The Trump Administration is moving ahead on its health care reform plan that aims to put consumers back into the driver’s seat of their health care, especially in the face of the COVID-19 pandemic.
The vision behind the reforms is a 124-page document, released by the U.S. Department of Health and Human Service (HHS) on December 3, 2018, entitled “Reforming America’s Healthcare System Through Choice and Competition.” The document outlines dozens of ways in which over-regulation is hurting patients, doctors, employees, and employers.
“Although the president never talks about it and his administration has done little to advertise it, there really is a Donald Trump plan for health reform, and it’s radical,” says health economist John C. Goodman, president of The Goodman Center for Public Policy, which co-publishes Health Care News.
“This is the first time an administration has ever said that in health care, government is the problem, not the solution,” Goodman said. “The Trump vision for health reform calls for deregulation on a massive scale.”
Government in the Exam Room
HHS Secretary Alex Azar, along with then-Labor Secretary Alexander Acosta and Treasury Secretary Steven Mnuchin, alluded to government health care obstacles when they presented the plan to the President.
“Health care bills are too complex, choices are too restrained, and insurance premiums and out-of-pocket costs are climbing faster than wages and tax revenue,” the secretaries wrote. “Health care markets could work more efficiently, and Americans could receive more effective high-value care if we remove and revise certain federal and state regulations and policies that inhibit choice and competition.”
The plan is in stark contrast to the “public option” and “Medicare for All” proposals put forward by the Democratic party, says Brian Blase, who helped draft the Trump health plan when he served as a special assistant to the President at the National Economic Council.
“The Democrats tend to support empowering government and bureaucracies to limit the choices of consumers to what the elite central planners think is best,” Blase told Health Care News. “They also believe in massive corporate welfare for health insurance companies and big hospital systems to prop up the status quo.”
Putting Consumers in Control
The plan involves five general categories of reform aimed at empowering the private sector and keeping government regulation at bay.
Reforms include giving employees access to portable health insurance they can take with them when they leave their employer (see related article, page 13); making it easier for patients to get round-the-clock medical care from providers who are available at nights and on weekends; providing virtual consultations that allow patients to be examined and treated in their own homes, allowing health plans to specialize and become “centers of excellence” for the treatment of various chronic diseases; and giving patients the opportunity to manage and control more of their own health care dollars.
Blase says there have been notable successes supporting those general areas to date: elimination of the individual mandate penalty “which mostly harmed lower-income families who couldn’t afford the expensive government-approved plans,” new rules “that allow consumers to know real health care prices,” a decrease in prescription drug prices “resulting from deregulation and expanded competition,” and health insurance reform through the expanded use of association health plans and lower cost, short-term plans that are renewable in case illness.
The pandemic especially opened the door for virtual health and expanded telemedicine as the Administration began reimbursing such visits under Medicare, Blase says.
“The Trump Administration’s focus was empowering patients with expanded choices and information to be better consumers and ensuring robust competition between providers and insurers to offer the highest quality care at the lowest possible cost,” Blase said.
AnneMarie Schieber (firstname.lastname@example.org) is managing editor of Health Care News.
“Reforming America’s Health Care System Through Choice and Competition,” U.S. Department of Health and Human Services, Department of Labor, and Department of Treasury, December 3, 2018: https://www.heartland.org/publications-resources/publications/reforming-americas-healthcare-system-through-choice-and-competition