Congress will soon shift its attention to health care. As our nation’s policymakers prepare to play doctor-in-chief, they must remember the Hippocratic Oath: First do no harm. We cannot afford to sacrifice the strengths of our current system, which delivers unparalleled quality care to most Americans. Unfortunately, it appears that Congressional efforts will do just that. It seems clear that their plan to push for “affordable health care” won’t really mean less expensive health care; it will mean lower quality health care. This lower quality care and potential rationing will particularly affect women, children, and their families.
The time for reform has come. All Americans must get the medical treatment they need when they need it. In reforming our system, we should begin by recognizing what American medicine does right.
First, U.S. care emphasizes quality. Indeed, America leads the world in medical research. This is why people come here from around the world when they get sick. If you want to routinely enjoy the newest advances in drugs and technology, you want to live in the U.S. Health statistics disguise some of America’s strengths because many of us make poor lifestyle choices. But doctors work hard to make us healthy again: Americans enjoy better cure rates and speedier recoveries than anywhere else in the world. Particularly striking are the better survival rates from cancer in the U.S. compared to other countries.
Second, American care emphasizes patient choice and the doctor-patient relationship. While insurance companies are often demonized, we are far better off with many competitors offering a variety of plans than getting stuck with a government “one-size-fits-all” system. Indeed, Americans expect to choose their doctor and to change doctors when they desire. Often we don’t appreciate the importance of patient choice until we lose it-when we end up in an insurance plan which doesn’t include our long-time family doctor, for instance. But even then we can go outside the policy if we are willing to spend more. Most Americans have far more health care alternatives than others around the globe.
Third, more than 250 million Americans are insured. Clearly, we have a moral obligation to worry about the millions of Americans who are uninsured, yet it’s important to understand that the notion that 46 million of us are uninsured is technically accurate, but misleading. Many of the uninsured are voluntarily uninsured: 40 percent have incomes above $50,000 annually. Nearly as many are poor, but are already eligible for government programs. About ten million of the uninsured are not American citizens. About eight million people are chronically uninsured-that’s entirely too many, but not nearly as tragic as 46 million.
Fourth, every one of those eight million receives medical treatment. The lack of health insurance doesn’t mean a lack of health care. Hospitals are required to treat people, irrespective of financial status. This isn’t a good situation, since patients do not receive proper preventive care, hospitals get stuck with unnecessary costs, and emergency rooms end up treating people who belong in a general practitioner’s office. Nevertheless, it’s important to recognize that America already has a system of universal health care, flawed though it might be. Thus, a firm medical foundation exists. Any reform program should build on this base, ensuring that “affordable” health care means lower cost, not lower quality, and that “universal” health insurance means raising the standard of care for the uninsured, not lowering the quality of care for the currently insured. Unfortunately, virtually every proposal for turning medicine over to government would do the opposite on both counts.
The basic structure of most government “reform” plans is to provide coverage for everyone and, since expanding coverage inevitably increases costs, both limit benefits for patients and impose price controls on providers. The details do little to change the ultimate result: lower quality care and fewer choices for all. This is the inevitable result of any system which turns control of health care over to government. Nationalized systems always ration health care. Governments might declare health care to be a human right but, as Sally Pipes of the Pacific Research Institute observes, “Access to waiting lists is not access to health care.” In Canada, the country of her birth, it is easier for a pet than a human being to get a MRI or CT Scan.
This doesn’t mean that the government should do nothing to try to reform our health care system. One of the most hopeful recent medical trends has been the rise of consumer-directed care. That is, patients taking a more active part in choosing both their coverage and treatment. Washington, backed by the states, should encourage this process. Moving the tax deduction for health insurance from employers to individuals, expanding health savings accounts, creating a national market for health insurance, eliminating special interest state insurance mandates, further limiting abusive medical liability litigation, providing income-adjusted vouchers to help low-income people purchase insurance, reducing regulatory burdens on low-cost medical clinics, and introducing more options for Medicaid and Medicare recipients are just a few of the ways that policymakers could build on the strengths of U.S. medicine by expanding health care choice and quality for virtually all Americans.
Health care reform is a critical issue. But it is essential that policymakers do it right. True reform should provide all Americans with more access to doctors of their choosing, more treatments of their choosing, and less interference from insurance companies, Washington bureaucrats, and special interest groups.
Michelle D. Bernard is the president and CEO of the Independent Women’s Forum and Independent Women’s Voice and is an MSNBC political analyst. Bernard is author of Women’s Progress: How Women and Are Wealthier, Healthier and More Independent Than Ever Before.