Healthcare Reform

Proposal for

Libertarian Healthcare Reform

Affordable, High Quality Medical Care – Get More for Less

Benefits 

Medical services will be available when patients need them 24 hours a day, 7 days a weeks. Patients won't have to wait until Monday or pay extra for night or weekend emergency visits, or wait weeks or even months for an appointment.

Health care visits and online consultations will be longer and more efficient, giving both practitioners and consumers adequate time to fully discuss, diagnose, and treat their health conditions.

Most medical records will be digitized; there will be fewer medical errors.

Health care consumers will be able to better manage and control their health care problems.

Red tape, bureaucracies, and the resentment that comes with government subsidies for health care will be replaced by humane, loving, and dignified charities, along with one-on-one care.

Consumers will have a choice between more expensive or less expensive treatments.

The problem with overcrowded emergency rooms where people without coverage are forced to go for treatment will be at least partially resolved.

Anyone would be able to go to an inexpensive Primary Care Centers, use telemedicine and buy inexpensive drugs.

Millions of people not covered by insurance, including undocumented immigrants will be able to get primary care. If they have enough money to buy food, pay for an apartment and gas, they will have enough money to pay for their medical care once it will be available and affordable. 

Libertarian Healthcare Reform will not overburden the country’s budget and it will cost less to the consumers.

Addressing major problems:

For those who pay for medical care by themselves: currently we pay large premiums, co-pays, out of pocket expenses and deductibles. We can’t pay less than your monthly premiums. We can’t see a doctor without paying co-pay. The Libertarian Healthcare Reform offers you to save money every month by paying UP TO the same fixed amount as you must pay now.

Instead of paying a large fixed amount PLUS deductibles, out of pocket expenses and co-pays, you will pay small monthly premiums for catastrophic insurance and for insurance against loss of coverage. You yourself will have the power to choose providers and pay for medical services until you reach a certain limit. This is when your insurance coverage kicks in.

You get to shop around and make your own decisions based on the price and quality that you want, instead of paying the price and getting the services mandated by an impersonal, government bureaucracy. The Libertarian Solution will provide higher-quality and less expensive health care than what you have now.

For those who need help from society: today some of you are getting food stamps, others on a program that offers you assistance in housing, others getting help with education, and still others on a variety of programs that provide medical coverage. Society spends billions of dollars on people whose job is to provide you with the portion of assistance you are getting, and the services are often of poor quality. Instead of wasteful government programs, the Libertarian Healthcare Reform will provide you with one-stop assistance, and a choice of what to do with the money you will be receiving. Those who need assistance will get CASH from the taxpayers and they will be able to spend it the way they see fit.

If they decide to rent a bigger apartment, they can do it. If they want to buy more food, or get themselves better medical care, they can do it.

For the neediest, taxpayers will cover or subsidize catastrophic and loss of coverage insurance, plus provide cash payment.

Those unable to help themselves will get help until they can get back on their feet again.

For those who have pre-existing conditions: Under the laws proposed by the Libertarian Party there would be no such thing as losing insurance when you lose your employment or for any other reason. Part of your medical insurance premiums will go toward insuring you against loss of coverage. In other words, there will be NO problem with people who were insured, lost their coverage and as a result couldn’t find a carrier to insure them.

Once insurers are permitted to sell insurance at mutually acceptable prices and competition in the insurance market is not restrained (the same way all other products and services are sold), insurers will accept you but will demand higher premiums if you are at high risk of needing more health care than the average person. If you are sick and in need of more services than a client without pre-existing conditions, the insurer can still make a fair profit due to higher premiums.  So why would they drop you? If you can’t afford the higher premiums, society will pick up the difference between the regular payment you would pay if you would have no pre-existing condition and the payment that insurers will ask from you because of your pre-existing condition. 

The above offer is a win-win-win situation for everyone. It is better for those who can afford to pay for medical care by themselves, it is better for those who need public assistance, and it is better for the society as a whole. It will improve quality of life and available health care services for everyone. 

How it works:

1.     Problem: Medical care is expensive. On top of high monthly premiums, there are co-pays and out of pocket expenses that are becoming very hard to afford even for the middle class.

