Michigan Can Assist In Real Health Care Reform

From the Detroit News: "Michigan can assist in the creative destruction of Obamacare".

An excerpt from the article:

Just like the smartphone pretty much eliminated the market for cell phones and calculators, enterprising doctors and other medical providers are starting to eliminate the demand for insurance companies and government bureaucrats to spend our health dollars for us. In Michigan, Lansing is poised to help this “destructive” process.

State Sen. Patrick Colbeck has introduced legislation to clear the way for direct primary care. For a fee, doctors deal directly with patients and bypass costly insurance or government regimes. Considering the traditional health insurance system adds about 40 percent to typical medical bills, charges to treat many common diagnoses are steeply discounted. For instance, treating an ingrown toenail costs $50 under a direct primary care doctor in Kansas. Under the traditional system, he’d have to charge $200.

This health care model is nothing new but is seeing a resurgence thanks, ironically, to a clause in the Affordable Care Act itself which Colbeck calls a “free market loophole” that he wants to drive a Mack Truck through.

The direct primary care model already has a reported half million people on board and is rapidly picking up steam with doctors, patients and even investors. It is really an offshoot of the higher priced “concierge care,” which is also gaining popularity.

From Colbeck's website:

[L]legislation sponsored by Senator Patrick Colbeck (R-Canton) to assert that Direct Primary Care Services should not treated as an insurance product was reported  out of the Senate Insurance Committee.  The purpose of the bill (SB 1033) is to assure physicians who convert their practice to a Direct Primary Care Service model that the administrative burden associated with insurance regulations will not interfere with their treatment of patients. 

Colbeck's position is absolutely right -- a "direct pay" practice should not be subjected to onerous insurance regulations.  

This approach will allow consumers and physicians to more easily contract to their mutual benefit -- saving money and lives in the process.

(Link via Dr. Megan Edison.  And if you haven't done so already, please feel free to check out her group blog on health care policy, RebelMD!)

Catron: GOP Governors Squander SCOTUS Victory

An unfortunate update from David Catron: "Eight GOP Governors Squander SCOTUS Victory".

He reminds us that the 2012 Supreme Court decision

...dealt the Obama administration an important defeat on one of the two primary issues decided, namely whether the federal government has the right to withhold all matching funds from a state that fails to expand Medicaid according to the dictates of the unpopular health care law.

Medicaid is a joint state-federal program, yet a provision of Obamacare required the withholding of all federal funds from noncompliant states. The plaintiffs argued that this was so coercive that it amounted to an unconstitutional “commandeering” of the states. Seven of the nine justices agreed. This victory, despite the Court’s ruling that the individual mandate is somehow a tax, was viewed by many as an opportunity for GOP governors to thwart implementation of an integral component of the law.

To the disgust of Obamacare’s opponents, however, eight GOP governors have nonetheless decided to comply with the law’s Medicaid provision. Arizona’s Jan Brewer, Florida’s Rick Scott, Michigan’s Rick Snyder, Nevada’s Brian Sandoval, New Jersey’s Chris Christie, New Mexico’s Susana Martinez, North Dakota’s Jack Dalrymple, and Ohio’s John Kasich have all caved. Even worse, several of these people have been vocal opponents of Obamacare and govern states that participated in the lawsuit that produced the Court’s favorable ruling.

 He discusses the fiscal implications, then adds:

What makes this so infuriating is that these Republican governors are waving the white flag after winning a hard fought legal battle in order to escape this very dilemma.

 (For more details, read the full text of "Eight GOP Governors Squander SCOTUS Victory".)

DetNews: Obamacare Favors Big Hospital

The 11/8/2012 Detroit News notes, "Obamacare favors Big Hospital, less competition".

This is just the latest incarnation of a much older strategy.  Jonah Goldberg’s book Liberal Fascism described how the Roosevelt administration sought similar consolidations of American agriculture and business during the New Deal. As Goldberg noted:

[If] you want to use business to implement your social agenda, then you should want businesses themselves to be as big as possible. What’s easier, strapping five thousand cats to a wagon or a couple of giant oxen?

Similarly, it will be much easier for the government to control 100 large "Accountable Care Organizations" than 100,000 individual hospitals and private practices. (Via AAPS.)

Taxing MDs in Michigan

Michigan Governor Jennifer Granholm has revived the idea of taxing physicians to help make up the state budget deficit.

It would be like trying to solve the hunger problem by taxing the farmers who grow food.

Between the predicted 21% Medicare cuts and these additional taxes, I expect many Michigan physicians will either stop accepting indigent patients or just leave the state.

With the apparent stalemate at the national level on ObamaCare, we'll see more state-level action such as this. Will states attempt more government controls (as Michigan), or will they adopt genuine free-market reforms?