NEWS of The Controversy is slow today, so we’ll go off-topic and give you our thinking on one of the problems currently vexing the Congress — health care reform. This is a bit of a stretch for us because we have no expertise in this area; but we have far more sense than Congress, so we can’t possibly do worse than they’re doing.
What we suggest requires no congressional action whatsoever. Nor should there ever be any, because the Constitution gives Congress no authority over non-military medical matters.
We propose three simple ideas, any or all of which can be implemented by the states. Unlike the bill currently in Congress, our proposal isn’t 2,000 pages long; it’s only one page — this one. Here it comes:
1. Tort reform legislation. This isn’t a new idea. Wikipedia has an informative article on it: Tort reform, which includes a section specifically on the healthcare industry. To illustrate what we have in mind, the Wall Street Journal, in this article about the latest congressional health care bill, says:
Huge contingency fees and damage awards are the mother’s milk of frivolous lawsuits. That’s why 30 states have adopted caps on awards as the core of their reform, with huge success. Texas imposed malpractice caps in 2003, and the state has been rewarded with fewer lawsuits, a 50% drop in malpractice premiums, and a flood of new doctors. [That is, doctors are moving to Texas from states with high malpractice insurance costs.]
2. Reciprocity statutes to encourage interstate insurance competition. The concept is simple. One model would be state statutes that provide reciprocal recognition of concealed-carry handgun laws. All a state needs to do is pass a law saying something like this: “Any insurance company authorized to do business in (for example) New York, California, or Texas, may sell in this state any health insurance policy approved by any of those states, under the same conditions.” That would allow more competition and an increase of available choices. Reduced cost to the consumer — or at least a lower likelihood of cost increases — would be virtually assured.
3. Scholarships to increase the number of doctors and nurses. Why? It’s simple economics — if we increase the supply of qualified people providing medical services, we reduce the cost of those services. (Conversely, if we merely increase the number of bureaucrats in the system, as Congress proposes, that will inevitably increase costs.)
Speaking of cost, if a medical student’s scholarship with an adequate stipend costs $50K per year, then a thousand such scholarships would cost $50 million. Instead of a grant, the student aid could be in the form of a loan, to be forgiven, say, at a rate of 20% per year for each year the recipient practices in the state. Every state can afford this. A few states do it now, at least to some extent. See: Loan Repayment/Forgiveness Scholarship Programs.
We can even make a state’s scholarship program financially painless for the taxpayers, but here’s where it gets Curmudgeonly. For every scholarship granted, the state can fire a mid-level bureaucrat in some obscure and unnecessary state agency. Every state has thousands of such employees (Florida, for one tiny example, regulates Colonic Irrigation). Could we somehow survive without such state services? For the most part, when clerks aren’t harassing the citizenry they’re sitting in their cubicles consuming jelly doughnuts and producing flatulence. What’s preferable — thousands of new doctors and nurses, or thousands of government functionaries? By reducing the number of such drones, the state will gain medical practitioners, break even financially, and everyone will benefit. If the dismissed bureaucrats are as wonderful as politicians claim they are, they’ll find jobs in the real world.
That’s our plan. As we promised, it didn’t require 2,000 pages. We don’t pretend that it will solve all problems, but by increasing the number of doctors and nurses, and lowering malpractice premiums, we’ll bring down the cost of medical care. Interstate competition will make medical insurance more available and affordable.
Unlike the bill in Congress, our plan doesn’t cost a trillion dollars — it costs nothing except for the scholarship program, and we’ve shown how the cost of scholarships can also be zero.
The increase in state bureaucracy is another zero; and if our method of paying for scholarships is adopted, there will actually be a decrease in bureaucracy. Best of all, the intrusiveness of the federal government will be zero.
The politicians keep telling us we have a health care “crisis.” If so, the states can adopt or expand these measures now. What are they waiting for — a miracle cure from Congress? You know that ain’t gonna happen.
Copyright © 2009. The Sensuous Curmudgeon. All rights reserved.