What would libertarians do to reform healthcare in the US? This is a good list (by Sean Malone).
"1. Make ALL Health Care Tax Free:
Regardless of whether or not it's your employer who's buying or you, yourself, the playing field needs to be even. The government's special exemption for businesses is what caused health insurance to be tied to employment - Doing away with all taxes on medical care would lower everyone's costs and remove the incentives against individual insurance policies. When people are once again in control of their own insurance, they will once again be the actual consumer.
2. Repeal ALL Insurance Mandates:
Insurance companies are currently extremely limited on the types of plans & different price-levels they are able to offer their consumers, because the government mandates base levels of coverage. They effectively eliminate legitimate competition and restrict individuals' freedom to balance price with coverage. These mandates also shift the entire insurance system from true "insurance" which protects against financially catastrophic risk to insurance-as-3rd-party payer, thus skewing economic incentives towards over consumption, raising costs by billions of dollars.
3. Allow Insurance Companies to Compete Across State Lines:
The full-faith & credit clause aside, there is no legal or moral reason that we should not be free to purchase health care insurance from anyone who is willing to provide it for us. This makes insurance "portable", and steps up competition in an as yet unprecedented way, which will reduce costs, provide more flexibility and help individuals find plans that are right for them.
4. End the Cartels:
Insurance Companies, the AMA, Pharmaceutical Companies, and virtually all aspects of the health care establishment enjoy special legal protections of their position. These need to be eliminated. The American Medical Association currently retains control over medical licenses, and the number of doctors available in the United States - this causes regular shortages in doctors. That, in turn, limits access and increases the cost to the consumer. Insurance companies, Blue Cross & Blue Shield enjoy special legal status which prevents any real competition in insurance markets, and allows them to dominate insurance markets in virtually every state - Aetna & other big insurers enjoy similar (though not as ensconced) protections through tax-breaks and limited licenses. These things need to be eliminated in order for the market for health care to function properly. Both companies who manufacture health care goods, and doctors, nurses & other professionals who produce medical services - must be allowed to succeed or fail based on how they meet consumer demand, not based on how politically well-connected they are.
5.Tort Reform:
"Ambulance Chasers" and other disreputable legal services have set up a cottage industry around medical malpractice lawsuits - This is why it costs many doctors between $50-100,000 a year simply to hold medical malpractice insurance. Tort reform can help eliminate the frivolous lawsuits, thus reducing the need for such high priced insurance lowering the total cost to consumers.
6. Health Savings Accounts:
True insurance is a risk pool designed to help people manage unforeseeable expenses, not a way to pass off predictable costs onto other people. Tax-free health savings accounts can help people manage regular maintenance costs such as doctors visits, flu-shots, and minor medical procedures while leaving insurance to cover legitimate catastrophic care only. This would drastically reduce abuse of insurance and lower costs across the board as individuals - rather than government officials or insurance companies - made more direct decisions about their medical care.
7. Transparency in Costs:
This is significantly more culture than policy, but people need to be in the habit of asking for cost break-downs of their doctor & hospital visits. HSA's, an actually competitive insurance industry, and paying for more care directly would go a long way to encourage this. Knowing price enables people to weigh cost vs. benefits, and reflects the relative scarcity of different goods & services. When a 3rd party pays, whether that's an insurer or a government, those issues are never considered - thus raising costs, causing shortages and rampant over-consumption.
8. Begin Reducing Government as Health Care Payer:
Medicare & Medicaid, and most other social welfare institutions in the United States function as pyramid schemes. These pay-as-you-go financing methods are entirely unsustainable, and contribute greatly to increased costs. Reducing the government's involvement not only keeps the US financially solvent, but also will reduce costs to consumers over time.
9. Tax Reform for Charity:
Provide greater incentives for people to contribute to medical charities and to help support treatment for poor & low-income individuals. With fewer taxes overall, more money to spend out of pocket and cheaper health care overall, this shouldn't be difficult. America is already far and away the most charitable nation on the planet...
10. Freedom!
People should be free to determine who provides their health care, what type of care they want, who will be paying (insurance, HSA, generous benefactors, charities, credit cards, etc.), and what kinds of arrangements suit them the best. They should also be free to decide what arrangements to make regarding their bodies - if hospitals and other foundations wish to offer compensation for organs or bone marrow to increase the availability of transplants, they should be free to do so. This will free up financial arrangements so that instead of just one or two options, people can pick and choose from hundreds to find the one (or many) which suits them best. It also means that questions of medical ethics and religion are no longer an issue. If you smoke, or are overweight, if you want an abortion or if you want to try an experimental medication - a free system allows you to do these things if your insurer won't cover you, you have dozens of other options. But when the government pays, you lose these choices. When other people are forced to pay for your health, suddenly other people get some say in what you can and cannot do. Are abortions to be publicly financed? Stem cell research? Organ transplants? Drug rehabilitation? Sure... If you can get the votes. And if you can't... Tough luck."