LPC solution: Repeal federal and state laws that regulate what kind of insurance the carriers can or can’t offer to consumers. Allow them to offer any product they want in any state they want and at any price they want (like it is done in all other industries and markets) including catastrophic insurance with high deductibles. With the lower premiums of such insurance, consumers will be able to use money they are now paying as premiums, for direct payments to medical care providers instead. They will be able to negotiate prices for services by themselves and save. Prices for medical care will drop rapidly, in some cases up to 80%.  Don’t believe that?  Check out comparisons between prices hospitals and physicians charge insurance carriers and what the very same providers charge medical tourists.

2.     Problem: Medical drugs are expensive, especially prescription drugs. Some drugs from smaller companies and abroad are not available because they don’t have FDA approval.

LPC solution: Change the FDA to an advisory body, funded by user fees charged to pharmaceutical companies. End prohibition on imports or foreign made drugs and on the sale of drugs not approved by the FDA. The FDA limits our choices and keeps drug prices artificially high. Allow import and sale of any medical drug exactly as it is done with food and food supplements. Respect the natural human and constitutional right to control our own bodies and be free from unreasonable seizures of property.  As a result, the price of medication, both approved and not approved by the FDA will go down significantly, and consumer choices will greatly expand.

3.     Problem: Loss of coverage happens due to loss of job or job change. This is unlike most other types of insurance, for example auto insurance that pays for damages and medical expenses due to accidents whether or not the policyholder continues to pay to the carrier after the accident happened. Medical insurance companies refuse to pay for treatment of the illnesses that were developed during the time policyholders paid their dues if policyholders stop paying their dues or change jobs in the middle of treatment.

 LPC solution: Introduce insurance against loss of medical coverage. Money paid for this kind of coverage, a form of secondary insurance, would create pressure for primary insurers to continue offering coverage or face subrogation claims.  Premiums would be low, because availability of insurance would not be tied to employment, and insurers would be free to adjust premiums over their user base as needed to cover the cost of claims, without being restricted by political barriers.

4.     Problem: Insurance companies refuse to insure people with pre-existing conditions and find all kinds of excuses to drop coverage.

LPC solution: Repeal or reform California and federal laws that favor or incentivize  employer-based coverage over individual/family coverage or non-employer based groups, and enable competition for health insurance from health care cooperatives/pools  and mutual insurance funds. As greater numbers of consumers shop for health insurance on an individual or family basis and insurers compete for business from individuals instead of employers, insurers will lose incentives for refusing or dropping coverage due to pre-existing conditions, for several reasons. For example, insurers that fail to treat their customers fairly will lose their reputations and business.  Lifelong insurance for catastrophic conditions will be much more common, as prices drop and individuals realize that nobody can be forced to care for them.  Non-profit mutual insurance and cooperatives will increase and more people will join such pools from birth and retain long-term membership. While transitioning to the new system,  people who experience coverage gaps due to pre-existing conditions now and those who can’t afford medical insurance, insurance against loss of coverage and cash assistance will be offered as outlined above and below (Item 10).

5.     Problem: There is a shortage of some medical care facilities and services, because people who would otherwise provide these facilities or services are prevented from doing so by laws passed to benefit special interest groups. For example, competent business people are excluded from organizing the majority of medical services to the consumers. They are not even allowed to form partnerships with medical professionals. This government-enforced monopoly is narrowing consumers’ choices and driving prices up.

LPC solution: Drop any and all regulations that limit participation of honest service providers in the health care marketplace, regardless of licensure or certification. Creative business people will bring competition and solutions to the medical care market, and with it, reduction of prices and increase in quality of services, as it has done in every other industry in the US.  Maintain legal protections against fraud and medical malpractice.

6.     Problem: Long wait times exist for appointments and procedures. Medical care in physicians’ offices and hospitals is very expensive.

LPC solution:  Allow opening of a network of Primary Care Centers staffed with nurse practitioners, doctors and other medical care professionals.  Allow health care providers to offer advice via Internet-based communication technologies. Such centers managed by business people will provide less expensive medical care, will be open 24/7 and will immediately shorten waiting in doctors’ offices, and encourage innovation and competition in health care, instead of stifling it by more regulation.

