Tom Price: Healthcare decisions should be made by patients, not government or insurers

Since the beginning of the healthcare reform debate in 2009, President Barack Obama has frequently told the American public that Republicans don’t have alternatives to the Affordable Care Act, known to most as “Obamacare.”

But that’s not true. Rep. Tom Price (R-GA) has, for the third consecutive Congress, proposed the Empowering Patients First Act, a comprehensive alternative that addresses some of the main issues current facing the American healthcare system, including cost and access to quality healthcare.

Price’s approach to healthcare is unique. He spent nearly 20 years working in private practice as an orthopedic surgeon and he takes seriously the commitment doctors make to patients and their families.

United Liberty talked with Price about the Empowering Patients First Act on Friday at his district office in Roswell, Georgia.

Patients should be in control of their healthcare decisions

One of the most frequent criticisms of Obamacare is that it gives Washington and insurance companies more control over the healthcare system. Price, who has served in the House since 2005, explained that his approach to healthcare differs from Obamacare because it would put crucial healthcare decisions back in the hands of patients.

“Patient-centered to me means that patients and doctors are making medical decisions, not government, not Washington, D.C., not even insurance companies,” Price told United Liberty. “It ought to be patients and families and doctors.”

“The President continuing to state over and over that Republicans have no alternatives, they haven’t put anything forward, is not only disingenuous on his part, it’s outright deceitful,” he declared. “And what we’ve seen now is Obamacare through the implementation phase, through the sign-up phase, and now we’re seeing the construct of what it’s going to be like for the American people. And it’s not going to be good.”

Price explained that his opposition to Obamacare is because the law “violates every single principle that [doctors] hold dear when it comes to healthcare.”

“Whether it’s affordability, it’s raising costs, whether it’s accessibility, it will decrease and is doing so the ability of folks to get even minimal healthcare,” he said. “Quality, it’s decreasing quality. Responsiveness or innovation, it is violating those principles. And then it’s limiting the choices of the American people.”

Addressing the cost of healthcare

Price recognizes that the cost of healthcare is a very serious issue that must be addressed. But Obamacare doesn’t address this. In fact, he explained that the law actually adds more costs through expensive mandates and bureaucracy.

Unlike Obamacare, the Price’s proposal doesn’t have any mandates, meaning that the so-called “essential benefits,” which are partly responsible for higher health insurance premiums, would be nixed. What’s more, there is no individual mandate to purchase coverage, yet another fundamental difference in approach.

“What we recommend through the Empowering Patients First Act, HR 2300, is to say that look, you gotta get everybody covered, you can’t have folks out here walking around without health insurance, the system doesn’t work when they’re not covered,” Price noted. “But they need to be covered with insurance that they want, not that the government forces them to buy or tells them that they must buy under penalty of law.”

“The way that we do that is through the tax code,” he explained, equating later it to a “coupon” for whatever health plan an individual wants. “Tax deductions, tax credits, refundable tax credits, advanceable refundable tax credits, so that every single American has the financial feasibility and opportunity to purchase coverage, again, that they want for themselves and their family, not that the law is telling them they must purchase.”

Price also recognizes that there are some Americans who are priced out of the insurance market because they have a preexisting condition. His proposal would allow those people to pool together to help keep healthcare costs down.

The Empowering Patients First Act would also reduce the cost burden on taxpayers to the tune of $2.34 trillion over the next 10 years, according to a dynamic score of the legislation by Douglas Holtz-Eakin and Stephen Parente of American Action Forum.

Price spokesperson Ellen Carmichael told United Liberty that they have requested a score from the Congressional Budget Office (CBO), the nonpartisan fiscal analysis and research arm of Congress, but haven’t heard back. It’s worth noting that Holtz-Eakin served as director of the CBO from 2003 to 2005.

Decoupling insurance from employment

Most Americans are used to receiving health insurance benefits through their employer, a practice currently encouraged by the government through generous tax deductions. But free market advocates have criticized the employer-based system because it’s take healthcare decisions out of patients’ hands and hides the true cost of coverage.

Price also sees this as a problem.

