Ben Carson's Quiet Health Care Revelation

A huge chunk of the U.S. economy is tied up in health care ($3.8 trillion annually). Presidential candidate Dr. Ben Carson doesn’t stray far from big government’s role, and suggests taking the money that’s already there and redistributing it into new programs.

What is Carson’s health reform plan? The presidential candidate’s position pivots on four main points:  health savings accounts, catastrophic insurance, keeping Medicare and removing the middleman, aka bureaucrats and/or insurance companies. 

If you listen to Carson, you soon find his overall ideas haven’t changed much from many years ago, but he has fine-tuned details over time.  For example, in the past he called for a $2,000 per person per year infusion of cash collected by the government into health savings accounts so Americans can take control of their own healthcare needs. Carson held that HSA’s would get rid of the need for Medicare because an individual’s health insurance would no longer be tied to his employer. But now he says Medicare and HSAs can coexist, with both programs simultaneously feeding off the public trough.

Despite his evolving positions on healthcare, Carson remains steady in his contention that HSAs would eliminate the “middle-man” in the patient-doctor relationship. In the past, Carson singled out “for profit insurance companies” as the culprit, stating unequivocally in 2010, “the first thing we need to do is get rid of” them; now he simply defines middle-men as “bureaucrats.” 

In 2010, 14 years after his 1996 proposal that we needed a government-run catastrophic fund supported by a mandatory contribution of 10 to 15 percent of the profits of each health insurance company, Carson ratcheted up his radical approach with an even more radical suggestion.

In a Megadiversities interview, the future candidate stated, “The entire thing is completely out of control. The entire concept of profits for  insurance  companies makes absolutely no sense…the first thing we need to do is get rid of for profit insurance companies…we need to make the government responsible for catastrophic health care.” Carson’s plan also hinges on sending potential emergency room patients to clinics. “The government needs to find a way to make people go to those [neighborhood] clinics,” he said in the same 2010 exchange.

In 2012, a year before his famous speech, Carson again called for government-run catastrophic care. How did he suggest we pay for this? In America the Beautiful, he writes insurance companies will be “allowed 15% annual profit, 5% of which would go to the government’s national catastrophic health care fund.”

Just a few days ago, Chris Wallace of Fox News Sunday attempted to nail down Ben Carson’s policies on reforming health care with health savings accounts. Wallace asked Carson about his proposal to have the government set up accounts with $2,000 per person per year from cradle to grave for people to use for their health needs. Carson said he “changed his mind” and “that’s the old plan that’s been gone for several months now.”

Carson then switched the emphasis of another of Wallace’s questions from Medicare to Medicaid saying $5,000 per “man, woman and child” would get them a “concierge practice…and you still have a couple thousand left over for your catastrophic insurance.”

In the Wallace exchange Carson’s circular reasoning appears to lead back to a big government-style program to replace or supplement the ones already in existence.  

From Fox News Sunday

WALLACE:  How do you get the money for your health savings account?  I’m not talking about Medicaid, I’m talking about Medicare, because you used to say you were going to end Medicare and have a $2,000 government fee to every individual, man, woman and child. 

CARSON:  That's gone.  That is off the table.  We're not having the government do that.  I don't want a big government program. 

WALLACE:  Let me -- don't mean to interrupt, but I’m a little bit confused.  So, if I’m a regular person, I’m not indigent and I -- you're going to give me a health savings account, but you're not going to give me any money, why wouldn't I want Medicare?  What's the advantage of the health savings account?

CARSON:  Well, remember, you already if you're a regular person have a job.  And they're already giving you some health benefits.  So, instead of that money going into the inefficient system that it goes in now, it gets divided and divvied up into your family's health savings account over which you now have control and to which you can contribute anything you want.  That's the difference.

WALLACE:  Doesn't that mean there's going to be government money going into my health savings account? 

CARSON:  If there's already government money going into it, it certainly could, absolutely. 

WALLACE:  And would that be $2,000? 

CARSON:  But not -- but not new government money.  No, the same -- listen carefully, because this is the concept that sometimes can be confusing. 


CARSON:  The amount of money that we are already spending for health care in this country is astronomical.  And it's almost twice as much as many other countries in the world.  And yet, we have terrible problems with access. 

If we take those same dollars and divert them into a system that gives you control over your home health care, you and your health care provider cut out the middle man, the bureaucracy.  Those dollars go much further.  We won't have to use as many of them.  The dollars are already there, Chris. 

WALLACE:  I understand, but they're in a government system.  
Last question, I want to understand -- all right.  Let's say I’ve retired, OK?  I had a job, I had health insurance, now I’ve retired and I need government help for my health care.  Where's that money coming from? 

CARSON:  The same place -- the same dollars that would be going to you through Medicare would go into your health savings account.  You continue to use it just like you have been using.  However --

WALLACE:  So, in other words, does the government (INAUDIBLE) as a senior citizen?  

CARSON:  Right.  If you decide you don't like that system and you prefer just to keep the system like it is, I’m not going to deny you the privilege of doing that. 

Carson addresses employer-based health insurance suggesting the current system is “inefficient.”  Under his plan employers would “divvy up and divide” monies spent on health insurance for their employees. The funds would be added to their government health savings accounts.

Will employers be penalized if they don’t comply? How would private employers work with government bureaucrats to ensure an equal distribution of healthcare dollars among their workers? Wallace didn’t delve into the nitty-gritty, but he did grill Carson on certain inconsistencies in his plan.

Carson does not explain how taking the “old, same” money from Medicare and putting it into HSAs reduces the cost of hospital stays, outpatient surgeries, lab, and radiology testing, cancer treatments, etc. More importantly, how does that limit government involvement in setting national policy that will affect our healthcare? 

So the government, in switching Medicare funds to HSAs, means we still have Medicare.  But how can money be in two places at the same time? And since it's  a government program, how can HSAs not be subject to the same waste, fraud and abuse rampant in the Medicaid program, in particular?

Also, typically health care spending is skewed toward the last years in life.  Carson has said in the past, “it is well known that up to half of the medical expenses incurred in the average American’s life are incurred during the last six months of life.”  In the same journal article (Harvard Journal of Minority Public Health, 1996) he wonders whether it is not better to allow the person to “die with dignity” rather than “prodding, testing and operating on them ad nauseam.” 

While 20-somethings might build up a nice balance on Carson’s plan before they’d need to dip deeply, what is this going to do to the 70-somethings? How would Carson’s HSAs benefit the 70 or 80 year-old with diabetes or  Alzheimers? 

According to Carson’s campaign manager, Terry Giles, the neurosurgeon has been thinking deeply about the issue for 19 years. During that time he has tweaked and “perfected” his ideas, says Giles.

When questioned about his past thinking on healthcare as compared to recent statements, Carson often says he is evolving.

Carson has rearranged a few deck chairs on what he considers America’s sinking ship of a healthcare system, but as Wallace points out, Carson’s shift to HSAs is another government program funded with taxpayer dollars.

Carson can’t seem to shake his October, 2015 plan loose from its early roots. Before his 2013 Prayer Breakfast speech, Carson’s rhetoric was decidedly pro-big government and anti-private insurance companies when it came to shaping his healthcare program.

While Republicans are calling for the downsizing of government bureaucracies, Ben Carson wants to redistribute what’s already in place.

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