By Dr. Deane Waldman • 3/23/17
Obamacare. The American Health Care Act. The Emergency Medical Transport and Labor Act. The Health Insurance Portability and Accountability Act. Health Insurance Marketplaces (now called exchanges.) The Medicare Access and CHIP Reauthorization Act. Medicare. Patient-centric healthcare. The Unfunded Mandate Reform Act.
These are some of the ways that Washington has "fixed" our healthcare system. Other than failure, they have one other attribute in common: they're Washington-generated, Washington-in-control. For more than 50 years, the federal government has dominated healthcare using a military command-and-control model.
To use a medical analogy, Washington has been the attending physician for a sick patient named healthcare for decades. With all the "treatments" imposed by the doctor-federal government, healthcare has become sicker and sicker, and sicker.
Spending on healthcare has more than tripled, rising from 5 percent of GDP in 1960 to 17.8 percent in 2016. Many accountants fear it will be 20 percent by 2025. That would be a 400 percent increase in 65 years. And what has the public gotten for all that spending?
It is increasingly hard to find a doctor. More than 30 percent of doctors can't afford to accept Medicaid reimbursement schedules. Even as millions of Americans gained health insurance through Medicaid expansion, Obamacare paid fewer and fewer doctors to care for them.
Therapy-by-Washington has made healthcare unaffordable as well as health insurance. Obamacare succeeded in making health insurance even more unaffordable. Now the House Republican healthcare bill, the American Health Care Act, wants to take back the insurance that the government gave for free.
When the same doctor (Washington) treats the same patient (healthcare) over and over with multiple different fixes, and the patient just keeps getting sicker, the problem is not the fixes — it is the doctor. Healthcare needs a new physician, one that is not Washington.
If not Washington, then who? If not by federal regulation, then how?
Instead of looking to Washington to save us with one more fix that fails or backfires, it is time to give the states a chance. Let the states decide on their healthcare. Call it the Fifty Plan or better, StatesCare. Let the states use whatever model(s) they choose to have whatever system their people want.
Why Read This Article:
See that Washington has failed us in healthcare: Let the states try.
By Deane Waldman, MD, MBA, author of "Curing the Cancer in U.S. Healthcare"
Professor Emeritus of Pediatrics, Pathology and Decision Science, and holds the “Consumer Advocate” position on the Board of Directors of the New Mexico Health Insurance Exchange, and Adjunct Scholar (Healthcare) for the Rio Grande Foundation.
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