“We ought not have a system where if you change your job or you lose your job, you lose your health coverage,” he said. “Right now, between 60% and 65% of the American people get their health coverage through their employer. If they changed their job or they lose their job, they ought not have to get a different kind of health coverage when they move to the next job that they have.”

For young people, the Georgia Republican explained, this could mean anywhere from 12 to 15 different employers in their lifetime and, under the current system, 12 to 15 different healthcare plans.

“The way that we solve that is very simple, we make it so everybody owns their own coverage regardless of who’s paying for it — so it’s like a pension plan, it’s like a 401(k) plan,” Price said. “If you change your job or you lose your job, you simply take your health coverage with you and plug it in there.”

Price contends that the employer-based system isn’t responsive to patients because, ultimately, they don’t own their health plans. Insurers don’t look at them as their customers, rather they treat the employer or third-party administrators as the customer. But if patients were left in control of their heath insurance, insurers would be responsive to their concerns.

“When you own it, then they know you’re the customer,” Price explained, “that means that they want to be responsive to you and what it sets up is a system that’s much more patient-centered than insurance-government-employer-centered.”

A new, unique approach to tort reform

Republicans have frequently pointed out that medical malpractice lawsuits is one of the areas that are driving up healthcare costs. This came out during the congressional debate over Obamacare after a CBO report found that enacting tort reform would reduce the federal budget deficit by $54 billion. Unfortunately, no real steps were taken to end medical lawsuit abuse.

Price, however, takes this issue head-on in the Empowering Patients First Act, and does so through a very unique approach.

“People get confused. They think that lawsuit abuse reform is simply to help decrease the costs for the doctors and hospitals to purchase malpractice coverage. That’s not it at all, that’s a minimal amount,” Price explained. “The real big cost driver in healthcare is the practice of defensive medicine.”

“It’s the things that I did as a physician, it’s the things that every single doctor in this country does to make certain that if they’re ever called into a court of law for a malpractice case, that they can honestly look the judge and the jury in the eye and say I don’t know what you wanted me to do, because I did everything,” he said. “When in fact everything is rarely necessarily to either diagnosis or treat a problem. That’s the practice of defensive medicine.”

A 2010 Jackson Healthcare study found that defensive medicine costs Americans up to $850 billion each year — approximately a quarter of all healthcare spending in the United States —  and that 92% of surveyed physicians practiced defensive medicine in the preceding 12 months.

“This is $800 billion of wasted money in our healthcare system,” Price noted. “You talk about driving up the cost of healthcare for every single American and health coverage for every single American, this is it. It’s the largest cost driver in healthcare, and Obamacare does nothing to decrease those costs.”

The Empowering Patients First Act would require the federal government to enter into a contract with a “qualified physician consensus-building organization” to “develop best practices guidelines for the evaluation and/or treatment of medical conditions.” These guidelines would be used to determine whether a doctor who is the subject of a medical malpractice lawsuit acted appropriately in diagnosing and treating a patient.

“If the patient wants to take a physician or a hospital to court, then they ought to be able to do so. We ought not limit that at all. That’s a right that is guaranteed in our Constitution,” Price said. ”But we ought to make it so that if the doctor does the right thing, it has to be a higher standard. You have to have clear and convincing evidence that they didn’t do what they were supposed to do.”

“This is a lawless administration”

In discussing Obamacare’s top-down approach to healthcare, United Liberty suggested that the law was “one step below” a socialized healthcare system, sort of knocking those who have glossed over control the law gives to the federal government.

But the Georgia congressman had an interesting take on it in terms of the administration’s unilateral delays and changes to the law, which include delays of the employer mandate and an “administrative fix” for canceled health plans.

“I’m not certain that it’s even one step below because of the dictates and the mandates in the program, and the manner in which the President has treated this program, that is to make up the rules as he goes along,” Price said. “It is even, I would suggest, worse than a socialized program because it’s not even accountable to the legislative branch that passed it in the first place.”

“This is a lawless administration as it related to healthcare and continues to put in place things that the American people simply don’t want,” he added.

If you interested in learning more about Rep. Tom Price and the issues he’s pushing in Congress, you can keep tabs on him on Twitter, Facebook, and YouTube. You can also learn more via his official congressional website.

 


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