- - Thursday, March 11, 2010

“Primum nil nocere.”First, do no harm. This guiding principle is a bedrock of medical care. Sadly, those politicians who would rewrite our health care laws do not live in the same universe as do the doctors and health care professionals who must practice it.

Imagine if, like physicians, politicians were personally held to the incredibly high level of scrutiny that includes civil and financial liability for any unintended consequence of their decisions. Imagine if they were forced to spend tens of thousands of dollars each year on malpractice insurance and still faced the threat of multimillion-dollar lawsuits with every single decision they made. If so, a government takeover of health care would be the furthest thing from their minds.

Obamacare proponents would have us believe that we will add 30 million patients to the system without adding providers, we will see no decline in the quality of care for the millions of Americans currently happy with the system, and -if you act now!- we will save money in the process. But why stop there? Why not promise it will no longer rain on weekends and every day will be a great hair day?

America has the finest health care delivery system in the world. Let’s not forget that and put it at risk in the name of reform. Desperate souls across the globe flock to our shores and cross our borders every day to seek our care. Why? Our system provides cures while the government-run systems from which they flee do not. Compare Europe’s common cancer mortality rates to America’s: breast cancer - 52 percent higher in Germany and 88 percent higher in the United Kingdom; prostate cancer - a staggering 604 percent higher in the United Kingdom and 457 percent higher in Norway; colon cancer - 40 percent higher in the United Kingdom.


Look closer at the United Kingdom. Britain’s higher cancer mortality rate results in 25,000 more cancer deaths per year compared to a similar population size in the United States. But because the U.S. population is roughly five times larger than the United Kingdom’s, that would translate into 125,000 unnecessary American cancer deaths every year. This is more than all the mothers and fathers, aunts and uncles, cousins and children in Topeka, Kan. And keep in mind, these numbers are for cancer alone. America also has better survival rates for other major killers, such as heart attacks and strokes. Whatever we do, let us not surrender the great gains we have made. First, do no harm. Lives are at stake.

Obamacare: Fixing price at any cost

The justification for Obamacare has been to control costs, but the problem is there is little in Obamacare that will do that. Instead, there are provisions that will ration care and artificially set price. This is a confusion of costs and price.

As one example, consider the implications of Obamacare’s financial penalty aimed at your doctor if he seeks the expert care he has determined you need. If your doctor is in the top 10 percent of primary care physicians who refer patients to specialists most frequently - no matter how valid the reasons - he will face a 5 percent penalty on all their Medicare reimbursements for the entire year. This scheme is specifically designed to deny you the chance to see a specialist. Each year, the insidious nature of that arbitrary 10 percent rule will make things even worse as 100 percent of doctors try to stay off that list. Many doctors will try to avoid the sickest patients, and others will simply refuse to accept Medicare. Already, 42 percent of doctors have chosen that route, and it will get worse. Your mother’s shiny government-issued Medicare health card is meaningless without doctors who will accept it.

Obamacare will further diminish access to health care by lowering reimbursements for medical care without regard to the costs of that care. Price controls have failed spectacularly wherever they’ve been tried. They have turned neighborhoods into slums and have caused supply chains to dry up when producers can no longer profit from providing their goods. Remember the Carter-era gas lines? Medical care is not immune from this economic reality. We cannot hope that our best and brightest will pursue a career in medicine, setting aside years of their lives - for me, 13 years of school and training - to enter a field that might not even pay for the student loans it took to get there.

Giving power back to people

I believe there is a better way. The problems in the American health care system are not caused by a shortage of government intrusion. They will not be solved by more government intrusion. In fact, our current problems were precisely, though unintentionally, created by government.

World War II-era wage-control measures - a form of price controls - ushered in a perverted system in which we turn to our employers for insurance and the government penalizes us if we choose to purchase insurance for ourselves. You are not given the opportunity to be a wise consumer of health care and compare prices as well as quality in any meaningful way. Worse still, your insurance company is not answerable to you because you are not its customer. It is answerable to your employer, whose interests differ from your own.

Insurance companies have been vilified for following the perverse rules that government has created for them. But it gets worse. The government, always knowing best, deploys insurance commissioners across the land to dictate what the insurance companies must provide, whether you want it or not, and each time, your premiums increase. Obamacare will make all of this worse, not better.

One of America’s founding principles is our trust in the people and their economic freedom to rule their own lives. We should decouple health insurance from employers and empower patients to be consumers once again. Allow them to determine the insurance plan that best meets their families’ needs and which company will provide it. This will unleash a wave of competition that will drive costs down in a way that price controls never have. Eliminate the artificial state boundary rules that protect insurance companies from true competition and watch as voters demand that their state insurance commissioners get the heck out of the way. Innovative companies will drive down costs similar to how Geico and Progressive have worked for automobile insurance. And it won’t cost taxpayers a trillion dollars in the process.

This free-market approach has worked for everything from high-definition TVs to breakfast cereals, but will it work for medicine? It already is. Take Lasik eye surgery, for example. Because patients are allowed to be informed consumers and can shop anywhere, doctors work hard for their business. Services, availability and expertise have all increased, and costs have decreased. Should consumers demand it, insurance companies - now answerable to you rather than your employer - would cover it.

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