Five Health Care Reform Solutions That Make Sense

Massachusetts, the bluest of states in our union, stunned the nation on Tuesday when it voted to end Washington’s unbridled spending and plan for government-run health care. Seventy-eight percent of Republican Scott Brown’s voters strongly oppose the current health care legislation. Sixty-one percent of Brown’s voters said deficit reduction was more important to them than health care.

Americans still want health care reform, but they are looking for clear, patient-centered, fiscally responsible solutions. Physicians for Reform offers such a plan. Here are five reforms we propose.

REFORM #1: Sell Insurance Across State Lines

FACT: State mandates drive up costs

• Health insurance for a 25-year-old male in New Jersey costs nearly six times what it does in Kentucky, largely because of state mandates.

• Introducing choice and competition reduces business overhead. Businesses could use these savings to raise wages or hire workers. This stimulates the economy without spending a dime of federal money.

FACT: Interstate competition optimizes legislative oversight

• Competing incentives push states toward quality and efficiency. Increased regulation protects patients. Decreased regulation attracts business. If fifty state legislatures compete to balance patient protection against affordability, effective and efficient oversight will emerge.

• The alternative is to have federal mandates—giving Americans no choice and leaving the political class with no competition.

We the People provide oversight

• Independent watchdog groups could rate states and insurance companies on cost and patient satisfaction. This sifts the good from the bad.

• Armed with knowledge and incentive, Americans would push insurers to offer better, cheaper products tailored to their specific needs.

CONCLUSION: Allowing businesses to purchase insurance across state lines empowers We the People, not Washington, and does not cost a dime. CNN’s Wolf Blitzer repeatedly questioned President Obama’s senior adviser David Axelrod about this reform. Axelrod offered no reason why it would not work. This measure should enjoy bipartisan support.

REFORM #2: Let individuals purchase health insurance with pre-tax dollars

FACT: Insurance companies serve businesses, not patients

• Businesses purchase employee health insurance with pre-tax dollars. Individuals purchase insurance with post-tax dollars making their insurance far more expensive.

• This reform lets patients buy products that meet their needs and makes insurers more accountable to patients.

CONCLUSION: This reform empowers We the People and requires no federal spending.

REFORM #3: Encourage Health Care Savings Accounts (HSAs)

FACT: HSAs reduce health care costs without rationing (cutting Medicare)

• No one spends someone else’s money as wisely as they spend their own. This is the fundamental problem of any third-party-payer system (whether insurance companies or government).

• When a third party pays, nobody cares about cost. HSAs encourage patients to ask:

1) How much does this cost?

2) Do I need this test or medication?

• HSAs let patients control their own money, decreasing health care spending by 13%.

• This “bends the curve” without rationing care. During 2005 and 2006, traditional insurance rose 7.3% annually. Lower cost / higher deductable plans combined with HSAs rose only 2.7% annually.

FACT: HSAs encourage “young invincibles” to buy insurance

• Allowing patients to transfer unused, pre-tax HSA dollars to retirement accounts gives “young invincibles” a reason to purchase health insurance.

• Washington’s “reform” forces younger / healthier Americans to buy insurance under threat of fines or prison.

CONCLUSION: By addressing a fundamental problem of today’s health care system, this reform “bends the curve” without rationing care. Again, it empowers We the People without plunging America further into debt.

REFORM #4: End abusive medical litigation

FACT: Frivolous litigation drives physicians out of medicine

• Tremendous upheaval occurs when physicians are accused of malpractice—even when acquitted. Bringing tens of millions of new patients into the system requires more physicians, not fewer.

FACT: Frivolous litigation reform lowers cost and improves access to care

• Americans spend approximately $124 billion every year because physicians practice defensive medicine. Frivolous lawsuit reform could reduce healthcare spending by approximately $70 billion annually.

• In 2002, 62% of counties in Texas did not have an obstetrician. After passing frivolous medical litigation reform in 2003, nearly 600 obstetricians returned to practice medicine in the Lone Star State by 2007.

CONCLUSION: Ending abusive litigation “bends the curve” without rationing care. Physicians for Reform outlines medical litigation reform that reduces frivolous suits, expedites legitimate suits, and holds negligent physicians accountable. (

REFORM #5: Covering the uninsured

FACT: We can insure the uninsured without expanding American debt

• Approximately 25% of patients who visit the emergency room where I work do not have health care coverage. Clearly something must be done.

• A system of tax credits can help the uninsured purchase coverage. This would cost approximately $80 billion annually. Reforms #1 through #4 will save approximately $120 billion annually, covering the uninsured. Healthcare reform must be viewed in terms of American debt, not federal deficit.

Getting Health Care Reform Right

Scott Brown's election to the Senate gives the nation a chance to slow down and rethink health care reform. It gives our lawmakers an opportunity to keep the patient at the center of American health care. And to do this we must:

- Scrap the current legislation.
- Enact the five reforms listed above.
- Pass each reform separately, one bill every four months.
- Limit each bill to 50 pages.
- Let each bill pass or fail on its own merits—no pork, no pay-offs.
- Make final language available to the public for at least 7 days prior to voting.

We the People
want patient-centered, fiscally responsible reform. Change for the sake of change is not enough. Massachusetts voters made this clear. Washington, listen and give Americans real solutions. Only then will we support you at the ballot box. 

C. L. Gray, M.D is president of Physicians for Reform. For more visit