The Senate once again is heading into the operating room to try to “fix” the U.S. health-care system. But beware of legislators wielding a scalpel. Both patients’ bills of rights that senators are carving up are fatally flawed. It will drive up costs, cause millions to lose their health insurance, force more private physicians into group practices, and spend more health-care dollars on lawyers. The most hotly debated issue is whether patients can sue their health plans. A bill by Sens. Edward Kennedy (D., Mass.) and John McCain (R., Ariz.) would rely much more heavily on lawsuits than a competing bill introduced by Sens. John Breaux (D., La.) and Bill Frist (R., Tenn.). But with either, the new wave of litigation could bankrupt health plans and divert billions of dollars from health care to lawsuits. Why do consumers need an act of Congress to make the market more responsive? This is America! People are used to getting what they want, when they want it, for the price they’re willing to pay – but not in the health sector. The solution, however, is not to create a bureaucratic maze of impossibly complex legislation and lawsuits. Instead, we should have a system in which people can choose the health plans that suit their needs, plans they have bought directly or through groups negotiating in their best interest. Of course, people should be able to sue their health plans, but lawsuits should be their last resort. First, they should be able to vote with their feet and select a plan that caters to their needs. Then, if they are denied care, they could take their health plans to court for breach of contract just as they would under any other contract arrangements. Why can’t they do that now? Because they don’t own their health insurance policies and therefore have little recourse in either the marketplace or in the courts. Most Americans get their health insurance as a benefit through their jobs because tax law makes this arrangement so attractive. But this also means that the employer owns the health insurance policy and decides the terms. Whoever controls the money controls the choices. If it is employers, they will pick the health plan and decide the terms. If it is government, it will create tens of thousands of pages of regulation to govern the spending of every penny. The long-term solution is for people to select and own their own health insurance, picking a policy that best suits them, just as they do every day in purchasing life, home and car insurance. Competition will force health plans and insurance companies to respond to the demands of their customers for high-quality, affordable coverage. A number of initiatives being considered in Congress would help consumers get their own private health insurance by directing refundable tax credits to individuals. This option also would begin to revitalize the fragile and shrinking market for private health insurance. The real cure will be a health-care system in which people make their own decisions about the health coverage they want, coverage they can take with them if they move, change jobs, retire, or start their own businesses. This would be a giant step in the right direction toward a responsive free market for health insurance – one in which health-care dollars go to medical care, not lawsuits.
Grace-Marie Turner is president of the Galen Institute (www.galen.org), a not-for-profit public policy organization in Alexandria, Va.