To celebrate US's 247th birthday, take back freedom, starting with medical autonomy

Recently, both Houses of Congress announced they were going to get serious about fixing health care. 

House speaker Kevin McCarthy (R-Calif.) says he plans to create a commission to consider and fix the financial woes of the health care system, including unsustainable spending on entitlements.  The Senate intends to reintroduce the Trust Act, which claims it will rescue large federal trust funds such as Medicare from impending insolvency.

This is the height of irony.  The fox promises to protect the chickens in the henhouse from...the fox!

U.S. national spending on healthcare, the system, is unsustainable, and projected to reach $7.2 trillion by 2031.

For perspective, that amount, expended just on health care alone in the U.S., is slightly less than the combined GDPs of Japan and United Kingdom.

Family spending on health care — the medical service — is similarly unaffordable.  Average family spending on health care in 2023 will top $30,000, with more than 75 percent going to insurance companies. 

Despite this excessive spending by both country and individuals, access to care is insufficient, with Americans dying waiting for life-saving medical care, called death by queue

If the U.S. is spending these massive amounts of money, why can't people get care?  Why are wait times to see a doctor more than four months?  Why are nurses going on strike?  What do nearly a third of U.S. physicians refuse new Medicaid patients, and more than 50 percent refuse in Texas?

Where is all that money going if it is not facilitating care?!

A study in 1999 calculated that at least 31 percent of all U.S. health care spending went to middlemen, the federal healthcare bureaucracy in its myriad forms.

Some initials are well known, such as CDC, HHS, NIH, FDA, and CMS. 

Some are not often in public view, like ACF (Administration for Children and Families), ACL (Administration for Community Living), AHRQ (Agency for Healthcare Research and Quality), ASPR (Administration for Strategic Preparedness and Response), and ATSDR (Agency for Toxic Substances and Disease Registry), through an alphabet soup to U.S. PHS (Public Health Service).

The combined non-clinical, bureaucratic health care workforce numbers in tens of millions.  All must be paid. 

A 2019 calculation that included the additional health care regulations and agencies over the ensuing twenty years created in particular by the Affordable Care Act (ACA) suggests more than half of all health care spending went to BARRCOE: bureaucracy, administration, rules, regulations, compliance, oversight, and enforcement. 

That's $2 trillion's worth of medical care denied to Americans by their own government. 

The solution proposed by the House of Representations is to spend more money on commissions, consultants, and advisory groups, and then expand an already burdensome, Byzantine, impossibly expensive regulatory structure.

The Senate wants to shore up bankrupt trust funds by, you guessed it, printing (spending) more money.

The White House wants to raise taxes.  All will require even more BARRCOE.

For more than fifty years, Washington has been fixing health care with the same two methods: increasing regulations and spending more money. 

Prior to 1965, the U.S. expended 6.5 percent of GDP on health care.

Last year, it was 19.7 percent.  The regulations created by the ACA alone required more than ten million words in the Federal Register.  The ACA organizational flow chart makes the L.A. freeway system look like simple straight lines.  The volume of federal regulations that govern health care is literally too numerous to count.  Paying for all of Washington's health care regulatory "fixes" is where the health care dollars are going.

When Congress says it is getting serious about tackling health care spending, Americans should worry.  The fox has been devouring the chickens for decades.  We can expect more of the same: new regulations and more spending on BARRCOE, money stolen from nurses and physicians.  And even less freedom — i.e., medical choice.

Some believe there may be cause for cautious optimism, as "the American public is ready for a true debate on health care's future."

If true, the discussion must start with the root cause of health care system failure: federal control of health care and resulting federal overspending, on itself.

Once the public recognizes that Washington is destroyer not savior, the cure for health care becomes clear — hard but simple.

Health care will work for We the People only when Americans regain decision-making capability — freedom — for how to spend their money rather than having third parties make that choice.  When We the People remove Washington from control of health care, two trillion "health care" dollars can be spent on health care, and Americans will once again have medical autonomy (freedom).

Deane Waldman, M.D., MBA is professor emeritus of pediatrics, pathology, and decision science; former director of the Center for Healthcare Policy at Texas Public Policy Foundation; and author of the multi-award winning book Curing the Cancer in U.S. HealthcareStatesCare and Market-Based Medicine.

Image: Pixabay, Pixabay License.

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