"The problem with socialism is that eventually you run out of other people's money."
—Margaret Thatcher
With a projected $1.8 trillion deficit for 2009, several trillions more
in deficits projected over the next decade, and with both Medicare and
Social Security entitlement spending about to ratchet up several
notches over the next 15 years as Baby Boomers become eligible for
both, we are rapidly running out of other people’s money. These
deficits are simply not sustainable. They are either going to result in
unprecedented new taxes and inflation, or they will bankrupt us.
While we clearly need health-care reform, the last thing our
country needs is a massive new health-care entitlement that will create
hundreds of billions of dollars of new unfunded deficits and move us
much closer to a government takeover of our health-care system.
Instead, we should be trying to achieve reforms by moving in the
opposite direction—toward less government control and more individual
empowerment. Here are eight reforms that would greatly lower the cost
of health care for everyone:
- Remove the legal obstacles that slow the creation of
high-deductible health insurance plans and health savings accounts
(HSAs). The combination of high-deductible health insurance and HSAs is
one solution that could solve many of our health-care problems. For
example, Whole Foods Market pays 100% of the premiums for all our team
members who work 30 hours or more per week (about 89% of all team
members) for our high-deductible health-insurance plan. We also provide
up to $1,800 per year in additional health-care dollars through
deposits into employees’ Personal Wellness Accounts to spend as they
choose on their own health and wellness. Money not spent in one year
rolls over to the next and grows over time. Our team members therefore
spend their own health-care dollars until the annual deductible is
covered (about $2,500) and the insurance plan kicks in. This creates
incentives to spend the first $2,500 more carefully. Our plan’s costs
are much lower than typical health insurance, while providing a very
high degree of worker satisfaction.
- Equalize the tax laws so that that
employer-provided health insurance and individually owned health
insurance have the same tax benefits. Now employer health insurance
benefits are fully tax deductible, but individual health insurance is
not. This is unfair.
- Repeal all state laws which prevent
insurance companies from competing across state lines. We should all
have the legal right to purchase health insurance from any insurance
company in any state and we should be able use that insurance wherever
we live. Health insurance should be portable.
- Repeal
government mandates regarding what insurance companies must cover.
These mandates have increased the cost of health insurance by billions
of dollars. What is insured and what is not insured should be
determined by individual customer preferences and not through
special-interest lobbying.
- Enact tort reform to end the
ruinous lawsuits that force doctors to pay insurance costs of hundreds
of thousands of dollars per year. These costs are passed back to us
through much higher prices for health care.
- Make costs
transparent so that consumers understand what health-care treatments
cost. How many people know the total cost of their last doctor’s visit
and how that total breaks down? What other goods or services do we buy
without knowing how much they will cost us?
- Enact
Medicare reform. We need to face up to the actuarial fact that Medicare
is heading towards bankruptcy and enact reforms that create greater
patient empowerment, choice and responsibility.
- Finally,
revise tax forms to make it easier for individuals to make a voluntary,
tax-deductible donation to help the millions of people who have no
insurance and aren’t covered by Medicare, Medicaid or the State
Children’s Health Insurance Program.
Many promoters of health-care reform believe that people have an
intrinsic ethical right to health care—to equal access to doctors,
medicines and hospitals. While all of us empathize with those who are
sick, how can we say that all people have more of an intrinsic right to
health care than they have to food or shelter?
Health care is a service that we all need, but just like food and
shelter it is best provided through voluntary and mutually beneficial
market exchanges. A careful reading of both the Declaration of
Independence and the Constitution will not reveal any intrinsic right
to health care, food or shelter. That’s because there isn’t any. This
“right” has never existed in America