to physicians account for only seven cents of every healthcare dollar spent, there has been a relentless movement to reduce it even further. Implementation of Accountable care organizations (ACOs) which pay directly to hospitals to then be distributed to doctors and other members of the healthcare team, payments to physicians based on their adoption of meaningful use (MU), and pay for performance have been used to control the physician. There is now a movement to force doctors to become participants whether they like it or not.

In January, the democratic Speaker of the House in Hawaii introduced legislation to tie a doctor’s license to practice medicine in the state to taking Medicare. For those who think it is a good thing to subjugate doctors using the meme that healthcare is a right, they need to recognize that it will have a chilling effect on access to doctors not just because it is inherently wrong to conscript anyone to perform a service, but because it will irrevocably change the doctor patient relationship in a fundamental way. It will be the death of the doctor patient relationship and your doctor will become an indentured servant who will no longer be a patient advocate. It is already happening though the insurance pre-certification process and through services that are deemed ‘covered’ by insurance company policies and Evidence-Based medicine which has been adopted by government panels instead of medicine practiced by doctors on the front line giving patient care. The continued movement down this path will inevitably lead to the flight out of medicine of those doctors who advocate for a patient’s right to individualized healthcare unencumbered by the mandates of the government and the cronies from the medical insurance industry that have partnered to drive American medicine in a race to the bottom.

Free market healthcare and the innovative doctors who practice it are the last best hope for the practice of affordable quality healthcare that advocates for the needs of the patient. The following is the basis for a Doctor and Patient Bill of Rights that if adopted will promote actual healthcare reform:

• A doctor’s license to practice medicine can never be tied to taking any medical insurance (government or commercial)
• There shall be no national licensure for physicians (A doctor’s license should remain limited by the state in which they choose to practice)
• Health savings accounts can be used by an individual to purchase any type of medical service/product a person chooses and should not be limited by what an insurance company states is ‘covered’ (e.g., over the counter medication, surgery, medical cost sharing)
• Money in Heath Savings Accounts can be passed to any one that is designated by that person, and can be part of an estate; and therefore should be considered as wealth that can be passed to someone
• The money placed in the health savings account should be tax free and have no limit.
• Premiums paid for commercial medical insurance should be completely tax deductible
• Covered medical services should be determined solely by the Medical Specialty Board and not by insurance companies or the government.
• A certificate of need should be determined by all players in a market including independent private healthcare providers (surgery centers
• Price transparency should be required by all health care providers (hospitals, labs, radiology, pharmacies, doctor’s offices etc..)
• Make Maintenance of Certification optional
• Carve out Direct Patient Care practices and Medical Cost Sharing options as separate from the regulations required for medical insurance companies as they are based in direct payment from the patient for healthcare.
• Require medical insurance companies to disclose when they are working with pharmacy benefit management companies and pharmacies to set the price of and medications for prescription formularies.