The administration claims that it simply wants to create a "healthcare exchange" in which there is a menu of options including a "public option" to compete with the more than 1,300 private companies now offering coverage. The government’s idea of competition is probably very much like that kid in your neighborhood growing up whose dad owned the field where you played baseball. He got to make up the rules regarding baselines, foul lines, where the bases were, etc. If you disagreed, he threatened to have his dad kick you off the field.

The brat’s team always won. -- From "Baseball, health care and government control Part 1"

The stated goal of the administration’s overhaul of America’s health care system is to reduce costs, provide broader coverage and improve quality. Those are all desirable goals but the current house proposal will actually increase the federal deficit by $1 trillion over 10 years according to the most recent Congressional Budget Office estimate.

It will, by the President’s own admission, fail to provide health care coverage for up to 10 million currently uninsured people. As I stated in Part 1 of my column, if this were strictly about reducing costs and increasing coverage (I invite you to sit and think about that math for just a moment) then obviously the current house bill is a loser. Then why is this being pushed so urgently?

The White House sees a historic opportunity to grab one-sixth of the world’s largest economy and make it their very own. They know that this opportunity will go spinning off into the universe very soon, never to be seen again. The lexicon of single-payer, universal care, advisory panels will go the way of the pet rock and mood rings.

Here’s a truly radical thought, especially for this administration. Why not let free market principles lead us out of this morass? According to Milton Friedman, free markets are the most efficient and fair mechanism we have to allocate resources. Here are some suggestions:

1.) Allow insurance companies to compete nationwide. Currently insurance companies are tightly regulated on a state to state basis. This ends up producing a very limited selection based primarily on who was there first and who can give the most during campaigns. Let’s open this up and see truly competitive pricing and coverage.

2.) A complete review of in-office procedures. As a radiologist, I’m prevented by law from ordering a test from a facility in which I have a financial interest. But if I’m an internist or cardiologist I can own as much equipment as I like and order anything. The law needs to reflect the current business environment and eliminate the in office exception to the Stark II law. According to a 2006 General Accounting Office report, in-office imaging for Medicare Part B rose from 6.9 billion in 2000 to 14 billion in 2006. When you consider that imaging is only a part of in-office procedures and Medicare is only a part of the overall reimbursement landscape, we’re talking serious money.

3.) Require 12 years of health and physical education in the public schools. I hate unfunded mandates as much as the next conservative. But in the past 20 years the public schools have done our populace a huge disservice. In our zeal to create a more culturally diverse and sensitive population, we have cut these programs and created the most obese population on earth. The cost of this is going to be enormous. In addition, the population is so illiterate regarding it’s own health they’ve become poor healthcare consumers.

4.) Require publication of price lists of all procedures and services. This is a thorny subject in medicine. The current thought is to charge whatever the carrier will pay. This suppresses competition in the marketplace. Healthcare consumers cannot comparison shop based on price. This also suppresses quality in medicine since a poor provider can get the exact same payment as a great provider. People will pay for quality if they know the difference.

5.) Begin the move away from government involvement in healthcare. This is completely counter to the current move in Washington. Good. The original cost for Medicare in 1965 was $3 billion. The current unfunded liability for Medicare (obligations for current citizens over the next 75 years) is $34 trillion. Even if the current Medicare tax is increased to 15% it will still be insolvent. Medicare was supposed to be pay-as-you go. Just like the current White House proposal.

If allowed to evolve, the American healthcare system will not only be a model of efficiency, it will continue to be the envy of the world in medical innovation. Otherwise we are condemning our children and grandchildren to a lower level of care and a lower standard of living.

To read previous articles by Dr. Timothy Baker, click this link to access the Archives Page.

Dr. Timothy Baker is a practicing radiologist and a partner in Radiology of Huntsville in Huntsville, AL. Currently he serves as Vice-Chairman of the Department of Radiology at Huntsville Hospital. Dr. Baker currently is a sitting board member of Hosea 4:6 Ministries.

Disclaimer: Opinions expressed are solely the opinions of the author and may not reflect the opinions of Radiology of Huntsville, Huntsville Hospital or any other healthcare provider.

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