The convincing re-election of President Trump provides an opportunity to put America back on the right track in all areas of our society that are in disrepair. Healthcare has not been a focal point during this election cycle because of the enormity of the other problems confronting us, but it is still important. President Trump has carefully selected individuals who are serious thought leaders in healthcare matters to lead it. Both incoming HHS Secretary Robert F Kennedy Jr and CMS Director Dr Memet Oz have been strong voices emphasizing that we are not a healthy society. They, among others, often state that our medical system is not focused on healthcare but rather on sick care. Turning this around requires a paradigm shift and bold actions.
Making America healthy again requires making healthcare great again. Americans are sicker not only because of bad habits, bad choices, and chemicals in our food supply but because people cannot afford healthcare and often forego seeing doctors or taking needed medication. The medical system is sick and needs an overhaul. Federal and state intrusion into healthcare has harmed the medical system irreparably.
The lack of competition in healthcare, the absence of a free market system, the over-regulation in the industry, and the favoritism shown to special interests in healthcare, including hospitals, are among the reasons healthcare is so expensive. Americans are not getting value for their money.
Physicians are advocates for patients, but less than 30% currently work for themselves. They are answerable to someone other than patients. This may mean hospitals that employ them or private equity firms that own them. In either case, decisions affecting patients may be based on financial and not medical considerations. Too much power in healthcare has been concentrated in hospitals, the most expensive places to deliver care and often not the best.
So here are some suggestions for Mr. Kennedy, Dr Oz, and all those who will work with them to fix healthcare. Understandably, many solutions need to take place at the state level or need to be codified by Congress, but some immediate action items would be a good starting point.
An immediate step would be to reinstate all the healthcare executive orders signed by President Trump, which were rescinded once Biden took office. Allowing patients to purchase short-term health insurance policies that address their needs rather than paying for expensive, one size fits all Obamacare-compliant policies would save individuals thousands of dollars.
President Trump supported Direct Primary Care during his last administration. This is a subscription model of healthcare delivery made between doctor and patient. No insurance is involved. The doctor works for the patient, and results in more affordable and usually better healthcare. Patients pay between $40-120/month to have a regular doctor who can manage over 90% of medical care in his or her office. Making it easier for patients to access this model is necessary. Allowing patients to access their Health Savings Accounts to pay the monthly fee for this arrangement is one way to make this happen.
Competition lowers healthcare costs. Onerous regulations have made it impossible for physicians to compete with hospitals. Obamacare prohibited physicians from opening hospitals or surgery centers that accept Medicare. The Stark regulations- a law protecting the public from physician “collusion”- make it nearly impossible for physicians to collaborate. This all needs to be eliminated.
The problems in healthcare requiring fixing are extensive, ranging from insurance reforms, eliminating middlemen in healthcare, as with pharmacy benefit management companies, tort reform, fixing VA healthcare, strengthening Medicare, overhauling public health agencies- CDC, NIH, and FDA, and eliminating DEI in healthcare and medical school curricula. Bold changes must be made to make healthcare tremendous and make America healthy again.
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