Guest Columnist

On health care, neither Republicans nor Democrats are on the right track

Decouple health insurance from employment to begin addressing health care costs

Devices used to take blood pressure, temperature, and examine eyes and ears rest on a wall inside of a doctor's office M
Devices used to take blood pressure, temperature, and examine eyes and ears rest on a wall inside of a doctor's office March 22, 2010. REUTERS/Lucas Jackson

Over the past year, the vast majority of Iowans I met along the campaign trail enthusiastically embrace the proposal to completely dissociate access to private health insurance from employment. For those who have not yet considered what this practical legislative imperative looks like, envision this:

You now have peace of mind knowing that your health care coverage continues regardless of your work routine, or employment status. The federal tax breaks your employer had been getting to insure you now go to you instead. You deduct the cost of health insurance from your taxable income. Health insurance market monopolies, and complicated health care networks have been dismantled, creating equal access to more affordable, high-quality health insurance policies for everyone in your state — farmers, business owners, artists and computer software engineers alike. Selecting and maintaining your private health insurance would be similar to obtaining car or homeowners insurance, only the process is simplified, and consumer protections ensure easy-to-understand choices. Health insurance companies are now competing with each other to enroll you, and your choices as a health care consumer now have the power to help shape how the U.S. health care industry works. Medicaid truly prevents medical bankruptcies because you no longer have to go bankrupt, or have subsistence-level income to access the program. A simple, temporary income-based buy-in is all that is required from people earning more than those previously qualifying for Medicaid to get help pay for medical treatments any year they seek it. The U.S. economy is rebounding as individuals are earning higher wages, and firms are investing more in other means to retain employees and grow their businesses.

As ideal as this may all seem, it is the sort of U.S. health care system that is well within our reach as soon as 2021.

Herzog: Iowa needs a no-party senator in Washington, D.C.

Engaged Iowa voters have a no-nonsense choice in November

We have to completely decouple all private health insurance from employment to even begin to contain health care costs. Linking health insurance to employment may be the biggest historic blunder in the development of the U.S. health care system, and it remains economically indefensible.

The biggest failure of the Patient Protection and Affordable Care Act, or “Obamacare,” was giving in to insurance companies and corporate lobbyists with provisions to prop up our broken health insurance market structure. We must maintain the important consumer protections that were achieved by this legislation: protection for people with preexisting conditions, oversight for health care service outcomes and incentives to reduce hospital-acquired conditions, among other well-substantiated benefits. But the employer-mandate schemes, and taxpayer-funded subsides that prop up our complicated and opaque premium-pricing and payment-for-services systems have to end.

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When Democrats offer to add a “public option” to this broken, convoluted mess to fix it, or Republicans claim that publicly displaying the underlying negotiated prices for services between insurers and service providers will do the trick, they are both dead wrong. My proposals have the most potential for bipartisan support, resulting in enduring legislation by establishing economic incentives for all stakeholders to focus on improving health efficiently.

Affordable health insurance requires distributing risk differently, over the population of an entire state or rating areas defined by federally regulated standards. This has the potential to ensure more varied and reliable payment resources for our rural health care service providers. It would create the right economic incentives for individuals, local service providers, insurers and regional public health entities to work together to improve the health of all the people within each community.

It is important to keep an eye on the privatized delivery of public health insurance programs with already one-third of Medicare and three-quarters of Medicaid enrollees in privately administered health insurance plans. The impact on people receiving such services must be consistently monitored and evaluated with enforceable standards. Once we optimize the private health insurance market for consumers, we will have more public funding left over for adequate regulatory oversight, and focused additional support for high-cost outliers with reinsurance programs.

Though I have been advocating for these important changes for years, the current pandemic only bolsters support for my proposal. After working in health care for decades, I became an economist in order to finally bring about the vitally needed health care reform our nation has been waiting for.

As Iowa’s independent candidate for U.S. Senate, I am dedicated to making sure that we will finally discuss the important health care reform solutions that legislators of both major political parties continue to overlook. Electing me as Iowa’s first non-partisan U.S. senator in 2020 is our best chance of making the health care reform ideal a reality.

Suzanne Herzog is an independent candidate for U.S. Senate in Iowa.

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