The Patient-Centered Reform Solution
In former U.S. Senator Rick Santorum’s recent call to action in RealClearPolitics (July 4, 2019), he clearly stated that successful health care reform must be state-empowered and patient-centered. It must provide affordable access to health care that invests in the improved health and wellbeing of every resident, every patient in the communities in which they live.
Health caring – the passionate and effective delivery of “health care” – requires time, commitment, and human relationship. Government-controlled care, which is politicized, insurance-centric, and institutional rather than patient-centered, multiplies costs, and suffering at every turn. It diminishes the human person, human relationship, human dignity, access, and responsibility. It results in reduced life expectancy and increasingly sicker populations, in mind, body, and spirit.
As noted by Senator Santorum, the central features of reform therefore should include:
- the empowered patient,
- an active patient-physician advocate relationship,
- and the empowered state
According to a new study released by the Georgia Public Policy Foundation we can, in fact, effectively expand health care access and make health care more affordable by empowering states, patients, and physicians. As the preamble of the study notes, “This plan, specifically designed for Georgia, will decrease the number of uninsured, decrease costs for millions, and improve quality in a patient- centered system.” In the two innovations studied, individual market premiums would be reduced by more than $500 per member annually. For a family of four this means more than $2,000 savings per year. If the patient elects a plan with a direct patient-physician relationship, they will experience additional savings of more than $800 per member annually.
The reforms studied in the Georgia report are substantive and reflect the significant results of empowering states, patients and physicians. But the two innovations studied are just the tip of the spear. There are many other opportunities that are realized through a state, patient, physician empowered solution set.
We must open the door to other powerful innovations that are focused on caring for every patient, reducing the cost of care for every patient and improving the health and health care of every patient. The essential framework for such a policy includes the following provisions:
We must move health care policy out of the morass of Washington D.C. politics and centralized political power. We can accomplish this by providing the states flexible funding per resident so each state, based on its needs, its communities and its opportunities, can work aggressively to care for all its residents. The flexible funding provided to the state must recognize the success of the state in caring for all their residents, based on objective measures. This policy rewards states for caring for ALL, effectively improving the health care and the health and wellbeing of all residents.
All patients must be provided access to care at a fair price for quality care – with no pre-existing provisions or limitations.
All patients should be provided options and choices that reflect their values and priorities, understanding the requirements of whole health and wellbeing; mind, body, and spirit.
We must continue to provide employers (as market leaders) increased tools and incentives to actively invest in the improved health, health care and wellbeing of their employees. Policy leaders must work diligently to apply the positive effects of these innovations across the state and community marketplace.
We must provide expanded coverage choices. This includes access to Health Savings Accounts independent of insurance plans, so that ALL patients can save for their future health care needs in accordance with current contribution limits. These options must be available to Medicaid eligible, near eligible and Medicare populations. If a patient is actively engaged in the management of their health as prescribed by their physician, the plan should issue a wellness dividend to the patient’s Health Savings Account.
We must advance (as in the Georgia study) models of patient-paid Direct Primary Care so that primary care physicians go to work directly for their patients and not the insurance company, health system or government. The patient and their primary care doctor must build a relationship fully focused on caring and advocating for the health and wellbeing of the patient, lowering cost and improving care outcomes.
We must allow health care providers that directly care for uninsured patients to take an income tax deduction for the price of the care they donate to the uninsured patient. Doctors should be rewarded for their direct charity and every patient must know they are welcomed and respected.
We must specifically provide small employers (less than 50 employees) with the option to fund an employer Health Reimbursement Arrangement, so that employees can purchase insurance coverage in the individual insurance market. As the Georgia study illustrates, this opportunity is significant in its impact on reducing cost and the number of uninsured.
We are all paying heavily in money and blood for a broken health care system dominated by central government, the insurance industry and institutionalism. It is time to set a new path; liberate and empower states, patients and physicians to expand access to quality health care for all Americans. Nothing less is worthy of us.
David Wilson is the CEO of Wilson Partners, a health care consulting and policy firm dedicated to advancing patient-centered health care. David Hoppe is the former Chief of Staff to Presidential Candidate Jack Kemp, Senator Dan Coates, Senator & Leader Trent Lott, Senator Jon Kyl, and Speaker of the House Paul Ryan.