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On January 5, Donald Trump mocked "head clown" Sen. Chuck Schumer (D-NY) on Twitter for opposing his plans to fix the Obamacare disaster. That brought to mind this ad Heartland ran in 2009 to try to stop Obamacare. So the analogy has now come full circle.

 

 

The Issue

The proper role of government in financing and delivering health care is one of the hottest public policy issues of our time.

Some experts call for more regulation and more subsidies, while others call for less. All levels of government in the U.S. are coping with rising spending on health care for their own workforces and rapidly rising spending on programs for the poor and elderly.

With the increasing encroachment of the national government in health care policy over the past several decades, states are limited in their ability to influence health care policy in tangible ways without being granted permission by Washington, DC. Many policy options that would result in lower premium costs and higher quality care are not available to the states. But states are not entirely without options for improving coverage and laying the groundwork for innovative reforms of an entitlement system that currently fails the people it endeavors to help.

One of the most common criticisms against free market reforms is the myth that our supposedly free-market health care system before the Affordable Care Act caused health insurance and health care costs to rise, leaving millions of people uninsured. This is untrue. The fact is the United States had a government-mismanaged market in health care that public policy distorted and often blocked from properly functioning.

Numerous laws and regulations--ERISA, HIPAPA, McCarran-Ferguson, HMO Act, state benefit mandates, to name just a few--have turned health care into one of the most heavily regulated markets in America, doing much to hinder and destroy the innovation needed to lower costs and improve quality.

A national debate is taking place concerning the best ways to achieve a more efficient and equitable market for medical services and health insurance in the U.S. Advocates of free-market health care believe too much reliance on government regulations and subsidies is the cause of many current problems, and that solutions can be found in returning to sound market principles.

Our Stance

To move our health care system to one that is truly a market, one that improves quality while also reducing costs, will require repealing many bad public policies. New health care policies should focus on reducing the current reliance on third-party payers, encouraging both innovation and entrepreneurship, moving control over health care decisions to patients and rolling back the burdensome regulations reducing health care access and increasing costs. New innovations emerge in health care every day; products and services like health savings accounts, telemedicine, minute clinics and direct primary care could improve the cost and access of health care for millions if the government could only step out of the way.

Featured Subtopics

Hospital building
The most significant step lawmakers can take in this area is to repeal certificate of need laws. If full repeal is not possible, states should limit the application of CON restrictions to larger projects.
Patient with doctor
The growing use of generic drugs, retail clinics, medical tourism, concierge medicine, physician-owned specialty hospitals, and the reduction in the use of hospital emergency rooms may all be attributed to the growth of consumer-driven health care.
Woman with regulatory binders
The architects of the Patient Protection and Affordable Care Act argued ensuring everyone had health insurance would encourage patients to take advantage of preventative care and use their own doctors instead of emergency rooms. The reality has been the opposite
Table with ideas and light bulb
State legislators need to be careful not to hinder the growth of an industry that has brought affordable and convenient basic health care services to millions by imposing more regulations.

Additional Subtopics

  • Insurance
  • International
  • Malpractice
  • Mental Health
  • Prescription Drugs
  • Privacy/Patient Rights
  • Providers
  • Media Bias
  • Public Health
  • Rural Health Care
  • Single Payer
  • State Programs
  • Stem Cell Research
  • Why Spend Too Much

Videos

Title: Emerging Issues Forum (EIF) Chicago: Health Care Panel
Description: This panel discusses how states can expand competition and reduce the cost of health care – even with the Affordable Care Act in place. Solutions discussed include using telemedicine, rolling back certificate of need laws, and embracing direct primary care. The panel also addresses Medicaid expansion. Speaking on this panel are Cato Institute Senior Fellow Michael Tanner, Opternative Chief Executive Officer Aaron Dallek, and Georgia state Sen. Judson Hill (R-Cobb County).

Health Care Experts Team

The Heartland Institute's experts on health care policy are available for legislative testimony, speaking engagements, and media interviews.

Staff & Fellows Policy Experts