This New Year, Congress Must Resolve to Deregulate

As we move into a new Congress – with new leadership, new committee chairs, and fresh faces – are we going to see more of the same out of Congress or will the institution finally perform its duties and fix the problems that we are all facing? While the smart money is on more Groundhog Day-style politics, now with McCarthy as Speaker of the House, the best decision that he could make would be to take bold stances.

Bold stances come with some political drawbacks. They will be less likely to pass quickly, less likely to garner full support of the caucus, and less likely to provide quick campaign talking points. However, bold stances would allow anyone who jumps on board to show that they have a vision, they have the backbone, they have the qualities that it takes to truly help make America a better country.

For instance, our healthcare system is broken, and there aren’t enough Band-Aids to fix it anymore. The problem is that year after year, problem after problem, and data point after data point, Congress has reacted by passing the buck and patching the system with short-term bandages rather than doing the hard work necessary to fix the system. Congress has passed laws for more paperwork, taking providers’ valuable time that could be otherwise spent with patients. Congress has lowered reimbursement rates, further limiting the time providers reasonably spend with patients. Congress has passed laws that restrict insurance plans, limiting patients’ choices for care.

Congress needs to look at what fewer regulations would do for the system, and this could easily be a bi-partisan push. As a guide, members of Congress could start by looking at the regulations that were lifted to deal with COVID. They made changes to Certificate of Need laws, they made changes to licensing requirements, and they made changes that allowed telehealth to flourish. These changes all gave providers and patients more freedom, more choice, and created a lot of flexibility in an otherwise straitjacketed system.

Without this deregulation, our over-regulated system would not have been able to adapt to the pandemic. And if it was good for a year or so, why not make it permanent?

The questions that members of Congress must ask themselves is did these changes increase access, increase quality, and decrease prices? The changes did. So, why should we still keep these regulations in place today? Why not roll them back for the long-term?

Then, empowered by deregulation, Congress could move their way through the system looking at what other regulations might get in the way – raising prices, decreasing access, and harming quality. Fortunately, there are some simple places to start. First, physician-owned hospitals were banned by the Affordable Care Act. Those regulations should be lifted allowing doctors to innovate in their own market. Second, Congress should consider a proposal like the Personal Option from Americans for Prosperity which increases access to care while also giving patients more freedom and more market control.

And, while deregulation might sound like a Republican word – the truth is that some of the most important deregulations over the past few decades have been pushed by Democrats. Under the Carter Administration, air travel was deregulated, rail was deregulated, and trucking was deregulated. This deregulation allowed the industries to flourish and expand, which allowed investments in the Reagan years to pour into them.

The only problem is that two competing chambers of Congress both need to decide to work together, they need to decide to lead, and they need to decide to make bold choices. Fortunately, they have two years before the next election, so they have time to work together, to compromise, and to lead before they can again separate and attack each other – hopefully for not being bold enough. For not giving individuals more choices and more freedom.

Boldness isn’t a short-run strategy, but if either Chamber wants to make a mark on history and public policy then they will look toward making the hard decisions that will lead to long-run prosperity and health.

Robert Dean MD, PhD is a Board-certified otolaryngologist practicing in Tucson Arizona.