7.     Problem: Employers pay for insurance with pre-tax dollars, while individuals are forced to pay with after-tax dollars.

LPC solution:  Allow income tax – exempt Medical Savings Accounts (MSAs) to any and all insured, unless and until the income tax is itself repealed. Allow deduction from taxes any and all expenses made for health care treatment, prevention or improvement, including gym memberships, chiropractors, masseurs, vitamins, food supplements, weight loss programs, and similar products and services known to help preserve good health. 

8.     Problem: Each and every hospital and provider creates and maintains a medical history for each of their patients. On top of obvious mistakes and errors, it takes a huge amount of time and effort by the health care providers and raises the cost of medical care.

LPC solution:  Allow patients to compile and maintain their own medical history that they maintain control of and share with providers at will, using secure data technology supplied by private enterprise. Protect medical privacy by reasonably laws against private and government snooping.

9.     Problem: Government regulations forcing insurance carriers, hospitals and other providers create limitless and often unnecessary paperwork that take huge amounts of time, a need to hire additional personnel which adversely affects costs of medical care.

LPC solution: Ease regulatory compliance for medical care providers and hospitals. Consumer choices and liability for actual fraud and malpractice can regulate health care far more effectively than even the most conscientious and well-informed bureaucrats.  And most bureaucrats are not that well-informed or conscientious.

10.                        Problem: There are people in our society who are unable to pay for medical care.

LPC solution: All assistance to the needy can and will be in the future paid for by private donations. However until a credible help network is established and the voting public understands that welfare can be entirely replaced by voluntary assistance of various kinds, taxpayers may be required to provide a basic safety net. Lawful citizens and residents who are in need of public assistance may thereby be provided with (a) catastrophic medical care insurance, and (b) combined cash assistance in lieu of all current health care assistance programs, housing assistance, food stamp and other assistance programs where taxpayers’ money subsidizes or pays for the products or services to the needy shall be converted to a one “cash assistance” program.  To help pay for basic social services without raising taxes or borrowing, non-essential government services and funding for foreign military adventures should be cut.

Who will benefit the most?

Single mothers will be able to discuss their own or their children’s problems with medical professionals without leaving their own living rooms. They will not need to spend time in doctors’ offices or hospitals in order to receive simple prescriptions.

People in rural areas will have an immediate access to any specialist. Drugs can be delivered to them by mail or special delivery after short conversation by Skype or similar electronic services. 

Inner city families will have access to their neighborhood Primary Care Centers. The visits will cost less and an expert can be immediately consulted online, unlike the current need to go first to a family doctor, then to schedule appointment with a specialist.  

Poor families will have not only catastrophic insurance but also a monthly sum of money they can allocate toward their needs as they choose. One month that may be medical expenses, another more on food, still another on books or entertainment. They will have an opportunity to shop for less expensive options.  In turn, due to consumer choice, medical care providers will compete for business, creating a free market where those who offer superior value to the consumer can succeed. 

People with pre-existing conditions will have a variety of options to choose from, and will be covered at first by taxpayers and eventually by donations. Going forward, those with pre-existing conditions will no longer face problems with finding insurance.

Everyone will benefit from opening Medical Savings Accounts that will allow putting aside non-taxable funds for future medical needs, until income taxes can be phased out of existence.

Everyone will benefit when business people who are prohibited today from forming medical corporations, hiring doctors and offering medical services able to enter the field of medical care and re-vitalize the market, pushing prices down and quality of services up.

Everyone will benefit when inexpensive drugs enter the market, allowing consumers more choices and pushing prices of FDA-approved drugs down.

Everyone will benefit by the opportunity to use tax-exempt funds for health care.

Contact info:

Leon Weinstein

leonweinstein@hotmail.com

      

The following members of the Libertarian Party advised, provided critique, suggestions or worked on this proposal:

Robert Page
David Kozlowski

Lee Welter

Beau Cain

Carla Howell, Political Director, National Libertarian Party

Jonathan Jaech, Southern Vice Chair, LPC

Kevin Duewell

Antoine Hage 

Brian Thiemer

Jim Hoerricks