“Coverage is not the measuring stick we should be using” to determine whether an Obamacare replacement is good legislation, Health and Human Services Secretary Tom Price said at the National Review Institute’s Ideas Summit today. “What we should be using is care.”
In a wide-ranging interview with Yuval Levin, Price pointed to those who technically have insurance, but because their plans include enormous, unaffordable deductibles, those patients have “a card, but not care.”
Price said the vast majority of Americans get health insurance through their employer, about 175 million. Another 55 million get it through Medicare, and about 60 million through Medicaid. Then there’s about 18 million in the individual market, and Price declared that Obamacare “just destroyed the individual market.
Don’t listen to me, listen to the insurers.” He said that in just the past year, the number of health issuers on the individual market nationwide had declined from 232 to 167.
“Five states have only one issuer,” Price said. “We’re trying to save the insurance market and also save the delivery system for everyone across the continuum. We need a significant amount of market stability, not for the insurance companies, but to ensure patients can get access to the care they want.”
From one perspective, Price is a man with far-reaching power over how the American system of providing health care operates for the next few years, as the text of the Affordable Care Act says “the Secretary shall” or “the Secretary may” 1,442 times. Since enactment, the Department of Health and Human Services has issued more than 5,000 “guidance letters” to providers, issuers, states and other entities in the health care system.
Price said he wants to go through every regulation that imposes a cost and ask whether the benefit it conveys is worth the cost. But he pointed out that his department cannot rewrite the rules of Obamacare quickly, pointing to requirements for publication of proposed rules, public comment periods, departmental consideration of those comments and then putting forward an interim or final rule. “That’s a process that has to be followed, and we can’t truncate that process.”
He contended that prices could be driven down with sufficient competition among insurers, coupled with an adoption of more efficient technology. He lamented doctor’s offices where staff still use paper patient charts and contended, “the innovation that has gone into almost every portion of our society has missed significant portions of the health care sector.”
Like Kellyanne Conway, Price was optimistic that a “Phase Three” of replacement, that included some support from Democratic sectors to reach a 60-vote threshold, would come to fruition. He pointed to Health Savings Accounts as a concept that had support on both sides of the aisle. He suggested that the potential cost savings from insurer competition from selling across state lines might appeal across the ideological divide.
“This feels like a tough piece of legislation, but this is how the process moves forward,” Price said. “It feels like it’s headed in the right direction.”