Expert proposes US healthcare reform — The Hill
In the United States, Clifford Porter, a senior healthcare fellow at the Texas Public Policy Foundation, proposed a package of federal changes in health insurance, Medicare operations, and pricing for medical services. In an op-ed for The Hill, he stated that the reforms should strengthen patients’ and doctors’ control over treatment and reduce healthcare costs.
Porter links the high cost of healthcare to the role of insurance companies, hospitals, and intermediaries in the pharmaceutical market. He criticizes the Affordable Care Act, also known as ObamaCare, and opposes the Medicare for All model. In the author’s view, a government healthcare system may require tax increases or restrictions on access to medical care.
Insurance proposals
Among the proposed steps is expanding access to catastrophic health insurance plans for people of any age and income level. The author also proposes making health savings accounts, or HSAs, available for all types of insurance plans, including for Medicare participants.
Separately, Porter calls for allowing employers to offer workers cost-sharing mechanisms and other health coverage options outside the Affordable Care Act marketplace with the same tax benefits. Another of his proposals is to allow short-term insurance plans for up to one year, renewable for up to three years, for people changing jobs or insurance plans.
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Hospitals, Medicare, and medicines
The author proposes repealing Affordable Care Act restrictions on physician ownership of hospitals. He also advocates recognizing direct primary care clinics in the Medicare system and clarifying Internal Revenue Service rules so that such clinics can be compatible with HSAs for providing wholesale medicines and medical supplies.
Porter calls for ending the practice under which Medicare pays hospitals higher reimbursements than independent clinics. In his view, this has contributed to large hospital systems acquiring independent medical facilities.
He also proposes limiting the influence of Pharmacy Benefit Managers on drug prices and access to medicines. According to Porter, three such companies control 80% of the market. He insists on greater transparency in corporate insurance contracts and disclosure of conflicts of interest and kickbacks.
The author claims that the combination of changes he proposes could reduce healthcare costs by 50%, but does not provide calculations in the op-ed to support this estimate.
