By Gregory L. Schneider
Wichita (Kansas) Eagle
Here is a quiz: Which presidential candidate said the following?
"Have you ever wondered why is it that in America, patients cannot choose their own doctor? Why, in the land of the free, do government bureaucrats, insurance companies and employers make your health care decisions instead of you?... The answer is simple. Unlike every other aspect of American life, there is no free market in health care."
Time's up. None of the candidates is responsible (and that may be a problem for voters next year).
The person behind the words is Sen. Tom Coburn, R-Okla., who will be speaking at the 10th anniversary dinner for the Flint Hills Center for Public Policy in Wichita on Friday. Coburn will speak on his prescription for a healthy America.
Coburn has introduced a bill, co-sponsored with Sen. Jim DeMint, R-S.C., under which "patients have the control to make their own decisions and can select from competing health care plans and providers." Labeled the Universal Health Care Choice and Access Act (S.1019), the proposal is nothing less than a complete reworking of the health care system.
Coburn proposes to do this by changing the tax code that governs the current system. "The existing tax code discriminates against individuals who do not receive health insurance from their employer, and that has contributed to 46.6 million Americans who have no health insurance," he said. Employers receive tax breaks, which have led to a government subsidy for "health insurance" rather than "health care." This has created a third-party payer system that prevents individuals from controlling their own health care decisions.
Coburn proposes a tax rebate for individuals to purchase health insurance and encourages the use of health savings accounts. Combined with a qualified high-deductible insurance policy (generally covering catastrophic costs), HSAs are a key part of the patient-power reforms he envisions.
Coburn also proposes designing insurance plans to fit individual needs, to do away with community rating, allowing insurance to be purchased across state boundaries (similar to auto insurance), creating price transparency, and allowing for portability of insurance should the consumer change jobs.
For Medicare, Coburn proposes a number of reforms, including rewards for choosing healthy behavior, offering competing plans and changing Medicare's chronically low reimbursement rate.
Coburn's proposals go a long way toward maximizing individual control over health care decisions and allowing for a true market in health care to develop. You aren't hearing such things from the presidential candidates, but thank goodness someone in Washington, D.C., is speaking out about the need for patient-power reforms of health care.
Gregory L. Schneider of Topeka is a senior fellow with the Flint Hills Center for Public Policy in Wichita.