President-elect Donald Trump and the Republicans in Congress are being urged to scrap the idea of comprehensive health insurance as they work out reforms, or wholesale ditching, of the Affordable Care Act.
Guaranteeing comprehensive health insurance directs consumers to make bad choices, as well as costing $1 trillion in government subsidies every year, according to health care analyst Brian Blase, a senior fellow at George Mason University’s Mercatus Center.
“I think comprehensive health insurance has produced a lot of problems resulting in no one knowing what prices are, and reduced the incentive for consumers to be good shoppers,” Blase told Patient Daily. “Government policy is biased in favor of comprehensive health coverage. As a general point when thinking about reforming the health care system, you have to tackle some of the big problems and one of the worst is that bias.”
Blase is unsure, however, if there is the political will or numbers to scrap the idea that everyone must have comprehensive health care.
“I do not know, but I think we should try and move in that direction whatever we do,” he said.
Under the Affordable Care Act, all new individual policies sold after Jan. 1, 2014, must cover the 10 essential health benefits with no annual or lifetime caps.
In a piece published by Forbes, Blase argued that adding up the costs of Medicare, Medicaid, Obamacare and the tax exclusion for employer-sponsored insurance, the federal government is providing more than $1 trillion in subsidies for comprehensive health insurance each year.
“The subsidies tend to be delivered directly to insurance companies or hospitals,” he said. “Outcomes would undoubtedly be far better if financial assistance was provided directly to consumers and market forces —producers attempting to satisfy consumer desires and consumers looking for the best deals — were allowed to flourish.”
In the Forbes post, Blase cited an essay by David Goldhill, author of How American Health Care Killed My Father.
Goldhill advocates for a consumer-centered health care system, making use of different forms of financing for different elements of care.
“With routine care funded largely out of our incomes; major, predictable expenses funded by savings and credit; and massive, unpredictable expenses funded by insurance,” he said.
Blase believes that when considering what should replace the Affordable Care Act, Congress and the Trump administration should focus on the drivers of excessive spending, especially comprehensive health insurance.
“By doing so, president-elect Trump can best attempt to deliver on his promise of 'great health care for much less money,'” he said.
Trump’s health policy, as published on his website, does not directly address the issue of comprehensive health insurance.
The future U.S. president did promise a more consumer-centered system, allowing people to shop across state lines and use Health Savings Accounts (HSAs). Contributions into HSAs would be tax-free and should be allowed to accumulate, according to the policy statement.
