Iowa Caucuses Kick-Start 2008 Election: Center for Health Transformation Outlines Bold Plan in Des Moines Register
Today Iowans begin the process of electing our next president. Whoever that may be, healthcare will most certainly be at the top of his—or her—agenda. In an op-ed for The Des Moines Register, The Center for Health Transformation's Founder Newt Gingrich and Project Director David Merritt outlined a comprehensive approach to lowering healthcare costs, improving quality, and achieving 100 percent coverage. This op-ed is a summary of a detailed plan to transform health and healthcare that will be released in March.
Tackling costs of health care requires some huge changes
By Newt Gingrich and David Merritt
SPECIAL TO THE REGISTER – June 13, 2007
From presidential candidates and trade associations to governors and industry coalitions, it seems that everyone has a plan on how to extend health insurance to the 45 million Americans without coverage. While they have their hearts in the right place, they fail to grasp the magnitude of the problem.
The uninsured crisis is a symptom of the larger structural problem of rising health-care costs. As in medicine, we must cure the disease, not just alleviate its symptoms. By driving down costs and making health care more affordable for every American, we can achieve 100 percent coverage. But to get there, we must implement four transformational changes.
1. Individuals must take an active role in becoming healthier.
Diabetes and obesity kill hundreds of thousands of Americans and cost our system hundreds of billions of dollars every year. But such deaths are, overwhelmingly, a consequence of poor individual choices. Individuals must be incentivized to make better decisions. For example, Blue Cross Blue Shield of Michigan introduced Healthy Blue Living, where individuals can save 10 percent or more on their premiums, co-payments and deductibles if they work with their physician, exercise, eat right, control chronic conditions and don't smoke.
Personal responsibility extends to the purchase of health insurance. Citizens should not be able to cheat their neighbors by not buying insurance, particularly when they can afford it, and expect others to pay for their care when they need it. However, an individual mandate is an acceptable option only when the larger health-care system has been fundamentally changed. It is unjust to require an individual to buy into a broken and dysfunctional system.
2. We must create a culture of health that leads to responsible choices.
We can do this by redesigning how public and private institutions influence individual behavior. For instance, parents and the public-education system have failed to control childhood obesity, a rate that has tripled since 1980, according to the Centers for Disease Control.
To reverse this, physical education should be required for every student in grades K through 12 five days a week. Students should be weighed, their body mass index calculated, and the results and relevant educational material sent home to parents. School lunches, breakfasts and vending machines should promote healthful foods, so that unhealthful alternatives are penalized or prohibited.
Grocery stores in poor neighborhoods should receive tax incentives to provide a wide selection of fresh fruits and vegetables. The food-stamp and WIC programs should be redesigned to incentivize purchase of healthful foods. State and local governments should make significant investments in bike paths, sidewalks, public parks and recreation programs to encourage physical activity.
3. We must dramatically improve and modernize the way we deliver care.
We should eliminate any financial incentive to do any test, treatment or therapy that does not directly benefit the patient or add value to the care process. Payments to doctors and hospitals must change from a transaction-based to an outcome-based model. This will encourage the use of new technology, such as electronic health records, and adherence to evidence-based medicine, which will lead to higher-quality, more efficient care.
4. We must radically change the way we finance health insurance and health care.
Between individuals and their doctors are hoards of middlemen and red tape as far as the eye can see. Putting the consumer squarely in control is essential, so that the individual citizen is the primary driver of cost reduction in health care.
Consumers should have the right to purchase a health-insurance policy from anywhere in the country, creating a truly competitive, national market. Health Savings Accounts should be available to everyone, regardless of how or whether they obtain insurance, and HSAs should be opened and funded for low-income individuals and families. Information on provider performance and price, as well as that of insurance companies, should be available to consumers - before they receive care.
We should incentivize the individual to root out waste by pursuing better care at lower cost. And individuals who purchase their own insurance should receive the same tax benefits as employers who provide coverage.
The health-care system as currently designed is incapable of insuring every American. It will always result in rising costs, poor quality and an unhealthy population. Any plan to cover the uninsured that builds upon such a dysfunctional system throws good money after bad. We can do better.
With real change, we will lower costs and make health care affordable for every American, and that will lead to 100 percent coverage. Our country and our citizens deserve nothing less.
Former House Speaker NEWT GINGRICH is founder of the Center for Health Transformation. DAVID MERRITT leads the "Insure All Americans" project at The Center.
