Townhall.com, November 2004

"The goal of a health care system should be to provide all citizens with access to quality and affordable health care. These goals can only be accomplished by strengthening the sovereignty of the patient and restoring the doctor-patient relationship, both of which require reducing the role of government."

Lawmakers on Capitol Hill have been aggressively trying to solve America's health care woes for many years. Congress recently passed legislation to reform Medicare and has debated legislation to allow prescription drug reimportation and medical malpractice reform. The question is not whether our health care system needs work, but how to best achieve effective reform.

In her book Miracle Cure: How to Solve America's Health Care Crisis and Why Canada Isn't the Answer, Sally Pipes provides a concise, yet thorough analysis of our health care system in America and offers practical, effective reforms. The answer is not more government control, she says, but less. By offering market based, consumer driven reforms, we can continue to provide affordable health care without sacrificing quality and innovation.

According to Pipes, people ask three things from their health care providers: affordability, accessibility, and high quality. It is hard to find a system that provides all three. Too often, lawmakers are so preoccupied with making health care affordable that they fail to consider the impact their policies have on the accessibility and the quality of the services being provided.

Our current system is plagued with skyrocketing costs, a decline in the doctor-patient relationship, and less individual control over one's own health care. Without substantial reform our current system is doomed for failure. Miracle Cure outlines some specific reforms that, if implemented, would go a long way towards ensuring quality, affordable health care for the next generation of Americans.

Medical malpractice reform is essential. Rising premiums for medical liability insurance are causing many doctors to leave the profession. In addition, these costs are being passed along to the patient in the form of higher prices for basic services.

Health insurance should be separated from employment so workers no longer lose their health insurance when they leave their jobs. Instead of having employers pay for comprehensive health insurance, they can increase wages for workers, who can then put that money towards their medical expenses. In addition, the tax code should be reformed to allow people to pay for routine medical care with pretax dollars that can be stored in tax-free Health Savings Accounts (HSAs). Managed care providers like HMOs hide the true cost of health care. By having patients pay directly for their medical care, they will be more conscious of the cost of care and have incentive to choose the best care at the lowest possible price.

Health insurance should be treated like any other type of insurance: to cover the cost of unexpected catastrophic events. It should not be used to cover routine medical expenses. We don't buy car insurance to help pay for oil changes and tune-ups, nor should we expect health insurance to pay for routine medical care.

Many politicians and lawmakers point to Canada's single-payer system as an example to be emulated in America. Canada's system of universal health care, free of charge for all citizens, sounds too good to be true. In many ways it is. Pipes, a native of Canada, is quick to point out that Canada's system is not the perfect solution that many perceive it to be. Though citizens do not have to pay for health care directly, they do have to pay in the form of higher taxes and severe reductions in the accessibility and quality of their health care.

The Canadian single-payer system provides incentives for people, doctors, and politicians to choose actions that are detrimental to their health care system. Free health care gives patients an incentive to visit doctors more, often causing overcrowding and long waits for routine medical care. Doctors, who are paid according to the number of patients they examine, have incentive to see more and and more patients, resulting in virtually no quality time between doctor and patient. Politicians have the incentive to reduce cost by forgoing expenditures on new technology and infrastructure. Without competition there is no incentive to improve the quality of care. Patients have nowhere else to go.

Health care reforms that encourage more patient control over their health care and less government interference are necessary in order to achieve true, long-lasting reform. If we want to continue to provide affordable care that continues to promote innovation and quality, sensible reform is needed. Miracle Cure provides practical, easy-to-implement solutions to America's health care crisis. We must avoid the temptation of increased government control and a Canadian-style single-payer system, and encourage free market, consumer driven reforms. In this book Sally Pipes provides a cure for our health care crisis. Hopefully politicians will heed her advice. Robert Zirkelbach is a former White House intern and congressional aide.

Robert Zirkelbach is a former White House intern and congressional aide.