"1. Make ALL Health Care Tax Free:
Regardless of whether or not it's your employer who's buying or you, yourself, the playing field needs to be even. The government's special exemption for businesses is what caused health insurance to be tied to employment - Doing away with all taxes on medical care would lower everyone's costs and remove the incentives against individual insurance policies. When people are once again in control of their own insurance, they will once again be the actual consumer.
2. Repeal ALL Insurance Mandates:
Insurance companies are currently extremely limited on the types of plans & different price-levels they are able to offer their consumers, because the government mandates base levels of coverage. They effectively eliminate legitimate competition and restrict individuals' freedom to balance price with coverage. These mandates also shift the entire insurance system from true "insurance" which protects against financially catastrophic risk to insurance-as-3rd-party payer, thus skewing economic incentives towards over consumption, raising costs by billions of dollars.
3. Allow Insurance Companies to Compete Across State Lines:
The full-faith & credit clause aside, there is no legal or moral reason that we should not be free to purchase health care insurance from anyone who is willing to provide it for us. This makes insurance "portable", and steps up competition in an as yet unprecedented way, which will reduce costs, provide more flexibility and help individuals find plans that are right for them.
4. End the Cartels:
Insurance Companies, the AMA, Pharmaceutical Companies, and virtually all aspects of the health care establishment enjoy special legal protections of their position. These need to be eliminated. The American Medical Association currently retains control over medical licenses, and the number of doctors available in the United States - this causes regular shortages in doctors. That, in turn, limits access and increases the cost to the consumer. Insurance companies, Blue Cross & Blue Shield enjoy special legal status which prevents any real competition in insurance markets, and allows them to dominate insurance markets in virtually every state - Aetna & other big insurers enjoy similar (though not as ensconced) protections through tax-breaks and limited licenses. These things need to be eliminated in order for the market for health care to function properly. Both companies who manufacture health care goods, and doctors, nurses & other professionals who produce medical services - must be allowed to succeed or fail based on how they meet consumer demand, not based on how politically well-connected they are.
5.Tort Reform:
"Ambulance Chasers" and other disreputable legal services have set up a cottage industry around medical malpractice lawsuits - This is why it costs many doctors between $50-100,000 a year simply to hold medical malpractice insurance. Tort reform can help eliminate the frivolous lawsuits, thus reducing the need for such high priced insurance lowering the total cost to consumers.
6. Health Savings Accounts:
True insurance is a risk pool designed to help people manage unforeseeable expenses, not a way to pass off predictable costs onto other people. Tax-free health savings accounts can help people manage regular maintenance costs such as doctors visits, flu-shots, and minor medical procedures while leaving insurance to cover legitimate catastrophic care only. This would drastically reduce abuse of insurance and lower costs across the board as individuals - rather than government officials or insurance companies - made more direct decisions about their medical care.
7. Transparency in Costs:
This is significantly more culture than policy, but people need to be in the habit of asking for cost break-downs of their doctor & hospital visits. HSA's, an actually competitive insurance industry, and paying for more care directly would go a long way to encourage this. Knowing price enables people to weigh cost vs. benefits, and reflects the relative scarcity of different goods & services. When a 3rd party pays, whether that's an insurer or a government, those issues are never considered - thus raising costs, causing shortages and rampant over-consumption.
8. Begin Reducing Government as Health Care Payer:
Medicare & Medicaid, and most other social welfare institutions in the United States function as pyramid schemes. These pay-as-you-go financing methods are entirely unsustainable, and contribute greatly to increased costs. Reducing the government's involvement not only keeps the US financially solvent, but also will reduce costs to consumers over time.
9. Tax Reform for Charity:
Provide greater incentives for people to contribute to medical charities and to help support treatment for poor & low-income individuals. With fewer taxes overall, more money to spend out of pocket and cheaper health care overall, this shouldn't be difficult. America is already far and away the most charitable nation on the planet...
10. Freedom!
People should be free to determine who provides their health care, what type of care they want, who will be paying (insurance, HSA, generous benefactors, charities, credit cards, etc.), and what kinds of arrangements suit them the best. They should also be free to decide what arrangements to make regarding their bodies - if hospitals and other foundations wish to offer compensation for organs or bone marrow to increase the availability of transplants, they should be free to do so. This will free up financial arrangements so that instead of just one or two options, people can pick and choose from hundreds to find the one (or many) which suits them best. It also means that questions of medical ethics and religion are no longer an issue. If you smoke, or are overweight, if you want an abortion or if you want to try an experimental medication - a free system allows you to do these things if your insurer won't cover you, you have dozens of other options. But when the government pays, you lose these choices. When other people are forced to pay for your health, suddenly other people get some say in what you can and cannot do. Are abortions to be publicly financed? Stem cell research? Organ transplants? Drug rehabilitation? Sure... If you can get the votes. And if you can't... Tough luck."