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Steve Horwitz: 8 steps to reform health care, lower costs, improve quality and increase access
View related content: Carpe Diem
If you want to really reform health care and make it cheaper and provide easier access, you can start with the following, after you end the [UN]Affordable Care Act:
- End the tax-favored treatment of employer-provided insurance.
- End the limits on interstate competition in the insurance market.
- End the community standards legislation.
- Tort reform.
- Deregulate the supply side of the market by loosening or ending licensing provisions and the AMA’s monopoly on the supply of physicians.
Update from MP: Perhaps it’s more accurate to say that it’s the Association of American Medical Colleges that controls and restricts the supply of physicians. For example, the chart above shows that the number of medical school graduates was flat at about 16,000 per year from 1980 to about 2010. During that time, the US population increased by 36%.
- Encourage the development of more walk-in medical clinics and other ways of avoiding third-party payment.
- Encourage health insurance to be actual insurance for major medical problems, not third-party payment for routine health maintenance.
- Expand the use of pre-tax dollars in health savings accounts.
There are surely more. But all of these have been on the table as alternatives for years. They would work from both the supply and demand side to accomplish the goals of lower cost and higher quality care.
It would not guarantee universal coverage, but the cost of covering everyone is that you give up on lowering cost and will eventually have to ration supply. You cannot have lower costs, expanding supply, and universal coverage. At best, pick two.