Louisiana Congressmen will seek to advance free market reforms in 2012

When Republicans were last in control of Congress they did not move aggressively to institute free market health care reforms that could have halted the slide toward ObamaCare, some of the medical doctors who now occupy U.S. House seats have acknowledged.

A trend towards government run health care began in the mid 1960s and has accelerated ever since, laments Rep. John Fleming (R-La.). Unless the Patient Protection and Affordable Care Act (PPACA) is repealed, U.S. citizens will likely find that they need to accommodate themselves to a more bureaucratic health care system akin to what citizens in Canada, the United Kingdom and other parts of Europe now experience, he warns.

Beginning with Medicare and Medicaid, the U.S. moved toward greater “governmentalization” over the health care system, Fleming explained in an interview.

Unfortunately, his own Republicans did not move forcefully enough when they the chance to push reforms that would empower consumers and limit the role of government, he said.

“The ObamaCare bill is really the culmination of a process that has been underway for some time now,” Fleming said. “It will be an uphill battle for Congress to undo the damage that could occur with the new rules and regulations if this law remains in effect.”

However, if the U.S. Supreme Court does ultimately rule against the PPACA, Republicans should take the opportunity to push for greater “price transparency” and more consumer autonomy within the health care system, Rep. Fleming, said. Allowing the government to operate as a third party that absorbs the costs upfront opened the way to higher costs and acute inefficiencies, he added.

Rep. Bill Cassidy (R-La.) concurs.

He is considering new legislation that would insert price transparency into the health care system.

Fleming and Cassidy are both medical doctors.

“If I were to go in for knee surgery, just as an example, I don’t know what the price of that surgery is for say another two months and that is part of what is wrong with our health care system,” Cassidy said. “We need to make people more aware of what the actual costs are. There is a tendency to think of medical interventions as being very benign, but you can have unnecessary procedures with unnecessary risks and this could lead to complications. One of the benefits of making consumers more aware of the price is that you limit their exposure to actions that may not be necessary.”

The kind of advertising connected with Lasik eye surgery should be broadly applied throughout the entire health care system, Cassidy suggested. Consumers typically see up front how much the Lasik surgery will cost, he noted.

Back in the 1980s, Fleming recalls that he would charge Medicare patients some out of pocket costs for lab work. Unfortunately, this is no longer an option, he noted.

“Today I would simply order the lab and the patient is totally out of it,”  Fleming said. “The patient is totally taken out of the equation and we have trained them not to care what health care costs. We can go one of two ways, we can re-engage the patient and have them pay at least a percentage of the cost, or we can leave this in the hands of the government. But when you run out of money the government gets to arbitrarily decide who gets care and who  does not.”

If the Republicans do strengthen their hand in the 2012 elections, they cannot let the opportunity go by again to institute free market changes that could alleviate existing financial pressure, both Fleming and Cassidy said.

“People fear change and not everyone is going to be on board with price transparency,” Cassidy said. “The concept is still in its infancy, there has not been a lot of work in this area.”

Going forward, Fleming said he favors the expanded of Health Savings Accounts (HSAs) as a way to mitigate against expenditures that may not be necessary.

“When there is a higher deductible involved it gives people an incentive to save money and make wise purchases,” Fleming observed. “We now instances where company employees are saving money in their HSAs many times above what their deductible.”

Fleming also favors changes that would allow health care consumers to shop across state lines for their insurance so they are not limited to just one choice in their home area.
“Make the insurance companies compete against one another so we can have a marketplace throughout the entire country,” Fleming said. “We don’t want to see one company in one state as a monopoly.”

Twenty-six states, including Louisiana, have filed suit arguing that the individual mandate included in President Obama’s health care law is unconstitutional. In August, the 11th Circuit Court of Appeals sided with the states and ruled that Congress exceeded its authority under the Commerce Clause. Previously, Florida District Judge Roger Vinson and Virginia District Judge Henry Hudson also ruled against the individual mandate. As the Pelican Institute has previously reported, the Goldwater Institute cut its own path here by challenging the constitutionality of ObamaCare’s Independent Payment Advisory Board (IPAB).

Kevin Mooney is an investigative reporter with the Pelican Institute for Public Policy. He can be reached at kmooney@pelicanpolicy.org and followed on Twitter.