Something unique in the history of American medicine may occur in the year 2017. If we are very diligent and careful, we may be able to take a small step backwards and reverse the tide of history.
For more than a century, government involvement in American medicine (and many other things) has moved in a single direction: more laws, more spending, more regulations, more controls, more bureaucrats, more agencies, longer waiting lists for referrals and treatment for military veterans, more codes (150,000 are not nearly enough) that must be correctly assigned to process every medical condition, and more government power over the most intimate details of our daily lives.
The only things that the government keeps under tight control are free choices by citizens, independent decisions by physicians and surgeons, innovation and the Food and Drug Administration’s (FDA) approval of new medications and treatments.
This year, much of that may change. The “Better Way” plan of the U.S. House of Representatives would eliminate substantial elements of Obamacare, including both the mandate forcing citizens to buy insurance and a long list of procedures and treatments for which coverage is mandated, once they do buy.
State insurance exchanges and the national exchange–huge administrative and regulatory bureaucracies–should fade and yield to real markets. Most of the highly subsidized insurance co-ops have already gone broke in spite of the billions spent propping them up.
Perhaps even more important than the flood of regulations and bureaucracy that can be reversed by dismantling Obamacare is the prospect of allowing more choice and freedom to consumers. The House provisions to expand health savings accounts include tax-free savings that can be carried over to pay for health care in retirement. A true national market that allows the sale of health insurance across state lines will result in savings from more vigorous competition. Liability reform will end huge settlements from litigation, reduce medical costs across the board and end the costs of defensive medicine– unnecessary treatments out of fear of litigation. Portability will allow everyone to take insurance with them from job to job and state to state.
But America shall not be saved by the death of Obamacare alone. The FDA, after 110 years, has grown into a massive, distant and indifferent bureaucracy that eagerly defends its own powers–insuring that no one in America can receive treatment without government permission. We must no longer allow medical progress and innovation to be strangled by this Leviathan.
The “Better Way” plan calls for clearing out the FDA to simplify, shorten and speed up the approval process for new medications and therapies. That can save lives and lower the cost of new drugs.
There are many other good ideas in the House proposals and from the teams being established by the incoming administration.
With caution, in 2017 we can reverse the flow of history and build more freedom rather than more government. With caution and diligence–because politicians are ingenious in slipping more government into legislation intended to reduce it. But now, finally, is the time to turn this all around and restore free choice to American medicine.
Richard E. Ralston
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