Commentary

Put Health Decisions Back Where They Belong

By Sue A. Blevins
January 2, 1998

Once again the federal government’s going to fix our health care. The president has appointed a new Advisory Commission on Consumer Protection and Quality in the Health Care Industry.

In order to justify more intervention in health care, the commission tries to capitalize on the fact that nearly half of employees nationwide are offered only one health plan. Many of those plans are health maintenance organizations and other types of managed-care plans that restrict health care choices. The commission’s solution? Create a bill of patient rights and responsibilities, and then mandate those recommendations through regulation.

Will this restore true free choice in health care? No, and here’s why. The commission:

* Does nothing to place the decision of who buys health care back in the hands of the people. Courts have determined that if government pays for a portion of health care, then beneficiaries must play by government rules.

* Increases the role of government officials, union leaders, and special interest groups in deciding what types of health care are to be covered.

* Increases government’s role in deciding how individuals should maintain their health regimes and related lifestyles. The commission has already taken the role of deciding what the appropriate diet is for all Americans.

Already, the commission plans to impose its patient bill of rights and responsibilities on more than 46 million Americans enrolled in government public health programs - Medicare and Medicaid recipients, military personnel and veterans, and federal, state, and local government employees.

There is a better way to handle today’s lack of health-care choices: Place the decision of who buys health care back in the hands of individuals.

One of the most efficient ways of giving consumers control over their health care is to change the way the tax code treats health insurance. Currently, employer-sponsored health insurance is fully excluded from taxation, but individually purchased health insurance is not. That lets the government manipulate the health insurance market, leaving workers with fewer options.

A universal tax-credit policy would give workers the same tax break as employers. If individuals don’t like the choices offered by employers, they’ll be free to buy health insurance on their own or through groups such as professional associations, churches, or labor unions - and still receive a tax break. Clearly, this is the most efficient way to help Americans gain greater control over health-care choices.

In a new study for the Cato Institute, I offer a method of objectively measuring choices available under various types of health insurance plans. This “Health Freedom of Choice Index” was applied to two federal health plans - the Federal Employee Health Benefits Program and Medicare - as well as to individual medical savings accounts (MSAs).

Of a possible 100 points, the FEHBP plans scored from 45 to 75, Medicare 45, and MSAs 100. Some of the FEHBP plans scored low because they restrict access to certain types of providers and treatments, including chiropractors and mental health services. Medicare scored only 45 points because it does not cover many types of preventive care and non-physician providers.

Government officials, unions leaders, and special interest groups shouldn’t make individual health-care decisions. Something as personal as health care should be left only to individuals and the providers they choose.

Sue A. Blevins is president of the Institute for Health Freedom in Washington and author of the Cato Institute policy analysis “Restoring Health Freedom: The Case for a Universal Tax Credit for Health Insurance.”