The cost for Americans to purchase “insurance” via the ACA, their employer or individually has continued to rise. Many are blaming that rise on a lapse in subsidies for ACA exchange plans.
But the facts suggest the exact opposite. More subsidies are an unproductive band-aid solution for a structural problem in health care that’s driving up the underlying costs: Patients don’t have control over their own health care dollars.
Instead, patients are stuck with substandard coverage and watch their hard-earned dollars and taxes go to fund administrators and billing departments instead of care.
America cannot prevent the upward spiral of overall health costs until we empower patients with the ability to control and direct their money for their own medical care.
Congress can start by actually listening to patients about what flummoxes them in our health care quagmire. The vast majority of Americans believe the health care system is rigged against them.
It’s easy to see why: Government programs, insurance companies, and large hospital systems all seem to prioritize the business side of care over the human side. Administrators now outnumber doctors in major healthcare settings by a ratio of ten-to-one. Large hospital systems continue to buy up smaller practices every year, raising prices and lowering quality.
Lawmakers seem to forget that these power-hungry corporations aren’t afterthoughts of bad policy. In fact, overfed third parties — which include insurers and government programs — are driving the costs. Lawmakers also forget that they represent the people and not corporations.
We’ve seen what happens when consumers are left without any choices other than ACA plans, a problem created when the government granted insurance companies the role of providing these plans. ACA premiums have risen each year, except for the years between 2018 and 2022. Deductibles have followed the same trend, with an even sharper rise in private insurance metrics. Americans were promised affordable care in 2010, but since the ACA was instituted, we are paying more for less, as everyone, especially the most vulnerable are often unable to get care.
It defies logical thinking that U.S. House Democrats, plus seventeen Republicans, passed a three-year extension of the ACA subsidies, thereby continuing to send money directly to the very companies that Americans distrust most. What’s worse is that many know there is a better way forward than continuing to subsidize failure and poor patient outcomes.
A better way is to fund people directly. Take away control and dollars from insurance companies and return them to the patients who need them and can best choose based on their individual needs.
It’s a commonsense solution that has not been addressed by politicians and policymakers until now. Americans hopefully had a thunderclap realization that when they control their own money, less of it is gummed up in the complex machinery created by insurers and the government. Even better: Patients can direct their dollars to choose the kind of personal medical care that everyone craves.
With policies like government-funded health savings accounts (HSAs), the options are limitless. Americans can pay for doctor’s visits, purchase prescription drugs, or save the money if they don’t require them. In one fell swoop, lawmakers can develop a tool for financial freedom while putting patients in the driver’s seat of their own care.
Last year, Senators Bill Cassidy (R-LA) and Mike Crapo (R-ID) unveiled a plan that involved government-funded HSAs as a load-bearing pillar. President Donald Trump’s Great Healthcare Plan included similar language, as the president has been a champion of sending health care dollars “directly to the people.”
Lowered costs are just the start of the benefits of giving patients’ power back. Such policies have effects far beyond what patients can see when they open their health care bills. When patients control the dollars, patients can shop for value, and those who care for them will need to compete for their business. Health care price transparency, a bipartisan ask for decades, could open a free-market renaissance in healthcare .
The time to act is now. Leaders in Congress and the administration will need to move ahead with meaningful health reform before Capitol Hill morphs.
Lawmakers hear this: Put patients in control in 2026 and empower them with choices before America locks itself into another toxic relationship with health care mediocrity.
Marion Mass, M.D., is a practicing pediatrician in Bucks County, a leading member of the Free2Care movement, and a member of The Independence’s advisory board.
Reprinted with permission from The Independence by Marion Mass, M.D.
The opinions expressed by columnists are their own and do not necessarily represent the views of AMAC or AMAC Action.
Way to go legislators, if you want to decrease the population. Government in my health care takes away my choices. I dislike the health care providers my plan has chosen to be on it’s limited list. Give the money to me and let me choose my own care and practitioners.
How did people manage without government agencies and departments and branches then, in time where there were no councilors, advisors and and help of all sorts, analysts and personal trainers. Teachers were in charge of the classrooms, principals in charge of schools, parents in charge of homes and children, somehow everyone knew their responsibilities and all functioned OK. Doctor was in charge of his part of the business, pharmacist of the other, patient chose. No nightmarish endless paperwork that no one even looks at, not being lost in the quick sand of bureaucracy a peon on a chess board , moved as necessary. How did this straight from Kafka nightmare became a reality , There is not one aspect of life that government branch does not control. This heard is doomed unless it stampedes.
Congress needs to act. Both sides of the aisle have been kicking the can down the road for too many years. The passage of the Affordable Care Act did nothing but raise premiums, provide us with less care, and cause many physicians to stop accepting insurance plans, or abandon their practices because of the stripping of their fees coupled with soaring costs. There were many physicians present at the protests in D.C. prior to the ACA being passed into law who knew where this would lead. There were many decent health care plans (mind you, not cadillac plans”) that were in place through employers that were stripped of their benefits, while the cost of the plans continued to rise. Funny isn’t it that at the time of the passage of the ACA, some news outlets were reporting that several unions to which the Democrats were beholden were able to have their insurance plans waived from the ACA rules and provisions. I personally had to pay additional fees every year on top of the rising premiums and lower coverage just to remain on the insurance through my spouse’s employer. The employer attributed this to the ACA. Congress, allow insurers to write policies throughout the country – a little competition can go a long way. Government run health care is a joke which can be observed simply by looking at the health care systems of Canada and countries across the pond. There’s a reason why people from other countries who can afford to do so come to America for health care – to escape the government-controlled systems in their own lands. Congress needs to work with President Trump to fix this and stop standing in the way. Although, it does seem that many members of Congress would be quite happy with government health care so that they have control. One can only hope if this is where the road leads us, that Congress and all employees of the federal government will be subjected to the same.
H.E.L.P!!!