Healthcare is the most mind-numbing area of policy in America. A century of regulation, bureaucratic buildup, and financialization have rendered it so opaque an industry, that it can barely be comprehended. It’s become so financialized, we don’t even talk about it in terms of care anymore, we only talk about the financial tools we use to distribute costs: insurance.
Before we can change healthcare we have to change the debate around healthcare. It’s time to stop asking “who will pay”, we know who pays, we’re all paying. We’re paying with our lives and our livelihoods. Every life cut tragically short, every life never allowed to flourish, leaves a wound in the very being of our country. We’re paying with the lives of our healthcare workers who toil everyday under conditions that would leave most people in despair. We’re paying with our time and stress trying to navigate a byzantine system that puts bureaucracy above patients and providers. And we’re paying with $3.5 trillion a year, money that could be spent in infrastructure, education, ending poverty, paying down the debt, or just kept in our pockets. Stop asking “who pays”, start asking what we’re paying for.
Once you start asking what we’re paying for, you start to realize how grim things are. What does $3.5 trillion a year buy you? We have a declining life expectancy due to increased deaths of despair (suicide, drug overdoses, heavy drinking). We rank 44th in infant mortality. Imagine being the wealthiest country in the world and being incapable of preserving newborn life. Not just that, but we struggle to preserve the life of the mother as well.
For all the money we spend, we find ourselves less healthy than comparable countries who spend significantly less. We consume less healthcare and pay far more. We spend nearly eight times the OECD average on healthcare administrative costs and how well administered do hospitals seem to you?
So despite paying more per capita on healthcare than any other country we are far worse off. The next inescapable question becomes, “why?”. Why would we accept this system that takes our time, our money, our sanity, and delivers us nothing in return? How did this even happen? Aren’t we smarter than this?
Apparently not. The problem is that we’ve tied access to healthcare with health insurance and access to health insurance with employment. This has all sorts of negative impacts for healthcare and for the economy. It takes decision making power further and further out of the hands of patients and providers and concentrates it with bureaucrats. It keeps people tied to jobs for coverage. And it keeps wages down as employers must cover the cost of insurance and know employees are less likely to leave to maintain their coverage.
No one knows your health better than you and the further we take you away from the point of the decision, the worse it will be. By building a system around bureaucracy and profit, we’ve alienated people. We’ve made it such that the industry thrives and profits on sickness, not health. As it stands, every incentive is to treat, treat, and over-treat up till the point your insurance no longer covers it.
We have to change the incentives so the healthcare industry works for you and me and the doctors and nurses who keep it running. The priority has to be maintaining health and preventing disease. We have to reestablish the connection between patients and their providers and cut out the middleman. We have to separate healthcare from health insurance and health insurance from employers.
What Needs Done:
- Decouple healthcare from health insurance.
- Decouple health insurance from employment.
- Lower cost and improve quality of healthcare.
- Ensure access to healthcare for all Ohioans.
What I’ll Do:
- Create an interstate healthcare standards compact to simplify operation of healthcare providers across state lines.
- Explore how Ohio can pursue a Direct Care model while working within the stringent requirements of federal law and the ACA.
- Invest in new healthcare technology through expansion of the Ohio Third Frontier.
- Invest in new hospitals, targeting rural Ohio first, through a broad infrastructure program.
- Invest in our healthcare providers by expanding access to medical school, eliminating exhaustive paperwork, tort reform, and preventing burnout.
- Repeal Ohio’s Certificate of Need laws. CONs are effectively monopolies for existing medical facilities. They generally raise prices and reduce availability of medical services.