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As a physician deeply committed to improving the health of our nation, I have seen firsthand the challenges that plague our health care system. I wrote about these in Make America Healthy Again back in 2020.
Sadly, we are worse off now than we were then. The new presidential administration has an opportunity to enact meaningful reforms that prioritize patient care, personal responsibility and the strength of American innovation.
Here are five essential steps the administration should take to make America healthy again:
Robert F. Kennedy Jr. and President-elect Trump (Getty Images)
1. Promote Free Market Principles in Health CareThe strength of America lies in its free market, and this principle should continue to extend to health care. By reducing onerous regulations and fostering competition, we can lower costs and improve care. Further, price transparency is key to improving the quality of our private health care system.
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Requiring hospitals to publish the cash price of their services would allow patients to make informed comparisons on services regardless of their network status with the insurance provider. Insurance companies should allow money spent on all medical care, whether in-network or out-of-network, count toward the deductible. If the patient chooses a less-costly provider below the average price, they should share in the cost savings generated for the insurance company.
No patient should go bankrupt for emergency medical procedures. What we continue to see are insurance companies playing their usual games in order to either squeeze patients or doctors by not covering the cost of services provided and then "surprise billing" the patient because they didn’t pay their beneficiaries bill on emergency services. Emergency services should be paid by the insurance company regardless of network status. Patients should be focused on saving their life, not making sure they are heading to the right emergency department.
Promoting free market principles will also require an expansion of Health Savings Accounts (HSA) to be used on any medical services and should be allowed for anything wellness related, even if it’s for transportation to the doctor or running shoes.
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A free market environment encourages providers to compete on price, quality and service, leading to improvements in health care delivery. HSAs give patients control over their health care dollars. Providers who hope to attract those dollars will have to compete on quality or price or both.
2. Combat the Chronic Disease EpidemicChronic illnesses such as diabetes, heart disease and obesity are responsible for the majority of health care spending and preventable deaths in America. The administration must prioritize preventive care by incentivizing healthier choices.
Tax deductions for gym memberships, nutrition counseling and wellness programs could encourage lifestyle changes. Reforming agricultural subsidies to prioritize whole, nutrient-dense foods over processed and sugary products would help shift our nation toward better health outcomes. Government-funded subsidies should be limited to healthy foods that nourish the body and mind while local municipalities must make neighborhoods safe for outdoor physical activity.
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3. Empower States to InnovateHealth care must reflect the diversity of our nation. States should have the freedom to design health care systems that meet their unique needs. States have existing relationships with hospitals, primary care doctors, insurers and nonprofit organizations, which can be leveraged to improve population health.
Converting Medicaid funding to block grants would allow states to innovate and use resources more efficiently. This approach would foster creativity and accountability while ensuring vulnerable populations receive the care they need. States can also allow "emergency only" health insurance plans while allowing patients to use expanded HSA funds to pay discounted cash prices for preventative and routine care.
States can also expand Telehealth services to improve access to care and cap drug co-pays to make necessary medications more affordable.
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4. Restore the Doctor-Patient RelationshipOverregulation and bureaucracy have eroded the doctor-patient relationship, turning personalized care into an assembly line. The administration has to reduce onerous reporting requirements from Medicare and private insurers, giving physicians more time to spend with their patients.
Removing the stronghold large hospital systems have on independent physician practices and eliminating draconian restrictive convenances collectively will force competition to drive costs down while improving quality of care and allowing patients to choose their doctors.
Insurance companies have made deals with large hospital systems that consolidate care to save dollars and force out good physicians. They do this by keeping reimbursement rates so low that doctors and other medical service providers are forced to consolidate into siloed care or stop taking insurance altogether.
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5. Ensure a Secure Pharmaceutical Supply ChainThe COVID-19 pandemic exposed the fragility of our pharmaceutical supply chain. Over-reliance on foreign manufacturing has left us vulnerable to shortages of critical medications. The administration should incentivize domestic production of essential medicines and active pharmaceutical ingredients (APIs) to safeguard public health. A robust "Buy American" policy for health care supplies is essential for national security and preparedness.
Restoring America’s health requires bold action, a commitment to free-market principles and a focus on empowering individuals. By implementing these five strategies, the new administration can create a health care system that is affordable, effective and patient-centered. It is time to prioritize health over bureaucracy and empower Americans to take charge of their well-being.