The solution is freedom

I believe our healthcare system and its challenges need to be addressed in a new way that empowers our strongest asset in controlling the spiraling cost of healthcare: the U.S. consumer.

As you know, healthcare costs in the U.S. are increasing more than 30% faster than the rest of the economy and will consume 17% of our gross domestic product by 2011. (The U.S. spends less than 4% of its GDP to provide for the national security of our great nation.) This level of spending and inflation makes our current system unsustainable and real reforms are going to be necessary as our population ages.

Since World War II, when health coverage became a more widely offered employee benefit, healthcare spending has increased from 5% of our economy to 16% today. Systematically, the eye of the healthcare consumer has been removed from the marketplace. Whether it is employers offering a single insurance option or the government making healthcare choices on behalf of the elderly and the poor, consumers have been increasingly distanced from the decisionmaking—particularly those decisions based on costs and quality. The result has been a system with costs increasing at rates that are neither sustainable nor practical.

The solution is freedom for the consumer to pursue his or her own healthcare choices. Therefore, I propose three major reforms that would bring the consumer back into the healthcare equation:

Freedom to buy health insurance across state lines. Under current law, individuals and small businesses are required to purchase healthcare plans that are offered in their state of residency. Therefore, the health insurance customer is held hostage to state legislators and regulators who impose an increasing number of mandates on the marketplace.

For example, the average individual policy in the state of New Jersey costs $6,046 per year for a family of four, while a similar policy in Iowa costs only $1,965. This disparity in health insurance premium costs can largely be attributed to the level of mandates imposed by the respective states. New Jersey insurers are required to cover 41 mandates (including chiropodist and occupational therapists) vs. the 23 mandates imposed by the state of Iowa. Families and small businesses in New Jersey should be allowed to shop across state lines for the healthcare policy that best meets their needs, avoiding systems that encourage mandates.

Freedom to make informed healthcare choices through public disclosure. Today, when a consumer decides to make a purchase such as a new car, the buyer is empowered through easy access to information to find the best deal. With just a couple of clicks of the mouse, the buyer can find clear and concise information on the vehicle including price, reliability, upgrades, customer reviews and maintenance costs. Sadly, this same level of information is denied those seeking to purchase healthcare.

This lack of information keeps the consumer/patient hostage to the false market that has been negotiated between the hospital and the insurance company. Consumers should be permitted to find the highest quality of care for the lowest price. Therefore, hospitals and other healthcare providers should be required to place their fee schedules online or otherwise make them readily accessible for potential consumers. This return of market forces, open competition and empowered consumers would result in falling healthcare costs and rising care quality.

Freedom to innovate in order to save money and improve medical outcomes. Over the past 30 years, eight of the 10 most important medical breakthroughs originated in this country. The U.S. is home to some of the best medical minds in the world, yet government-driven healthcare fails to reward innovative thinking and new methods in hospitals.

The government bureaucracy that is Medicare determines the means by which a patient will receive care by mandating a payment scheme based on a particular treatment protocol. Should a doctor find an equally effective and less expensive manner by which to treat a patient that further involves less time in the hospital, the reimbursement rate for the process is significantly less and, in some cases, does not cover the total cost of care. Therefore, government management actually encourages expensive and more-ineffective care over better, less expensive alternatives.

Unfortunately, Medicare is slow to implement these innovations in protocols. Therefore, I propose the creation of four test hospitals—one university hospital, a public hospital and two community hospitals—that would, under the direction of an established commission, be deregulated institutions that would safely implement new procedures and cost-saving measures in order to determine and implement systemwide protocol improvements. By agreeing to participate, Medicare would cover all patient expenses not covered by insurance, including all revenue loss. In return, the institution would agree to strict oversight by the established commission and follow all protocols.

This pilot project would bring innovation back to healthcare delivery and identify in a rapid, safe and appropriate manner, changes in the system that would increase healthcare quality and reduce costs.

Rep. Duncan Hunter of California is a Republican candidate for president.

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