Do No Harm!
The physician’s creed to “First, do no harm” also is a warning to America’s policy makers and leaders as they consider massive changes to our health sector. Congress and the Obama administration are on a dangerous march to dramatically expand government control over America’s health care. The proposals being discussed will make matters worse, not better. Our freedom to make basic decisions about life, liberty, and health care is at stake.
To that end, we urge decision-makers to use the following principles to judge any health reform proposal, policy, or legislation that may be forthcoming:
No new government-run health insurance plan
A new national health plan, to be operated by the federal government, is being proposed with the claim that it would give Americans a choice between public or private health plans.
While there may be initial assurances that the plans would operate on a level playing field, the government inevitably will use its regulatory, pricing, and taxing authority
to favor its plan. Congress would give the government plan the power to dictate prices so it can artificially under-price private plans and drive them out of this one-sided "marketplace."
Many people then would be left with little or no choice, as employers would drop their current coverage and send their workers into the public plan. Research by The Lewin Group
shows that as many as 118.5 million Americans would lose or be switched out of private health coverage. This massive crowding out of private health insurance would undermine the
employment-based coverage that most Americans under age 65 have today.
Once private plans have been driven out of the market, people will realize that the government plan will not be able to sustain the quality and quantity of benefits they were promised.
Government instead will begin to ration care and services, driving out innovation, competition, and patient-centered quality.
No one-size government-dictated package of health benefits
Decades of experience in the states confirm that whenever benefit packages are determined politically rather than by the marketplace, legislators find it very difficult to say no to anyone asking that their services and products be included.
People would have a "choice" of only the expensive one-size-fits-all plan mandated by government, significantly increasing the cost of health coverage. Workers would pay for this more expensive coverage through lower wages, lost jobs, higher taxes, and lower-value health care.
No new jobs-killing mandates on employers
Employers would be required to pay an unspecified "meaningful contribution" toward their workers' health insurance or pay a new tax to fund the government plan.
If they are not
"playing" in the new system by directly providing health insurance, then they will be "paying" to fund the government plan. It is a political certainty that the option to "pay" this new
health insurance tax will be set lower than the current levels at which employers now "play" by providing their own coverage, enticing many of them to transfer their employees' insurance
coverage to the mercies of the new government plan.
Whether they choose to pay or to play, small employers will be hit especially hard by a new mandate to finance all or part of the health insurance premiums for their employees, directly
or through new taxes. Any initial subsidies to them will quickly be overtaken by higher mandated costs. As they absorb new tax burdens they cannot control, the result will be more lost
jobs and lower wages for workers.
No requirement on individuals to buy this expensive coverage
If the federal government requires everyone to purchase health insurance, it must define what qualifies as insurance.
All signals indicate this would be a very expensive benefits
package, designed as one-size-fits-all in theory but delivered as one-size-fits-none in practice. Sweeping government mandates create a conflict between escalating costs, limited resources,
and the false guarantee of rich coverage — triggering price and supply controls.
Many individuals will need subsidies to receive coverage that otherwise would be unaffordable to them, but taxpayers will resist filling an abyss. As a result, political leaders will
try to cover rising costs indirectly and invisibly — through general revenue subsidies, tax increases, deficit spending, and escalating fees, fines, and taxes imposed on employers. And
to make the mandate work, the government also must establish and enforce binding penalties for individuals who do not comply.
No federal institution that controls private health insurance
A new National Health Insurance Exchange is being proposed to "streamline the purchase of health insurance."
It actually would steamroll over private choice and patient preferences by providing a vehicle to extend sweeping federal regulation into virtually every corner of our health sector. This would reduce choice for patients and discourage or prohibit innovation and flexibility in health insurance offerings that today are helping many companies and families balance their health costs with other needs.
No government intrusion into our medical privacy
If the government exerts more control over our health sector and compels Americans to purchase health insurance, it also will be able to gain control over our medical information.
A mandate requiring each of us to purchase health insurance would require a system to track our compliance. And the government could even use this leverage to regulate our behavior — telling us that we can pay lower insurance premiums if we don’t smoke, for example, or that we must pay higher rates if we don’t comply with government-mandated treatment protocols. A mandate for health insurance coupled with government control over our health records would mean a loss of medical privacy for every American.
No federal government control over the practice of medicine through a federal health board, comparative effectiveness review, and other government intrusions into doctor-patient medical decision-making
The clear and present danger is that any centralized health board will use the cover of comparative effectiveness findings to meet budgetary bottom lines, at the expense of patients’ medical needs and personal preferences.
Congress
appropriated $1.1 billion in taxpayer funding for comparative effectiveness research in the economic stimulus bill, establishing the Federal Coordinating Council for Comparative Effectiveness
Research, which will assess medical treatments available to Americans. This provides an irresistible temptation for politicians to go beyond providing better information and start restricting
the treatment choices available to patients. House Appropriations Chairman David Obey (D-Wis.) said the intent was that drugs and treatments "that are found to be less effective and in some cases,
more expensive, will no longer be prescribed."
The clear and present danger is that any centralized health board will use the cover of comparative effectiveness findings to meet budgetary bottom lines, at the expense of patients'
medical needs and personal preferences. This is a particular danger to the health of people who suffer from rare conditions or who need access to specific medicines and treatments but
who may lack the political power to influence the reviewers' decisions.
These flawed ideas for radical change should be rejected if ever they appear in any health reform plan. Only those reform proposals that preserve the freedom, innovation, and quality of American medical care should be supported. We believe a better functioning, more competitive, and transparent marketplace would cover more people and deliver the higher-value care we seek.
DO NO HARM! Please sign the petition to let elected officials know you believe that any proposal that includes any of these Do No Harm principles should be rejected. Tell them you don’t want centralized Washington control over our health sector.