Health Care Alternative: Consumers, Not Government, Knows Best

This is big, what’s happening. President Obama appears to have misstepped on a major initiative and defining issue. He has misjudged the nation’s mood, which itself is news: He rose from nothing to everything with the help of his fine-tuned antennae. Resistance to the Democratic health-care plans is in the air, showing up more now on YouTube than in the polls, but it will be in the polls soon enough. The president, in short, may be facing a real loss.


Peggy Noonan, “Common Sense May Sink Obamacare,” July 24, 2008, Wall Street Journal

His lectures, explaining his health-care proposals, and why they'll be good for everybody, are clearly not going down well with his national audience. This would have to do with the fact that the real Barack Obama—product of the academic left, social reformer with a program, is now before that audience, and what they hear in this lecture about one of the central concerns in their lives—his message freighted with generalities—they are not prepared to buy. They are not prepared to believe that our first most important concern now is health-care reform or all will go under. The president has a problem. For, despite a great election victory, Mr. Obama, it becomes ever clearer, knows little about Americans. He knows the crowds—he is at home with those. He is a stranger to the country's heart and character.

Dorothy Rabinowitz, “Obama’s Tone-Deaf Health Campaign,” Wall Street Journal, August 13, 2009

On the defensive because of an increasingly skeptical public, President Barack Obama has recently spoken extemporaneously about his health plan. In doing so, he has revealed his lack of understanding about aspects of medical practice and the reasons for rising health-care costs.

Scott Gottlieb, MD, Obama and the Practice of Medicine, Wall Street Journal, August 14, 2009

The solution sounds simple, and it is. To create a real market, we need to hand consumers the money companies now spend for them. Then, employees would own their policies and carry the coverage to the next job. Today, millions of workers cling to jobs just to preserve their health benefits. The result of liberating them would be a revolution, with providers tailoring a galaxy of new plans -- rich, high-deductible, and everything in-between -- to the needs and budgets of consumers writing their own checks.

Shawn Tully, “Designing the Ideal Health System, “ Fortune, August 14, 2009

It is no co-incidence I have picked the above quotes from business publications, for a market-driven system is the best low-cost alternative to Obamacare.

You won’t hear this from the White House, or Congress, or most of the major media. Their mindset is that the government knows best, and that mandates, profit caps, fines, penalties, price controls, and a web of regulations issued by government officials and wise men in the capitol are necessary for “affordable care with choice.” That is the message from those who control the Bully Pulpit and who set the media agenda.

Another Message

There is another message – health care consumers know best. Liberate them to spend their own money, to buy their own policies free of federal standards, shop for the best value from doctors and hospitals, and carry their policies from job to job, and, in the end, they will make the right decisions.

It’s a message from the marketplace – the customer is always right. American consumers, on balance, are usually right and have more common sense than government when it comes to a dysfunctional economy, to shopping frugally, to minimizing taxes, and to avoiding long-term debt.

Yes, consumers will make mistakes, but not on the scale that government does. When you’re writing your own checks and saving money for retirement, and picking health care that’s best for you will spend your money more wisely. You will ask: What does this cost? Can I afford it? How does this doctor compare to other doctors in cost and outcomes?

But it is a message that a center-left government, led by a center-left president has a hard time accepting. It violates their fundamental belief system – that they are born and bred to govern and only they have the intellect and moral sense to lead the people to the promised land, which is more government, more controls, and more dependency.

Enough moralizing on my part. Here is a recent letter to the editor I wrote to the editor of the Wall Street Journal, which says it all, or most of it.

To the Editor:

Dr. Scott Gottlieb’s August 14 piece, “Obama and the Practice of Medicine,” is on point. President Obama is out of touch with clinical realities. A remote government bureaucracy can’t possibly regulate all medical decisions at the point of care. Patients and doctors must have a direct stake in prices, as well as outcomes.

Furthermore, the President is tone-deaf about American culture. Americans trust doctors more than government. Patients desire prompt access to modern medical technologies, they rely on doctors’ clinical judgment, and they want collaborate with doctors to make their own medical decisions.

The best way to do this is through health savings accounts with high deductibles. More than 10 million Americans now own this accounts and participate in high deductible plans. This approach sensitizes patients and doctors to cost and induces doctors to compete on the basis of price and outcomes.

Richard L. Reece, MD, Old Saybrook, Connecticut

Dr. Reece consults with The Physicians’ Foundation and is the author of Obama, Doctors, and Health Reform: A Doctor Assesses the Odds for Success (IUniverse, 2009)