Thinking Outside the ObamaCare Box

By Kelly McCutchen

Health care costs threaten to bankrupt our country. Debates over Medicaid expansion, the Medicare “doc fix,” the State of Georgia’s health plan, coverage of autism and so many other health care issues merely shift these costs from one party to another.

The time has come for a “let’s go to the moon” challenge that truly addresses the underlying problems.

Higher education costs are on a similar trajectory. A few years ago, governors Rick Perry of Texas and Rick Scott of Florida challenged their higher education institutions to design a four-year bachelor’s degree program for $10,000 or less.

Not $10,000 a year but $10,000 for all four years.

Many schools rose to the challenge, met it and now offer these low-cost degrees.

Why not health care? And why not Georgia as the leader? This state leads the nation in health care information technology, has some of the best health care institutions in the nation and is a leader in telemedicine. Despite this, many areas of the state continue to struggle with near Third-World health care conditions.

The challenge is this: Create affordable access to health care for $2,000 a person.

Why $2,000? This is about the amount taxpayers already pay to offset the unpaid medical bills for uninsured Georgians.

Start with a blank slate: Waive the rules and regulations that needlessly raise costs. Much like charter schools, waive regulations in exchange for accountability and results. Requirements would include reliable access to primary care and private insurance coverage for unexpected, catastrophic health care costs.

How realistic is this? Florida’s pilot Medicaid program covers non-disabled adults for less than $2,000 per person. A “new” model of care, Direct Primary Care, is already available in many states and resembles the days before the complexities of insurance. Referred to as “concierge care for the little guy,” these plans provide almost unlimited access to primary care services for around $800 per person. For many individuals, catastrophic health insurance policies to cover large expenses are as low as $100 a month.

With more flexibility, innovation and better use of technology, the goal becomes realistic.

Perhaps the best way to test the idea is to make the offer and let entrepreneurs fill the need. To avoid corporate cronyism – and because individuals have unique needs and should decide what’s best for themselves – the $2,000 would be deposited into each person’s Health Savings Account to fund any arrangement that meets the criteria. Individuals could choose from numerous options to help customize their coverage to their particular situation or condition.

There will, of course, be details to work out. Older Georgians and those with chronic diseases will be more costly, but payments could be adjusted to account for this. Keeping these individuals healthy is where the biggest costs savings lie. Unused funds would return to safety net providers to pay for the care of the uninsured.

Far better than expanding traditional Medicaid, this serves not only as a way to provide coverage for the uninsured, but the costs of health care would be driven down by innovation, benefiting everyday working Georgians. No one would have a problem finding a doctor to see them; no one would lie awake at night worrying what would happen if they were diagnosed with cancer.

If we can put a man on the moon, we can find a way to provide affordable health care. If the private sector can fly rockets to the International Space Station, the private sector can find a way to offer quality care at affordable costs.

Georgia is well positioned to answer this $2,000 health care challenge and provide hope for the rest of the nation. The savings to taxpayers would be in the billions of dollars. Lower health care costs for businesses would make them more globally competitive, leading to a surge of new job creation.

What are we waiting for? Let’s get started.


 U.S. Spending by Category in CBO’s Alternative Fiscal Scenario (Percent of GDP)