by State Senator Dr. Mark Green (R-Clarksville)
In my third and final op-ed on the healthcare crisis facing America, I’ll discuss the last major problem causing the crisis as well as a solution to address it. You can read part one here, and part two here.
Liability reform is a major area for saving billions of dollars. No one wants to be sued, causing doctors to go crazy ordering CAT scans and labs to make certain that if we are called to the witness stand, we can say we did everything we could. Frivolous lawsuits and exorbitant awards are costing providers and their insurance companies millions of dollars in insurance premiums. Those costs are then passed onto the patients in increased healthcare costs, and thus, increased insurance premiums. In some states, like Florida, three lawsuits and you lose your license.
In a recent poll of emergency physicians, 65% said that they could save over $500 per 8-hour shift by decreasing unnecessary tests as a part of their defensive practice. Another 16% felt they could save between $200 and $500 dollars. I ran a level 2 trauma center that saw 75,000 patients a year. If we assume a conservative savings per shift of $400 dollars–less than a single CAT scan–then in my emergency department alone, stopping the defensive practice of medicine would save $1,314,000 a year. There are over 5,000 emergency departments in the country.
But how can you have a government-run program to help people who need assistance, and yet allow free market practices set the price? The government already has a program in place that does just that.
The food stamp program, now called the Supplemental Nutrition Assistance Program, or SNAP, is where more than 40 million Americans receive assistance. People who qualify are given a debit card and allowed to purchase the food they desire. The market price for food remains unchanged because the consumer is choosing how to allocate the resources. The consumer recognizes there is a limited amount and thus chooses prudently on how to spend the money.
As a State Senator, I innovated and passed a pilot project bill to create a patient-centered and patient-controlled option for our state’s Medicaid population. Simply put, it’s a medical expense swipe card with a reduced amount of dollars available for medical purchases coupled with a catastrophic insurance plan. The recipient is told the card is for healthcare expenses and the card is only usable at allowed facilities—and any money they do not use comes back to them with their earned income credit, thus incentivizing them to shop for lower prices and save money.
We must reverse the incentives that have driven a rise in healthcare costs at twice the rate of inflation than the rest of the economy. Until we put free market principles back into healthcare, we cannot fix it. Consumer-centered health care shifts control of choice, decisions and payment to the patients and their providers. This system reverses the current incentive to spend regardless of the cost. It would remove the government from price fixing and thus allow the market and competition to push the price down. This health savings account-like approach could save similarly 9%. For Tennessee, that would nearly pay for the expansion population just in savings, requiring not a single dollar from the federal government. Lastly, coupled with real tort reform, physician defensive practices would decrease and significantly enhance savings.
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State Senator Dr. Mark Green (R-Clarksville) is the Republican nominee for the 7th Congressional District seat in the U.S. House of Representatives.