Return control of our health system back to doctors and patients

by William Lawson, MD

Representative David Price recently wrote the Chapel Hill News to “set the record straight” regarding Washington’s newly‐passed health care legislation.

Rep. Price argues that the government’s central planning will make health insurance more affordable for small businesses and individuals. Touting tax credits covering 35% of premiums for small businesses with less than 25 employees and less than $50,000 in average annual wages, Rep. Price asserts that the new law will encourage small businesses to offer health coverage for their employees.

What happens if a business adds a 26th employee? Bye‐bye, tax credit. Now employees will be forced to choose between a pay raise and insurance, and employers will choose between hiring employees and offering health insurance.

Rep. Price doesn’t tell the 4th district that eligibility requirements for the credit are so restrictive that it will impede small business expansion. According to the National Federation of Independent Business, the tax credit, which has a 6‐year limit, will have little impact.

Rep. Price also claims that reform will lower insurance premiums for businesses and individuals through state‐based exchanges offering group rates. The nonpartisan Congressional Budget Office disagrees, however, and projects that insurance premiums with the exchanges will actually increase by 10‐13%.

Higher costs are inevitable with new federal restrictions that limit coverage options and end high deductible health plans, while preserving the monopoly enjoyed by the few insurers licensed to sell in North Carolina. To offset these more expensive premiums, we’re asked to fund subsidies that require expensive tax increases simply to provide guaranteed revenue growth to insurance companies. Additionally, this plan keeps in place the unfair advantage that allows businesses to purchase insurance with pretax dollars, while denying individuals the same favorable treatment.

Since President Obama signed the reform into law, he and Rep. Price have repeated the outright lie that reform will lower costs. To the contrary, the actuaries at the Center for Medicare and Medicaid Services (CMS) say health costs will continue to rise by $311 billion over the next 10 years with this reform, and will rise even more if Congress continues to postpone cuts in Medicare reimbursement rates.

Furthermore, CMS actuaries predict some 14 million Americans will lose their current, employer sponsored coverage. CNN Money recently reported that many large companies, such as Verizon, AT&T and John Deere are considering dropping employees from current health plans.

As a physician, patient, and parent, I know we desperately need health care reform. This misguided legislation moves in the wrong direction, however, by placing more emphasis on health “insurance” than health care. So‐called “insurance plans” with low deductibles and co‐pays are not insurance at all – they are simply middlemen that add cost, ration care, and stand between patients and providers.

Instead, we must return control of our health care system to patients and providers. Successful direct‐pay practices like Dr. Brian Forrest’s Access Healthcare in Apex provide the highest quality primary care while lowering costs by up to 90%. The secret is eliminating the middlemen, and the expense required to deal with government bureaucrats and insurance companies. In fact, Dr. Forrest’s Medicare‐eligible patients find that his cash prices are lower than their Medicare deductibles in a typical “high overhead” practice. His Medicare patients will typically spend more on their cell phone service each year than on health care.

The combination of low‐overhead, direct‐pay medicine for outpatient care with tax‐deductible healthcare savings accounts and high‐deductible health insurance for hospitalizations and surgeries is the best way to empower patients and providers, lift the burden from employers and small business, and provide affordable health care for every American.

William (B.J.) Lawson is currently running as the Republican candidate to represent North Carolina’s Fourth Congressional District and blogs at Lawson for Congress.

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  • ErnieG

    This is the type of thinking we need- the recognition that health care is between the patient and a physician, and that we need to strengthen that relationship. The current model and Obama’s plan weaken that.

  • Howard Luks

    What do say to this… of course the current model and the model which will arise from the reform debacle will be unsustainable. No question… rationing, long waits, failed practices, rise of the mega group or captive PCs will fill the hc landscape in America. The 900 Billion dollar tab put on the pkg will easily hit 3 Trillion and it will NOT improve the efficiency, quality or access to care as *promised*. I’m getting a little tired of reading articles that conclude that doctors and patients should control the health care system where the author stops there…. where are the White Papers? Where are the biz models? If we are going to be serious about this, we need to do far more than postulate that a system which minimizes third party and government involvement can be successful.

  • paul

    the health care system will not be returned to patients and doctors until it has been completely sucked dry of money.

  • BobBapaso

    B J you are right. A wide spread system of health care savings accounts will restore the doctor patient relationship and eliminate third party interference as it grows. Let’s stop complaining about what has gone wrong and talk about how we can all get one. I’ll keep working on the devils in the details at my blog:

  • Michelle

    Yeah, you’re right. We should totally throw in the towel and go back to the status quo with millions of uninsured who increasingly cannot afford your services. That ought to put food on your table. Absolutely. The bill isn’t perfect, so let’s go back to screwing the people until we come up with perfection… which will be never… but that’s your goal, right?

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