Physician Patient

To lower costs and increase access to quality health care, we need innovation, marketplace competition, and expanded patient choices

Successful reforms must ease limitations on both demand and supply, promoting innovations that can alter the nature of health care delivery and lower costs.

The idea is to identify every potential limit on the supply of health care services, and then [if feasible] eliminate it. If the United States doesn’t do this, other countries will, and America will lose its leadership position in medical innovation.
[D]octors came to believe that, for any set of symptoms (and given certain patient data sets), there is only one correct, deterministic treatment pathway. This has stifled the variation that innovation requires.
[H]ealth coverage [has become] not so much insurance as prepaid medical care.

  • Taxes. Federal tax law favors employer-based coverage, which artificially lowers the cost of group insurance and raises the cost of individual plans. This may be the single most anti-competitive factor in the health insurance market, limiting the variety of available health plans. Breaking down these barriers could start with establishing tax parity for health insurance premiums and individual contributions to health savings accounts.

[H]ealth care innovators must be free to supply new goods and services and consumers must be free [and empowered financially] to purchase them.

  • [The FDA] can approve drugs in stages so that patients with serious, time-critical illnesses could gain early access, and benefit from “right to try” legislation that would grant terminally ill patients early access to drugs still in the approval process.
  •  [A]llow nurse practitioners and other professionals to practice independently (as they already do in numerous states) and authorize pharmacists to write certain prescriptions independently of physicians.
  • Reciprocity agreements or interstate licensing compacts could make it easier for doctors to move from state to state [and for their prescriptions to be honored in more localities].
  • [Training in inter-disciplinary treatment concepts and techniques:] Medical schools today remain focused on individual knowledge rather than [teaching and practicing in] the interdisciplinary teams and networks that characterize much of modern medicine. This results in overly specialized medical fields [and de-emphasis on effective collaborative, patient-centered  team work].
    • [Reform] Malpractice law. [Currently] Tort law invites lawsuits and discourages innovation while also raising costs. The vagaries of tort law also discourage the production of vaccines and the development of new drugs and devices. Potential remedies include capping awards for non-economic damages and shortening the statute of limitations on malpractice suits.

[Politically] This decentralized approach would eliminate the need for one [national] grand bargain—or for total control [of health care in] Washington, DC, by one party.

[My additions] and excerpts above on this fine Mercatus article from MPPA Board member Michael Ainslie, MD

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