In 2009, when President Obama first took on health care reform, three major issues in the existing system were almost universally agreed upon:
1. Forget cost, even if you had had it, health insurance was too complicated for the average American consumer to navigate.
2. Doctors were becoming less engaged with their patients due to a mountain of complex paperwork to be filled out simply for them to get paid.
3. Americans were confused and utterly frustrated on how to get access to the doctors they needed to see for their specific care needs.
In response, we got the Patient Protection and Affordable Care Act (ObamaCare), 2,700-plus pages of the most complicated public policy in the annals of American history. But wait, wasn’t the problem that health care was too complicated?
Clearly, Obamacare’s drafters didn’t follow the theory of Occam’s Razor: “The simplest answer is most often correct.”
For President Trump, a native New Yorker sitting in the Oval Office in the age of ride hailing, a revolutionary change in how we get a ride may point to simpler and better solutions for health care reform.
The taxi industry notoriously had a ridiculous amount of complex government-led red tape. Each taxi driver, to own a taxicab, needed a medallion, which is the large metal shield displayed on the vehicle’s hood. In New York City, for example, there are a fixed number issued. This put a limit on available taxi ride services for consumers and inevitably increased costs.
That is until, ironically, 2009, when Uber launched. Uber tore down every standing regulation. Drivers could use their own car, didn’t need a medallion, customers paid with a couple touches on their phone, and could track the ride progress from “hail” to drop-off. The lack of regulation with this influx of technology quickly sent Uber into the technological industrial sphere.
While the debate rages whether to repeal, replace, or even repair Obamacare, what if Mr. Trump could just Uber past it: less governmental regulation with more direct paths for patients to reach doctors, and vice versa.
Gerard Gianoli, thought leader and founder of Ear and Balance Institute, is a banner example of how simple solutions work in health care.
“As a thriving cash only doctor/specialist, we work directly for our patients, not insurance companies. 2017 offers so many technological opportunities to connect doctors like me directly to our patients, it’s like no other time in history.”
So what are Uber-friendly, non-Obamacare-related solutions that could be put in place now?
1. Repeal the McCarran-Ferguson Act. With this law in place, insurance carriers can only sell in the state in which they’re licensed. Mr. Trump has made tearing this law down a cornerstone of his plans. If we allowed carriers to market their offerings across state lines, utilizing app-based, user-friendly technology, many more companies would be able to bid for your business and be incentivized to make it simple, cost transparent and affordable.
2. Get rid of the prohibition in many states that doctors can’t work directly for companies. Many state medical boards still prevent doctors from working for companies under the theory that business concerns may interfere with their clinical judgment. That may have been true a generation ago, but modern health care is a data entry-saturated occupation. Forcing doctors to bear the brunt of administrative tasks while balancing patient care does nothing but increase wait times and burn out. Let doctors have companies take these duties on for them, so they can do what they went to school for — spend time with their patients.
3. Remove out-of-state doctor-licensing barriers. It can be a time-consuming administrative nightmare for even the most experienced doctors to get licensed in a new state. Typical patient issues in New Jersey aren’t that different than Arizona. Even if they are, can’t a doctor and his staff easily access online information about local/regional viruses and environmental factors that may be seasonally impacting patients? If an out-of-state licensed doctor can easily see a patient via Skype using tele-health technology, patients will have infinitely more provider choices and unquestionably more affordable cost options.
An example of an Uber-like, cutting-edge company is Virginia-based DocASAP, a technologically innovative company that solves patient access by driving collaboration between health systems and insurers. The only thing holding back these types of user-friendly solutions from exploding nationally are regulations passed during a time built for rotary phones and yellow cabs.
Americans crave solutions that are simple, user-friendly and accessible for all ages and income levels. Politics aside, Obamacare was an utter failure on simplicity.
My 13-year-old niece along with my 85-year-old mother-in-law can easily navigate their smart phones. Both can easily hail an Uber. In a 2017 world where that’s possible, why can’t we Uber our way past Obamacare?
• Bryan Rotella is the founder and CEO of Rotella Legal Group.