Transformational Health Care Reform

The American health care system is on an unsustainable path.

The increasing regulatory intrusion into health insurance has doubled down on the wrong incentives, and coupled with an aging population, is leading toward unsustainable government programs and a private system doomed to fail.

As a first step, health insurance should function like other insurance.

It ought to protect patients against the risk of significant, unexpected health care costs, rather than subsidize routine, minor expenses; and it should encourage, rather than minimize, consideration of price and value.

Sensible health care reform includes several key principles.

Health Savings Accounts should be a mainstay of health care payments, with far higher contribution limits and universal availability. HSAs promote consideration of price and smarter utilization of care, leading to lower costs and better health.

High-deductible plans and coverage with fewer mandates should be more widely available. They offer cheaper premiums and often meet the needs of younger, healthier people, as well as people who don’t value broader coverage.

The tax treatment of health care should be limited, to stop incentivizing more spending on health care. And the tax deductibility of health expenses should be the same for everyone, regardless of employment.

Medicare should be modernized to reflect today’s longer life expectancies and should include private insurance options and HSAs, to leverage the power of value-seeking by the elderly, the biggest users of medical care.

Medicaid should be transformed into a bridge to private insurance instead of expanding a substandard, separate system for the poor.

And the role of nurse practitioners, physician assistants, and retail clinics should be expanded to permit lower cost, more accessible primary care.

The pathway for broader access to high quality, affordable health care starts with increasing competition among providers and empowering consumers to seek value with their money.