It’s not good enough simply to rail against our broken health-care system without a plan for how we will address it.
It’s not good enough simply to rail against our broken health-care system without a plan for how we will address it.
I n 2017, Republicans failed to “repeal and replace” Obamacare. This was foreseeable, as Republicans running in 2016 on repealing Obamacare consistently failed to articulate the “replace” portion of this political rhetoric.
Such rhetoric caught up to Republicans in the House, Senate, and, yes, the White House — who represented the dog that caught the car. Ultimately their failure led to at least another six- to ten-year continuation of failed health-care policies made only worse by Obamacare, which even Elizabeth Warren can see is a disaster.
The health-care sector has continually consolidated — which was encouraged by Obamacare and has decimated competition. There were 90 mergers per year in the pre-Covid-19 years with a peak of 115 mergers in 2017. Now, Cigna and Humana are in merger talks for a deal that could exceed $60 billion in value. Meanwhile, networks have constricted. For example, MD Anderson in Houston — which ranks No. 1 in “Best Hospitals” for cancer, and where I received lifesaving treatment for lymphoma in 2011 — no longer takes individual insurance under Obamacare.
Worse yet, prices have skyrocketed. In the past year, average employer premiums have jumped 7 percent, the fastest clip since 2011, and family coverage is up to nearly $24,000 this year. The average family premium has increased 47 percent since 2013 instead of coming “down by $2,500 for the typical family,” as falsely advertised. This as American households are spending $11,434 more annually just to maintain the same standard of living as in January 2021.
But as both National Review’s and the Wall Street Journal’s editorial boards point out, it’s not good enough simply to rail against our broken health-care system without a plan for how we will address it. The good news is that Republicans in Congress do have plans for transformational reform that goes beyond Obamacare and straight to the heart of the problem — the complex web of insurance-run, government-mandated “coverage” and regulations that has removed doctors and patients from the center of decision-making.
Republicans have numerous options to massively expand the use of health savings accounts (HSAs) — the key to lowering prices through competition and the naturally occurring transparency that would flow from them. Today, roughly 30 million Americans hold HSAs, providing for over $82 billion in savings, but access to them is far too restricted. Only certain people can have one, and only certain medical expenses can be paid for without penalty. And currently, those with access can’t contribute enough per year to keep up with health-care costs. Fixing these restrictions could dramatically change our health-care system by creating an opportunity for Americans to own and control their own health-care dollars — tax free.
Second, we will refocus our system on access to care instead of coverage. Imagine a system where any patient could go directly to a doctor without having to check with an insurance or government bureaucrat first. This is not only possible; it’s the transformation we need to bring down costs. Fifteen percent to 30 percent of all U.S. medical spending is administrative, and “at least half” of that “does not contribute to health outcomes in any discernible way,” according to research from Fierce Healthcare.
Next, we must reform insurance. Obamacare overregulated insurance and limited everyone’s ability to pay for the insurance they need, in favor of impersonal “health plans” that are too expensive for most. We fix this by ending Obamacare’s expensive mandates and restrictions while making it easier for less traditional models — e.g., health-care-sharing ministries — to compete with big corporations.
Finally, Republicans can embrace full transformation by changing tax law to provide Americans their own HSAs to purchase both real insurance and real care and allow employers to contribute while still receiving the same tax benefit as the employer-sponsored insurance exclusion. This will allow every American to transport their insurance from job to job, encourage transparency, and foster lower prices through competition by releasing roughly 160 million Americans to shop for themselves.
Our health-care system — only made worse by Obamacare — has failed every American in some way. It’s time we did something about it. And if we are to save health-care freedom in this country, we must meet the moment and start working to get something done.