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Free Market Health Care

Former Mayor of New York City Rudolph Giuliani made the free market case for health care in the following article from The Boston Globe:

AMERICA is at a crossroads when it comes to healthcare.

All Americans want to increase the quality, affordability, and portability of healthcare. The 2008 election presents a decisive debate on how to reach this goal.

The Democratic candidates for president believe in a government-mandated model that looks for inspiration to the socialized medical systems of Europe, Canada, and Cuba.

Most Republicans believe in expanding individual choice and decision-making. I believe we can reduce costs and improve the quality of care by increasing competition. We can do it through tax cuts, not tax hikes. We can do it by empowering patients and their doctors, not government bureaucrats. Instead of being more like Europe, we need to be more like America.

America has the best medical care in the world. People come here from around the world to take advantage of our path-breaking medicine and state-of-the-art treatments.

But the healthcare system is being dragged down by decades of government-imposed mandates, wasteful bureaucracy, and massive distortions in the US tax code that punish self-employed and low-income workers. Since 2000, Americans have seen their health insurance costs nearly double. Frivolous lawsuits have led to defensive medicine and doctors leaving the profession. More than 45 million Americans are without health insurance.

America is best when we solve our problems from our strengths, not our weaknesses. Healthcare reform must be based on increased choice, affordability, portability, and individual empowerment.

We need to begin by bringing fairness to the tax treatment of healthcare. The current tax system penalizes millions -- including the rising ranks of the self-employed and 40 percent of employees at small firms -- who pay for insurance on their own and receive no tax benefit.

Americans without employer-based insurance, or those who would rather have individual coverage, should enjoy the same tax benefits as the 175 million Americans with employer-based coverage.

We can do this through a new tax-free income exclusion up to $15,000 for Americans without employer-based coverage. Any amount a family pays less than $15,000 -- for individuals, less than $7,500 -- could be put tax-free into a Health Savings Account. This would create a powerful incentive for more Americans to own their private health insurance -- making it portable instead of dependent on an employer.

If millions of people go into the marketplace looking for less expensive health insurance, it will drive the insurance companies to create less expensive products that meet individual needs instead of government mandates. Americans should have the option to buy health insurance similar to their auto insurance -- covering major costs while leaving decisions about minor expenses to the consumer -- while those happy with their current coverage can keep it.

Empowering people with real choice will improve markets and lower premiums. Expanded tax-free Health Savings Accounts could be used for insurance premiums, deductibles, and other expenses. With more flexibility and individual control, Health Savings Accounts can become a major source of tax-free savings and security for America's middle class. As savings are created and there are reductions in the cost of health insurance, we will develop a new health insurance credit for low-income individuals and families so they can purchase private insurance tailored to their needs. We want to empower individuals, not the government.

We also need to use the lessons of welfare reform in the 1990s and encourage Medicaid reform through block grants to the states. One of the advantages of our federalist system is that different states can try different approaches to solving problems and learn from each other. States should be empowered to meet benchmarks regarding the affordability of insurance options and the availability of preventive care. The result will be a healthcare system focused on wellness, not just sickness. And if a state insists on expensive mandates that keep healthcare options unaffordable, we will open the state insurance market up to interstate commerce so their citizens can shop for insurance options in other states.

To address the unaccountability surrounding healthcare costs, we need to end lawsuit abuse by unscrupulous trial lawyers. In some areas of the country it's impossible to find an ob-gyn. In Florida, liability insurance for general surgeons is approaching $175,000 per year and more than $200,000 for ob-gyns. Doctors and nurses who have devoted their lives to helping others are relocating or leaving the practice of medicine altogether, because they literally can't afford the insurance against frivolous lawsuits. The cost of saving lives is just too high. The American people understand this problem: That's why 73 percent of Americans support medical liability reform. Reasonable caps on noneconomic damages would fix this broken system and end medical lawsuit abuse.

The future of America's healthcare system lies in free-market solutions, not socialist models. We can increase individual choice and decrease costs by increasing competition, encouraging innovation while always compassionately caring for people in need. That's the American way to reform healthcare.


Free Market Health Care is possible and we should stop the potentially devastating further intrusion of government bureaucracy into our lives.

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