By Craig J. Cantoni
Jan. 17, 2006
Ten physician associations have issued 11 principles for reforming the American health care system. The principles are an intellectual, philosophical and ideological mishmash of platitudes, fuzzy thinking, and a bizarre amalgam of socialism and capitalism.
Immediately below is my list of seven reform principles that, unlike the 11 principles, are based on liberty and the rights of the individual. For comparison, the 11 original principles are below the list.
SEVEN PRINCIPLES FOR REFORMING AMERICAN HEALTH CARE BASED ON LIBERTY AND THE RIGHTS OF THE INDIVIDUAL
1. People own their bodies and have a right to decide their medical care without interference from the government. The government has no right to set the prices of the care, to specify the level of care, to ration the care, to dictate where the care has to be obtained, or to set any other terms and conditions on the care.
2. People have a right to keep their medical information in confidence between themselves and the medical providers and insurance companies that they have freely and personally contracted with to provide medical care and insurance. The government has no right to this information, except in the rare cases when the public health is endangered due to possible epidemics from highly communicable diseases.
3. Physicians and other medical care providers have a right to the fruits of their labor and to earn what they believe is a proper return on their education and training, and on the capital they have invested in their medical facilities. The government has no right to impose wage and price controls on them, just as the government has no right to do the same to any other occupation.
4. Because the government destroyed a consumer market in medical care/insurance in the 1940s, it has a responsibility to restore the market, so that people can have the same degree of choices in medical care/insurance that they have in food, shelter, clothing, transportation, property/casualty insurance, and other goods and services. This means that the government must rescind provisions in the tax code, regulations and law that keep a consumer market from developing.
5. No one has a right to charge someone else for medical care/insurance. Nor does the government have the right to coerce someone to pay for someone else’s medical/care insurance.
6. People should be allowed to decide on their own what their moral responsibility is to help the destitute and the unfortunate obtain medical care/insurance. Physicians should be allowed to make a similar decision about providing free or discounted care. The government’s role should be to remove legal barriers to association-based medical care/insurance, whereby people can obtain care and insurance through voluntary associations, including fraternal, professional, social and religious associations.
7. Another role of the government is to ensure that people save during their working lives for the infirmities of old age. The reason for this is that 80 percent of medical care is consumed in the last 20 percent of life, and that those who do not save for old age will become a burden on society. However, mandated savings should be owned by the savers, not by the government, and should be mandated only to the extent necessary to close gaps not covered by private charity and voluntary associations.
ELEVEN PRINCIPLES FOR REFORMING AMERICAN HEALTH CARE AS PUT FORWARD BY PHYSICIAN ASSOCIATIONS
1. Health care coverage for all is needed to ensure quality of care and to improve the health status of Americans.
2. The health care system in the U.S. must provide appropriate health care to all people within the U.S. borders, without unreasonable financial barriers to care.
3. Individuals and families must have catastrophic health coverage to provide protection from financial ruin.
4. Improvement of health care quality and safety must be the goal of all health interventions, so that we can assure optimal outcomes for the resources expended.
5. In reforming the health care system, we as a society must respect the ethical imperative of providing health care to individuals, responsible stewardship of community resources, and the importance of personal health responsibility.
6. Access to and financing for appropriate health services must be a shared public/private cooperative effort, and a system which will allow individuals/employers to purchase additional services or insurance.
7. Cost management by all stakeholders, consistent with achieving quality health care, is critical to attaining a workable, affordable and sustainable health care system.
8. Less complicated administrative systems are essential to reduce costs, create a more efficient health care system, and maximize funding for health care services.
9. Sufficient funds must be available for research (basic, clinical, translational and health services), medical education, and comprehensive health information technology infrastructure and implementation.
10. Sufficient funds must be available for public health and other essential medical services to include, but not be limited to, preventive services, trauma care and mental health services.
11. Comprehensive medical liability reform is essential to ensure access to quality health care.
Mr. Cantoni is an author, columnist and consultant who has been active in health care reform for over a decade. He can be reached at firstname.lastname@example.org.