Leavitt recently spoke on the Salt Lake based radio show, Radio West, about our health care system. Following are quotations from his interview.
To begin with, Leavitt sees our country heading toward economic disaster that will affect generations if the health care system isn’t dealt with effectively and soon. But he doesn’t believe either party is offering a viable solution.
If fact, he said republicans proposing a free market solution don’t understand the complexities of the situation.
I think my own party has been deficient in it’s capacity to talk about this issue. We have defaulted to an ideology as a response as opposed to a plan. And I believe my party has an obligation to step up and speak in a far more specific way than they have.
The democrats have a plan, but not a good one. Leavitt rejects the idea that a government run system is the answer because it relies on two wide spread myths. First: That the bureaucracy can effectively reform and manage the health care system. Second: That ramped up spending constitutes reform.
The WHO reports that in 2005 the U.S. spent 15.2 percent of it’s GDP on health care. The closest “developed” nation to that was Switzerland with 11.4 percent. The WHO ranked the U.S. 24th in life expectancy in 1999. According to NPR’s 2005 comparison of health care coverage, 18 percent of Americans under 65 are uninsured. In the other six developed nations listed, nearly all were covered. Clearly money doesn’t fix everything.
Obama’s plan would pour money into developments like computerizing medical records. In the long run, this might save money. But remember, 2016 is when Medicare goes bust. Other systems around the world teach us we can do things to create a much more efficient and cost effective system without these upfront costs. There are a plethora of blaring inefficiencies in our system that, if we fixed, would save money right off the bat. For example, ending Medicare coverage for tests that aren’t proven to give any benefit whatsoever. (See first comment by Maggie Mahar following the article)
In Leavitt’s view, government has a strong role in health care reform -- not managing it, but creating a framework for an organized market system. He poses the question whether health care reform should use food or national defense as a model.
We’ve made a decision that we’re not willing to let people go hungry. But does government make all the decisions about food? No… They set up guidelines to make certain it’s safe. We even have a system that if people can’t afford it we’ll subsidize. It’s called food stamps. And if you can’t go to the store and get your own, we’ll take Meals on Wheels to you. …
On the other hand there’s defense. You wouldn’t want to have more than one. That would be a bad thing. But the government should decide how it’s deployed, should decide how much we need, should decide where it goes.
As you might guess, Leavitt said he sees health care as being more like food -- a system overseen by the government to meet the needs of our citizens, but not planned by it. The government’s role here would be to regulate the insurance market to see that it is affordable, ensure people are made aware of the costs of health care as well as the quality of services, and to iron out inequities including subsidizing people who can’t pay for needed health care services.
Leavitt sees a slow moving congress and an inefficient bureaucracy as incapable, by themselves, of instituting the kind of reforms we need in health care.
Influence from powerful lobbyists is one reason for this. True reform would require shaking up the status quo and rebuilding a fair and organized system. As long as the decision is in legislators’ hands lobbyists will hold undue influence.
One person’s waste is another man’s living. And it’s very difficult to begin, in a congressional atmosphere, creating a conundrum and then resolving it in a zero sum game. They just can’t do it. So why are market forces important here? Because market forces, when they’re organized, are dispassionate enough to find their way to the highest quality at the lowest cost. Legislative bodies can’t do that.
Leavitt said some aspects to health care reform need innovative solutions. So he doesn’t believe the national government is best suited for the role as chief reformer. He would rather see the states take the lead.
We could solve the problem of access to health insurance within four years. … If the national government would say, ‘there is a compelling national interest for everyone in this country to have access to an affordable insurance policy.’ And if congress were then to fix the tax laws, do something about fixing the way hospitals are financed and then say to the states, ‘your job is to figure out how to provide a market place that’s organized and we’ll help you pay for parts of the subsidies.’ The states would figure this out. I know they would, because I’ve worked with as many as 30 of them who’ve been trying, but they’ve been blocked by policies at the national level.
The Federal government doesn’t need to micromanage health care reform or borrow another trillion dollars from our grandkids. Of course there will be upfront costs associated with getting people health care who haven’t been to a doctor in years. That would be a huge problem for a government funded program like Medicare, but it's an investment opportunity in a well organized market.
An organized market will quickly guide health care to a more sustainable path by cutting out waste. The government will need to do a better job regulating to smooth out inequality and catch those who would cut corners and compromise safety, but this is the government’s role in most sectors of the economy. This kind of reform will fix our health care system, not just shift who pays for it.