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Healthcare Is this Year’s Political Football

November 5, 2018 - 11:45am

Healthcare is the political football of the midterm elections. But unlike the game of football, there are no rules. And the goal is to win -- not for the benefit of the team (the voters), but to gain status and power. Politicians are looking for a sound bite that catapults them into the spotlight. Spartacus was a dud. People like free stuff. Let’s try Medicare-for-All! Of course, the ads won’t mention that taxes will be doubled and private health insurance is essentially outlawed.

Currently, eight bills proposing variations of federally sponsored healthcare are on the horizon. If one bill fails, another one is in the queue. The government’s attempts to improve our “healthcare system” by top-down control of doctors and their patients have failed. For example, electronic medical records meant to streamline and make medicine more efficient have done the opposite: they are costly, non-interoperable and waste 50 percent of doctors’ time. Insurers exited the ACA marketplace -- decreasing choice and competition. Lower insurance premiums were a pipe dream, while the profits of pharmaceutical companies and insurers soared. Many people were unable to afford insurance and certainly could not “keep [their] doctor” whom they liked.

Not only is it prohibitively expensive, but central control will bring use of more government guidelines, some of which have proven to not be in patients’ best interest. For example, in contrast to private medical organizations, the U.S. Preventive Services Task Force recommends biennial mammograms for those over 50 years. Yet, the incidence rates for invasive breast cancer in women under age 50 has increased since the mid-1990s and breast cancer is more common in African-American women than white women in the under-45 age group.

Likely ignited by the limited choices on ACA exchanges, the personalized medical care movement was gaining steam. Accordingly, the Trump Administration made increasing healthcare freedom a key priority. A year ago, President Trump released an executive order “Promoting Healthcare Choice and Competition across the United States.”

First, the president expanded association health plans, increasing the options for small business and self-employed business owners. These plans allow certain businesses to join together across state lines to purchase health coverage. Next, to provide more options for individuals facing high premiums, a new rule allows for the sale and renewal of short-term, limited-duration plans that cover longer periods than the previous maximum of less than three months.

Last week, a new rule to expand health reimbursement arrangements (HRAs) was proposed. An HRA is a type of group health plan that allows employers (only) to fund medical care expenses for their employees on a pre-tax basis. Any unused portion of the HRA in one year may be carried forward to subsequent years. The rule would allow HRAs to be used to fund both premiums and out-of-pocket costs associated with individual health insurance coverage.

There is more to be done. We have to create a medical care world based on choice and competition and high quality at a reasonable cost. A world where bigger is not better and simplicity is a virtue: decreased reliance on third-party payers, transparent affordable prices, and Health Savings Accounts (HSAs) for all. HSAs could be funded directly by employers, or by tax credits, or allowing everyone to earn a certain amount of money free of income and payroll tax to go into a medical expense account. The funds could be used to pay for anything reasonably related to healthcare as determined by the states, e.g., insurance premiums, deductibles, co-pays, direct patient care monthly fees, and health sharing ministries’ costs. The funds would be taxed if used for another purpose. Major medical (catastrophic) insurance policies would be available to all with state subsidies for those not working.

In this brave new world of providing broad access to excellent, but affordable medical care, the financially and physically vulnerable are not forgotten. There could be a tax credit for donations to charitable organizations that pay medical bills, modeled on tuition tax credits, up to a limit separate from the medical expense account. If Americans still want a third party to insure them for all health-related needs, they have the option to do so.

Don’t be fooled by sound bites: control is not compassionate. Turning over our lives to others places us at their mercy. The happiest people -- even the disabled chronically ill -- are those who have control -- the feeling that life’s activities are “self-chosen.”

The government should set some basic rules, free from lobbying influence of industries that will benefit from government-run healthcare. And let patients and physicians take control of the ball and run with it. When the goal is giving patients the opportunity to choose their own path to great medical care -- rather than a politician’s short-lived glory -- freedom always wins.

Dr. Marilyn Singleton is a board-certified anesthesiologist and president of the Association of American Physicians and Surgeons. She graduated from Stanford and earned her MD at UCSF Medical School. She teaches classes in the recognition of elder abuse and constitutional law for non-lawyers.


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There will be fewer people going into the Medical Field with "FREE-for-ALL" getting overworked and under-trained! Canadians (all of whom have this) have LONG waits - wealthier Canadians come to America and PAY for more critical care - what does THAT say?

It says that you should actually document your claim - with statistics.

Dt. Singleton: Apparently you're sketchy when it comes to the ACA. I guess it must be the Republican in you because you certainly didn't learn compassion at Stanford or that 'University' here in Florida. I guess the elders you mention must be the wealthy elders who are covered by Cadillac health plans, unlike those 'beautiful' American plans which charge $196 per hospital stay for the first 1-10 days ; is this is your kind of compassion and concern, Doctor? We don't need a Republican-Trump disaster healthcare. Go back to school, Doctor and this time, try to learn something !

Universal Healthcare insurance is not a political football. The Democratic party is for it; the Republican party is against it. Pretty clear-cut. Similarly, the Republicans are also against Social security, medicare, medicaid, and a woman's right to choose. Hard to believe how regularly the Republican rank and file vote against their own best interests, but they do.

Bankrupting the government for your peoples free shi+ is not in anyone's best interests.

The opinions of Alien Life Forms do not count nor are ALFs allowed to vote. So, take a hike, Shumway, back to Malmecia or wherever!

The uninformed, uneducated proletariat are not mindful enough to know that right after the passage of the ACA in this state, its Republican leadership effectively deregulated the insurance industry by passing Senate bill 1842, so insurers could charge whatever they want in premiums and cancel whatever plans they wanted w/o legislative approval. Oh, and then conveniently blame it on the ACA... NOT!

One thing that is important to note my good Dr., is you have strong vested, financial interest in ensuring that things stay the same, and you continue to make the most you possibly can on healthcare. I'm not saying that is wrong or greedy, but important to note nonetheless. Something has got to change. Of the 10 most industrialized democracies, 9 have gov't run or "socialized" healthcare. "Socialized", that is the political catch phrase that political entities use to evoke fear amongst the populace. Who is the only outlier of the group? The U.S. Why? One word. Money. The insurance, pharmaceutical and medical lobbies are the top 3 in terms of real dollars in this country. Bottom line, politicians are protecting their cash cow. At what cost? The U.S. currently spends 17 times more on medical care than the next highest country. Some estimates put it at 3 trillion per annum. For that amount, surely we should be number 1 in the world in healthcare efficiency and performance, right? Wrong. According to the WHO, the US ranks 37 out of 191 in healthcare efficiency and quality. The top 10 in efficiency and quality are all gov't run. Why? They can negotiate rates and savings as a single provider or payor, that no other entity could even remotely come close, and also promote natural competition for efficiency and quality for positive results. They also effectively eliminate those aforementioned lobbies and their profit margins. Now you have the rest of the story...

Funny thing is that old out of air football AKA healthcare is the closest thing to a leget issue the Dimms have. And they even screwed healthcare royally. "If you like your doctor you can keep your doctor - most Americans will pay $2000.00 less...ect...ect"

Another Shumway comment just oozing with Republican wisdumb!

Keep several cry baby towels nearby because you are going to need them around 9:57PM Tuesday night. Remember how you cried when Hillary lost? Cry Baby Cry Baby Ha Ha Ha Ha Ha !!!!!!!

Yes, I do think this piece of crap, Shumway must have been dropped at birth like all republicans!

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