Doctors Are at a Breaking Point

Let’s begin by recognizing that America has some of the best healthcare in the world – the best doctors, highly innovative companies, and top-notch researchers. At the same time, it is complex, bureaucratic, and unaffordable for too many. So, fed up with the floundering and changing government response to Covid and inability to access many of the amazing options available in US healthcare, frustrated Americans have reached the point where all they want is to be allowed to assess the risks and make their own decisions free from government mandates.

So, Americans are now calling for solutions – they are calling for more personalized options – end mandates that keep healthcare costs high and access to care low, and trust Americans to make the healthcare arrangements that work best for them and their families. It's the direction we need to be headed as a country.

American healthcare has serious challenges. It costs too much, there's too much paperwork and too many surprise medical bills, and many parts of the country suffer from a lack of medical staff and facilities. But if there is one thing we should have learned from the Covid pandemic, it's that more government will not solve any of these problems – it would only make them worse. 

The Covid pandemic brought out the very best and worst of our healthcare system. On the plus side are our doctors and nurses who rose to the Covid challenges and the astonishing innovation that brought us vaccines, testing kits, and therapies in record time. On the downside are the government rules that frustrated the ability of doctors and nurses to treat the infected and the bureaucracy that kept the innovation bottled up at the expense of patients who desperately needed help.

A few examples.

First, Washington promised that giving federal regulators total control over the development of Covid-19 test kits would speed up their distribution. Yet there were delays as government test kits proved inaccurate, and labs and hospitals were barred from creating their own. More recently, although taxpayers have provided almost $83 billion for testing, we’re waiting in long lines and struggling to find self-test kits for sale.

Second, Washington promised that personal protective equipment and ventilators would be a priority, but this critical equipment was delayed by regulatory logjams. Hospitals were only allowed to buy masks from suppliers approved by both the FDA and CDC, which led to long delays and shortages in the early critical days of the pandemic.

Third, state certificate of need and licensing laws limited the number of hospital beds and kept doctors and nurses from crossing state lines to work where they were needed.

It was only when officials began removing regulatory barriers – as with Operation Warp Speed, for example – that we began to see healthcare innovation really make an impact. Sadly, for many, it was too late.

But now we have a chance to move in a different direction, away from government-centric approaches to health reform like "Medicare for All" or a public option and towards a "personal option" that expands choice, reduces costs, and guarantees universal access. 

We don’t need a complete overhaul of the system; we need to keep what works and fix what is broken. Here are just a few things we can do to foster more competition, lower costs, and increase access.

At the top of the list, expand access to Health Savings Accounts. HSAs are like 401(k)s for healthcare. Money put into an HSA is not taxed if used for a qualified medical expense. Unspent HSA funds roll over each year and accumulated funds can be invested to cover future medical expenses.

HSAs save money by giving people more control over how they use their healthcare dollars and rewards them for being smart consumers. The problem is they are only available to those with a high-deductible health insurance plan – just 10% of Americans. All Americans deserve access to this important tool for controlling costs.

Direct Primary Care is another innovative solution being stymied by outdated laws. In a Direct Primary Care arrangement, there is no health insurance company involvement. Instead, patients pay a flat membership fee to a doctor in exchange for primary care and preventative health services. But IRS rules limit the availability of Direct Primary Care arrangements. Those restrictions should be lifted.

Some 35 states have certificate of need laws, which require hospital systems and other healthcare providers to get approval from a state government agency before they can build a new hospital, expand facilities, or add equipment – even something as simple and necessary as adding hospital beds – in a particular area. "CON" laws essentially establish healthcare monopolies, usually in underserved areas, limiting access to medical services and increasing prices. They should be repealed.

A personal option would give Americans more choice and control over their own healthcare.  Importantly, it would not require any new taxes. Unlike Medicare for All or a public option, a personal option would give Americans the quality they deserve from the doctors they trust at a price they can afford.

Diana Girnita MD, Ph.D. diagnoses and treats adult patients for a wide array of inflammatory arthritis, osteoarthritis, autoimmune diseases, and osteoporosis.