Healthcare
I'm the only candidate for Governor who understands health-care economics, and that's exactly what Virginia needs right now. We need to do a major rethink of healthcare policy in the United States and in Virginia if we are ever going to solve the problem of exploding health-care costs.
First, we need to fight any further federalization of health-care policy. Federal policies are a major source of the pathologies in our health-care system. Federal laws exacerbate many of the problems they were meant to address, they produce a host of new problems, and they render states powerless to fix anything. The Affordable Care Act is only moving us further in the wrong direction. Our experience with health care is proof that centralized planning by politicians and bureaucrats simply doesn't work.
I favor returning health-care regulation to the states. In addition to eliminating many of the laws, regulations, and tax rules that wreak havoc on the incentives faced by businesses and employees, we also need policy freedom at the state level with regard to public spending on health-care for the poor and elderly. Let Virginia take care of Virginians. We can succeed where federal programs have failed and achieve better health outcomes at much lower cost to taxpayers.
I favor a three-part approach to overhauling public health-care spending:
A salient example of bad state regulation is the "Certificate of Public Need" regime. Before a health-care provider can offer a new service or purchase a major piece of new equipment, it must prove to a state bureaucracy that there is a "public need" for the additional services being offered. The state bureaucracy exercises discretion under the influence of protectionist lobbying. The result is a process that is costly, counter-productive, and patient-harming. It snuffs out job-creation, entrepreneurship, and cost-saving innovation. It is totally unnecessary. The very fact that an entrepreneurial physician, or other service-provider, is willing to take on the business risk of making a major capital expenditure and offering a new service should itself be sufficient evidence of public need. The regulatory regime offers no additional benefits to the public, only private benefits at public expense.
In the same vein, the licensing and accreditation regime for doctors, nurses, and other health-care professionals needs to be revamped. Licensing and accreditation now serve the purpose of cartelizing the professions and, together with other regulations, reduce the supply of health-care providers, driving up costs for patients.
First, we need to fight any further federalization of health-care policy. Federal policies are a major source of the pathologies in our health-care system. Federal laws exacerbate many of the problems they were meant to address, they produce a host of new problems, and they render states powerless to fix anything. The Affordable Care Act is only moving us further in the wrong direction. Our experience with health care is proof that centralized planning by politicians and bureaucrats simply doesn't work.
I favor returning health-care regulation to the states. In addition to eliminating many of the laws, regulations, and tax rules that wreak havoc on the incentives faced by businesses and employees, we also need policy freedom at the state level with regard to public spending on health-care for the poor and elderly. Let Virginia take care of Virginians. We can succeed where federal programs have failed and achieve better health outcomes at much lower cost to taxpayers.
I favor a three-part approach to overhauling public health-care spending:
- Focus on catastrophic, not comprehensive, insurance/care.Comprehensive insurance programs are ridiculously expensive, but the benefits in health outcomes do not justify the cost. The most salient benefit is protection from financially ruinous catastrophic health problems, which can be provided at much lower cost by catastrophic insurance.
- Focus public spending on mental-health care. Studies suggest high returns on public spending on mental health.
- Focus on cash subsidies. Rather than having bureaucrats decide what services should be available and at what cost, providing cash subsidies gives patients greater flexibility to meet their individualized health-care needs and restores market incentives to keep costs down and to innovate in the provision of services.
A salient example of bad state regulation is the "Certificate of Public Need" regime. Before a health-care provider can offer a new service or purchase a major piece of new equipment, it must prove to a state bureaucracy that there is a "public need" for the additional services being offered. The state bureaucracy exercises discretion under the influence of protectionist lobbying. The result is a process that is costly, counter-productive, and patient-harming. It snuffs out job-creation, entrepreneurship, and cost-saving innovation. It is totally unnecessary. The very fact that an entrepreneurial physician, or other service-provider, is willing to take on the business risk of making a major capital expenditure and offering a new service should itself be sufficient evidence of public need. The regulatory regime offers no additional benefits to the public, only private benefits at public expense.
In the same vein, the licensing and accreditation regime for doctors, nurses, and other health-care professionals needs to be revamped. Licensing and accreditation now serve the purpose of cartelizing the professions and, together with other regulations, reduce the supply of health-care providers, driving up costs for patients.