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Patient-based Health Reform or “Fannie Med?”

Rick_scottSet against the backdrop of the $787 billion stimulus bill and deficit spending that dwarfs the federal outlays of FDR’s New Deal and LBJ’s “Great Society,” the idea of spending hundreds of billions – or even trillions of tax dollars – to buy universal health care coverage for all Americans isn’t much of a stretch anymore.

Faced with $30 to $80 trillion in unfunded healthcare liabilities ($110,000 to $300,000  per American under the age of 65) “health care reform” discussions are  underway between President Obama and members of Congress in the 111th Congress to spend even more on health care, and Americans are  beginning to hear more and more about “patients’ rights” and similar jargon.

The problem is that “universal health care” and “patients’ rights,” while sounding harmonious, are in direct conflict.  The path to effective health care reform must be approached from the perspective of individual patients and their relationship with their doctors, and not from a top-down, big government perspective.  Anything that interferes with an individual’s freedom to consult their doctor of choice to make health care decisions defeats the purpose of meaningful health care reform.

True health care reform centers on four “pillars” of Patient’s Rights:

Choice – Any health reform proposal must guarantee a patient’s right to choose their own doctor, and must protect a consumer’s right to choose the health insurance that best fits their needs and budget.  Reform efforts should expand the choices without dictating or distorting them..

Competition – In addition to increasing patient choice, eliminating state regulations on health insurance would allow for broader competition and lower prices for consumers.  Patients also benefit when doctors are free to run their practices like any other business, competing on the basis of results and price.  Requiring health care providers to publicly post their pricing and results so consumers can shop and compare will make our health care system more efficient at delivering quality care at an affordable price.  Effective reform must rely on market dynamics, not government controls.

Accountability – Health reform efforts must reward individuals who are accountable for themselves.  Those who pay for their own health insurance should get the same tax breaks employers get.  Creating one standard reimbursement form, regardless of insurance company, will reduce costs and shift accountability where it belongs – to the individual whose life is most affected by the decisions that need to be made. Rare is the politician who would argue that an insurance executive or a bureaucrat in Washington D.C.is in a better position to make critical health care decisions than individual Americans and their doctors.

Responsibility – Successful health care reform must place responsibility squarely where it belongs: on the shoulders of the patient.  Encourage individuals to take responsibility for their personal health by allowing insurance companies to charge lower rates for people who make healthy lifestyle choices.  Infusing personal responsibility into health care reform allows us all to maintain our cherished freedom to live our lives without government intrusion.  This principle works now: a 40 year-old who has been smoking since he was 16 knows his life insurance policy is going to cost more than that of a non-smoker. A driver with a heavy foot knows his car insurance rates reflect his need for speed.

Any serious discussion of health care reform that does not include choice, competition, accountability and responsibility – the four “pillars” of patients’ rights – will result in our government truly becoming a “nanny-state,” making decisions based on what is best for society and government rather than individuals deciding what is best for each of us..

Because of budget constraints, regulators in the United Kingdom dropped pap smears for women under 25.  The result – young women are dying of cancer that could have been treated if the cancer was discovered in its early stages.    Many Canadians have to wait months for diagnostic tests to determine whether their tumors are malignant, giving cancerous tumors time to worsen, spread and progress to an irreversible stage.

Some of the ideas being advanced by our leaders in Washington fail to consider patients’ rights , focusing instead on “government oversight boards,” “negotiations” with drug companies, and other bureaucratic solutions that refuse to put the patient-doctor relationship first.

Worse, the danger of Washington’s recent willingness to spend inordinate sums of money on anything deemed to be a problem, is that we are conditioning ourselves to believe that our government has unlimited resources – and that any problem can be solved by simply spending vast amounts of cash.  What politician wants to be in office when it comes time to admit we can no longer spend for services we have come to expect?

Fannie Mae’s and Freddie Mac’s failed experiment to improve home ownership for “low and middle income families” should be a wake-up call to those who believe more government involvement in American healthcare will help “low and middle income families”. These two initiatives resulted in politicians being accused of receiving favored treatment, low and middle income families being forced out of their homes and a federal bailout that could cost taxpayers as much as $2.5 trillion.  We never envisioned politicians receiving favored treatment, the housing meltdown caused by the expansion of these programs, nor the unbelievable number of low and middle income families being evicted from their homes with their life savings depleted.  It’s not difficult to imagine similar results under a national health care system.

Given the evidence, now is the time for an investment of political willpower to institute a dramatic shift away from the influence of government, and toward a patient-centric system with the principles of choice, competition, accountability and responsibility powering a revolution in American health care.  The shakiness and uncertainty that permeate our economy, some of which is caused by our lack of competitiveness because of healthcare costs, argue vocally for patients’ rights as opposed to government control.

Ultimately, the decision will come down to who we believe will better allocate our limited healthcare dollars: the government or each of us. If we get this right, everyone wins.  If we get it wrong, the damage to our economy and our quality of life and the quality of life for our children and grandchildren may be irreversible.  The last thing America needs is for Fannie Mae to become “Fannie Med.”

Richard Scott is co-founder and chairman of Solantic Corporation, a Florida chain of 23 urgent care centers which posts prices on the internet and on a “Starbuck’s style” menu board. He’s best known for being the CEO of
Columbia/HCA which grew to quickly being the largest for-profit
hospital chain in the 1990s before he was forced out when the Federal
government investigated allegations of fraud. After Scott left, HCA settled the suits for
over $1.7 billion. More recently Scott has become a participant in the national debate over health reform. In 2009, He formed the Washington-based political action group “Conservatives for Patients Rights”, an organization dedicated to market-based reform of the healthcare system.

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