I believe that the US healthcare system is seriously broken. The incentives in the current system are grossly misaligned, causing the US to pay almost double what other high-income countries pay per person on healthcare, while we see worse health outcomes on average. My healthcare plan aims to address these costs by simplifying the system and giving patients more options and information on where to get the best care for the lowest price. I aim to shift our health insurance system towards one that is electronically run, where the individual, not the employer, is in charge of choosing coverage. This will lower the administrative costs that account for around 25% of all healthcare expenses in our country, while making it easier for and cheaper for those unemployed to get insurance.
Additionally, I plan to adjust the incentives for medical providers away from ordering more tests and towards better patient outcomes by mandating that medical providers be paid for the value of their services, not just the cost they incur, pushing them to save money and improve their quality of care. I also plan to publish and organize price and outcome data for each provider on an intuitive, single website, allowing Americans to choose where to get the highest quality medical service for the lowest price. And ultimately, I recognize that much of our health is determined by the environments in which we live, so I plan to invest more in social services like housing, and education which will make all Americans healthier and will lower our healthcare spending over time.
I agree with many that we need to make insurance available to all Americans, but unlike Medicare for All or simply adding a public option, my plan aims to continue regulated competition among private insurers, which will allow for consumer choice and reduce costs, while also targeting administrative costs, which are a huge burden on our current system. Under my plan, all Americans can choose any provider they’d like, and no basic plan will be able to discriminate against pre-existing conditions or age. All insurance companies will be required to run as not-for-profit corporations and will have to provide a basic plan that covers basic and necessary medical needs at a regulated price. Additional, more comprehensive packages will be offered by these insurance companies at a higher price, so many Americans can keep the same benefits they receive now. No longer will insurance be tied to employment, meaning that everyone, regardless of employment status, will have access to affordable coverage, and programs like Medicaid and Medicare will be absorbed into this system, reducing administrative costs. And under my plan, the federal government will subsidize costs for those who can’t afford their insurance or medical expenses.
In 2019, the United States spent about $10,948 per person on health care. The average among OECD nations, which are largely high-income economies like ours, is $4,224 [source]
In 2017, the US suffered 175 preventable deaths and 88 treatable deaths for every 100,000 citizens. That is 42 preventable mortalities and 13 treatable mortalities over the OECD average [source]
The US spends around 25% of all its healthcare spending on administrative duties like billing and coding. Canada spends around 12% of its healthcare spending while England spends 16% on these administrative costs [source]
Between 2008 and 2014, there were more than 750 mergers and acquisitions of hospitals, reducing the total number of hospitals since 1975 by around 11%. This puts around 20% of all hospitals in the US in monopoly markets, allowing them to charge higher prices [source]
My plan also aims to be more aggressive in addressing the high costs of health care while improving the overall health of our nation. Unlike the Affordable Care Act and Medicare for All, my plan will invest in the social determinants of health, which experts believe have greater impacts on health than actual healthcare. By investing in and integrating the healthcare system with social services centered around housing, nutrition, and education, we can improve the health of all Americans while simultaneously reducing the number of costly health care services used. Inside medical facilities, I will push for systems that reward providers for better patient outcomes, not for just how many tests they order, through value-based payment structures that aim to improve the quality-to-cost ratio of medical services. I will be tough on pharmaceutical companies that inflate the costs of life-saving drugs by encouraging the entrance of many generic brands and by imposing stricter regulations on their advertisements and prices. I will push for price transparency, so Americans always know how much they will pay for a medical service and whether there are cheaper, higher quality options elsewhere. Additionally, I believe in bringing medical infrastructure into the 21st century by investing in telehealth and making health records electronic and accessible through a single, secure card that will reduce the time Americans waste regurgitating patient data to different doctors, and the time and money wasted on processing insurance claims. Simply by recognizing that much of health is determined outside of medical facilities and by reducing all the inefficiencies from providers and insurers in our current healthcare system, I believe my plan will raise the length and quality of life for all Americans, while leading us away from financial ruin and towards economic security and sustainability.