It is no secret that the United States spends more on health care than anywhere in the world and has little to show for it. I would like to make it clear to everyone first that no matter the structure of the health care system in the country, health care as is, is prone to waste, high costs, and lacking service. There is not one way to make health care work, a market system or a socialized system doesn’t necessarily matter all that much in the end so long as it works. Below I outline several proposals I think will improve health care for Ohioans whether the policies are implemented all together or just one or two. These proposals are a combination of deregulation, market solutions, new regulation, and government solutions.
Interstate Health Care Standards
It is often said by Republicans that health insurance companies should be permitted to operate across state lines. This is already the case, what is actually meant is that Republicans want insurance companies to be able to operate in any state without meeting the requirements of the state so that they could offer junk insurance at a low cost. I propose something different, something that actually will offer good health insurance across state lines at a lower cost.
I propose we coordinate with neighboring state governments to standardize our health care laws. This will allow health care providers to operate effectively across state lines without the additional cost of trying to comply with the bureaucracy of multiple states while maintaining quality. The more states we have coordinating, the cheaper and more effective it becomes.
I believe a simple step that could be taken to lower medical costs is for Ohio to allow nurse practitioners to operate their own practices without physician oversight. Many people see nurse practitioners for their primary care needs yet Ohio is one of several states that does not allow them to operate independently. By eliminating this regulation and allowing nurse practitioners to have their own practice we will improve the ability of Ohioans, particularly rural Ohioans, to receive primary care at a lower cost.
I feel the same could be done to an extent for dental hygienists. You are not likely to see your dentist for more than a minute or two, it is the dental hygienist that does the greater deal of work. Allowing a dental hygienist their own practice would also improve availability of service and lower costs. For any issues outside a hygienist’s purview, they could recommend a patient to a dentist.
Those most likely to be opposed to this shift would be doctors and dentists, those who stand to lose money. It is simply the case that where there is money to be made there is lobbying to be done of government. I encourage policymakers to remain resolute and take the action that serves the public welfare, not their pocketbooks.
Investment in Medical Research and Development
Ohio has global leaders in the health care industry like the Cleveland Clinic. We should leverage these existing institutions and invest in new medical technologies and new medical companies to grow this existing industry. This has two primary benefits with one policy initiative. First that advances in technology and a diverse market lowers medical costs for Ohioans as well as everyone in the world. Second that it grows Ohio’s economy and creates jobs. The health benefits of economic security are considerable after all. This investment can best be achieved by my major policy initiative of the Ohio Investment Bank.
Preventative Care for All
This policy is rather more ambitious than the others listed here and I am less certain of its effectiveness and its political feasibility. Nevertheless, I shall explain it to the best of my ability and open it up to discussion so that it can be improved or a superior alternative put forward.
As it stands now under the ACA all Ohioans must have health insurance and Ohioans have met this requirement from private insurance, employer provided insurance, government provided insurance, or simply failed to meet this requirement. First allow me to say I do not care for requirements on employers to provide insurance, I believe the point of so much government action in health care is to help alleviate the burden on employers. I would suggest a plan that eliminates this burden.
What I propose instead is that Ohio offer to all its citizens preventative medicine paid for entirely by the Ohio government. It would then be mandated that Ohioans purchase critical care insurance on their own. Preventative medicine is that which is meant to prevent the occurrence of illness rather than its treatment. This includes regular physicals, disease screenings, counseling, immunizations, birth control, and some prescriptions like insulin. I cannot at this time specify all that would be included, I think this would be a major policy that needs a fair amount of debate and consulting of relevant actors in the health care industry and the public.
This would improve the health of Ohioans over the long term because it would lower instances of more serious, more expensive illness. This improved health would, over time, lower costs for the government, Ohioans, employers, and insurance companies. Employers would not have to cover these costs anymore. Insurance companies would only have to cover critical care which are unexpected medical expenses and the instances of these unexpected medical expenses would decrease so insurance premiums would drop.
Market Application of Health Care Costs
This is a very simple regulatory change. Basically I support legislation that would require all health care providers to make all their prices for goods and services publicly available online in a searchable format. The expectation is that companies would quickly spring up to offer services that search this data and find consumers the best prices. Obviously in an emergency Ohioans aren’t going to search for the cheapest hospital in the ambulance but for every predictable medical cost Ohioans can plan ahead. This will steadily lower prices across the state as market forces will make health care providers operate more efficiently. Health care prices are inflated because insurance companies negotiate down prices for consumers, this is the primary service insurance companies seem to offer. With this service taken care of more efficiently by the digital age and market forces, one would expect insurance premiums to lower further as insurance companies focus on the primary task of collectivizing the risk of unexpected health care costs. It is a simple regulation that can accomplish much. Why hasn’t it been implemented yet? I don’t know, certainly one would hope it is not a result of nefarious motives of the health care lobby and our current legislators or the political parties that provide them their marching orders.
Growing the Economy
That’s right, growing the economy as a health care policy. Eliminating poverty and economic security are tremendous in improving one’s health. Our problems are complicated and interconnected, fixing the economy helps fix health care. Eliminate the stress of not knowing how to pay for things, of having to work three jobs to get by, of having to work unpaid overtime to keep a job, and you have better mental and physical health. Give people more money and the ability to make good health decisions, to go to the doctor when they’re sick, to eat healthy, to live comfortably, and their health improves both mentally and physically. It’s not difficult to understand. If we’re going to fix things in Ohio let’s do it right, let’s attack all our problems on all fronts all at once. To fix health care we must fix the economy, fix education, fix government, fix the environment, fix agriculture. It can be done, we just require the grit and resolve to do it.