Health Care

Improved Health Bill

"Repealing" Obamacare is only a first step.


The House repealed Obamacare!

OK, they didn't really—but they passed a bill that repeals some bad parts of it, like the individual mandate tax, medicine cabinet tax, flexible spending account tax and health savings account withdrawal tax. Good.

Now the Senate will create its own bill and ask the Congressional Budget Office if the House bill will save money.

But Obamacare was so bad, I fear these changes are just Band-Aids on a collapsing system. Instead, the Senate should pass my seven-point plan:

1. Repeal Obamacare, all of it.

With premiums soaring and insurers pulling out of Obamacare, let's start from scratch with something better.

2. Repeal all regulations and tax breaks that encourage people to buy group insurance instead of paying for health care directly.

Insurance is sometimes needed, but insurance is a terrible, bureaucratic way to pay for things. If we pay our own bills, competition will explode and prices will drop.

3. Abolish Medicare.

This won't happen, I know. We old people love Medicare; it makes so much health care seem free. We are also more likely to vote, and math-challenged activists from groups like AARP convince old people that no cuts are needed.

But that's a lie. Medicare and Social Security are unsustainable. They will bankrupt America. Then few of us will get help we desperately need.

Since politicians won't touch these "entitlements," we'll have to keep them for those already in the system. But phase out everyone younger! Liberate people to shop around, so we can all benefit from price competition and new treatments.

4. Abolish Medicaid.

Why force poor people into one government-run bureaucracy? Ideally, private charity will take care of those who cannot pay for themselves. If you don't believe that will happen, give the poor money or vouchers and let them decide which things to spend it on.
The poor have a wide range of preferences just like the rest of us. We give people food stamps—but we didn't create a single food-provision bureaucracy. Medicaid's one-size-fits-all rules help the poor less than they help bureaucrats and crony businesses connected to government.

5. Don't punish private spending.

If an employer buys your health care, it's tax-free, but the feds take a huge cut. End that, so that individuals buy their own insurance. Pushing them into group plans is not fair. It also distorts the economy by locking people to their jobs. Moving toward individual Health Savings Accounts would be a step in the right direction.

Better still, end rules that restrict private care. Instead of celebrating those who try to provide health services, government wraps them in red tape. Set them free to do good works.

6. End government subsidies for hospitals.

Hospital prices skyrocketed once the government started subsidizing them and dictating how they must operate.

No matter how much business hospital owners and managers lose because of unhappy (or dead) customers, they'll remain stagnant as long as they can keep sucking up government money and as long as government rules make their decisions for them.

7. End government subsidies for scientific research.

People think we need government for "basic research," but they're wrong. The profit motive isn't perfect, but when the market funds research, you get more innovation—like faster mapping of the human genome.

The sad truth is that the National Institutes of Health has become like every other bureaucracy. Most grants go to researchers like my older brother, Tom. He's brilliant, but he's 75.

NIH's risk-averse grant evaluators feel safer giving money to applicants with long track records. But most innovation comes from young people. Mark Zuckerberg was 19 when he started Facebook. Apple's Steve Jobs was 21. Google's Larry Page and Sergey Brin were 22.

People assume the NIH research brings us most new treatments and drugs, but that's not true either. To quote my brother from this winter's issue of National Affairs, "Three separate analyses concluded that 85 percent of the drugs approved by the FDA since 1988 arose solely from research and development performed within … industry."

We are safer if we free the market.