Op-Ed: Empower patients, not bureaucrats

There are many domestic issues of sufficient magnitude to be honestly labelled crises. President Donald Trump has begun to address illegal immigration issues, the woke virus, and even the deep state. But the budget budget deficit and “entitlements” are still considered untouchable.

Health care has been a crisis for more than 60 years, increasingly unaffordable and even harder to get medical care. That is despite federal “fixes” such as Medicare, Medicaid, EMTALA, HIPAA, and ACA to name the more well known of a myriad of health care acts, executive orders, mandates, directives, rules, and regulations.

Washington’s solutions for health care have exacerbated the crisis. Wait times for primary care can now be as long as 132 days. Americans are dying while waiting in line for medical care – death by queue. In 2024, U.S. tax revenue collected was $5 trillion while total health care expenditures were $4.8 trillion, most of it from taxpayers. Average household medical expenses were $32,066.

Washington’s regulatory approach has consistently produced fixes-that-fail-or-backfire (archetype from systems thinking). The third-party payment structure disconnects patients from their money and usurps medical autonomy. Federal regulations divert half of all healthcare spending from paying for care to fund federal BURRDEN: bureaucracy, unnecessary rules and regulations, directives, enforcement, and noncompliance activities.

The lack of free market forces causes shortages, poor quality, slow service, and overspending, just what Americans experience today.

Health care must be fixed, or two things will happen: increasing numbers of Americans will die needlessly, and the U.S. will go broke.

A different approach has been suggested that involves unwinding the federal regulatory apparatus, reconnecting people with their physicians, and regaining control of personal health care spending. This plan, called the Empower Patients Initiative will immediately meet intense resistance from political realists who will shout the following.

• Health care is a right – that makes it a federal responsibility.

• Congress will never, ever go for EPI.

• We couldn’t possibly undo all those regulations.

• People can’t shop for health care like they do for a car.

• Think of all those people thrown out of work.

• Entitlements are the third rail: touching them is political suicide.

• Government health care works in countries like the U.K. and France. So, we need total federal control, like single payer.

Medical doctors and economists, like us, don’t think like political realists. First, they seek out the etiology of sickness or the root cause of system failure, giving no credence to what is considered politically possible. Then, they “dissolve” the root cause, thereby curing the patient or system.

The root cause of our health care crisis is federal control. The cure is to return control to individuals, called we the patients. The Empower Patients Initiative does that.

EPI is a multi-step, multi-year plan that gradually restores financial control to Americans, reduces federal bureaucracy, saves taxpayers trillions of dollars, and achieves affordable, accessible health care for Americans.

Some of the EPI steps include:

1. Preparation: Campaign to educate and energize the public includes writings, videos and public service announcements. Books for the general audience are released in English and Spanish titled, Empower Patients – Two Doctors’ Cure for Healthcare.

2. Transfer current employer-sponsored contributions from insurance companies – average $23,968 in 2023 – to employee paychecks. Tax-free if placed in no-limit HSA.

3. No-limit HSA: New family medical spending account with no restrictions on health care spending or deposit limits.

4. Medicaid block grants: States know best how to serve their residents; fixed amount given annually by Washington.

5. Medical safety nets: States choose how to provide for the medically vulnerable; one size definitely does not fit all.

6. Deregulate insurance: Allow people to purchase whatever policies they want.

7. Medicare: Transfer funds to senior no-limit HSAs.

8. Radical reduction of unnecessary bureaucracy saves taxpayer dollars.

These actions will transfer financial and thus medical control from third parties – private insurance and the federal government – to individuals and reestablish free market forces. Consumers – we the patients – will be well-funded payers; with a powerful incentive to economize, spending will decline. Sellers – providers, care institutions, and insurance companies – will have to compete for patients’ dollars, driving prices down and greatly improving service.

While resistance to EPI will start with the political class, others will initially be skeptical.

Congress will vigorously oppose EPI as it takes away power and money from their control. It is up to the voters to put people into Congress who will prioritize patients first and adopt the EPI.

The public may initially object as EPI is a big change, and change makes people nervous. Hopefully, the preparation campaign, particularly the “Empower Patients” booklet, will resolve the misconceptions and false facts that plague healthcare.

Medical doctors are likely to resist, at least at first. They are socialized so as not to compete with each other and will be reluctant to advertise or market their services.

However, those who embrace EPI with its free-market principles will quickly experience the advantages: bureaucratic hassle gone, greater income, more time with their patients, and a return to professional satisfaction.

In the fable of the lady and the tiger, the man doesn’t know which door holds what. In health care today, there are two choices: federal control or EPI, but we know which one leads to death (by queue).

EPI may be unknown to many people, but anything is better than dead and broke, which is where health care is currently taking we the patients.