Donald Trump’s early cabinet picks are indications of how serious he really plans to be about certain issues. His choice of Georgia’s Tom Price for secretary of health and human services shows he’s very serious about repealing and replacing Obamacare.
Price, the Roswell physician just re-elected to a seventh term in the U.S. House, has spent years delving not only into health policy but, as chairman of the House budget committee, into federal spending more broadly. If Trump wanted someone who could bring a deep knowledge of both federal health policy and its funding, there’s no better choice.
The work starts with repealing Obamacare, but it hardly stops there. Over the past several decades U.S. health care has become progressively — pun intended — more centralized and heavily regulated. It’s also grown steadily less sustainable, both financially and in human terms.
Democrats had their shot at fixing America’s broken health system and produced a law that only made matters worse. The Obamacare expansion of Medicaid poured billions more into a program that, as shown by studies including an important running one out of Oregon, doesn’t work well for patients and doesn’t change their unwanted behaviors (such as visiting the emergency room for non-urgent needs). The “junk” insurance plans President Barack Obama decried as cheap but often useless were replaced by high-deductible plans that were expensive but often useless. The many mandates and restrictions for health-exchange plans left insurers offering different flavors of the same unappealing coverage — leading fewer and fewer insurers to offer fewer and fewer plans.
Despite the left’s derision about “free-market health care,” rare is the American too young for Medicare who has seen anything approaching a free market in health care.
It is not a free market when people visit doctors they didn’t necessarily want, in “provider networks” they didn’t get to choose, using overpriced insurance plans that may not provide benefits until they’ve racked up bills totaling hundreds if not thousands of dollars, paying for care subsidized by third parties, at prices they don’t necessarily know beforehand.
Under Obamacare, millions now do all this just to avoid paying a tax penalty, although they might also incur a tax penalty if their insurance plan costs them or their employer too much money.
Are we really surprised this system doesn’t work? And do we really believe so strongly in an either weaker or bolder version of it that we won’t try something different?
“Something different” is where Price comes in. By leaving Congress, he won’t be around to help draft Obamacare’s replacement. But by joining the Trump cabinet, he will be in position not just to advise those who do write it but to ensure it works as intended.
A number of things should be on the table, including: giving states the flexibility to customize care for the poor through Medicaid block grants; restoring health insurance as actual “insurance” against ruin in major events rather than what amounts to prepaid care plans; broader use of Health Savings Accounts; fewer mandates that restrict competition and more that promote it, such as requirements for price transparency; and modernizing the Food and Drug Administration’s agonizingly slow and extremely expensive approval process.
Those who have rightly criticized Washington’s current health policies can’t shrink now from making the changes they identified as necessary. Price is the right man to lead that charge.