GOP's Obamacare-lite needs to die, too: Column

With the Supreme Court hearing another challenge to ObamaCare Wednesday, Republicans are scrambling to craft their replacement plan. The leading contender is the "Patient Choice, Affordability, Responsibility, and Empowerment Act" — the Patient CARE Act — authored by Senators Orrin Hatch and Richard Burr and Congressman Fred Upton. They have heralded the plan as a "common-sense" proposal which includes "patient-focused" reforms without ObamaCare's "Washington mandates."

But despite its authors' good intentions and their exemplary work in other policy areas, it will do little to fix America's broken health care system. At best, it will be ObamaCare-lite. At worst, it will be ObamaCare by another name. And in either case, it will not fix health care.

So why is this Republican plan doomed to fail? Because when it comes to health care reform, its authors — along with the GOP as a whole — are in thrall to the progressive vision that simply expanding health insurance is the solution to America's health care ills. ObamaCare was predicated on this goal; so is the Patient CARE Act.

This objective cannot be achieved except through a monstrous, hundred or thousand-page-plus bill stuffed with market-distorting policies, special interest handouts and innumerable regulatory changes that keep Washington firmly in control of our country's health care system. Nor can it be achieved without harming patients. It requires a massive bureaucratic apparatus in which regulators are empowered to make choices such as how much plans should cost, what they should cover and a hundred other things.

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Unsurprisingly, bureaucratic micromanagement of such a complex issue has severe unintended consequences.

Simply look at America's health care system under ObamaCare. Costs continuously increase — see last year's 41% average spike in premiums. The doctor-patient relationship declines — see the ongoing drop in the amount of time patients spend with physicians. Bureaucracy strangles small and start-up providers — consider the drastic decline in private practices. The quality of medical care gets worse — a majority of doctors attest to this reality.

In short, the focus on health insurance has harmed health care — and the Hatch-Burr-Upton plan is little different. It bears striking similarities to the law it is meant to replace, including taxpayer subsidies for insurance and an "auto-enroll" feature ideologically linked to the individual mandate. Nor does it address the barriers that prevent new health care providers from offering superior products and lower prices, maintaining high levels of bureaucratic control over innovation and patient choice.

Which begs the question: If not health insurance, then what? Republicans should focus on improving the affordability, accessibility and quality of health care itself. This is a worthier goal than merely putting an insurance card in everyone's hand.

This simple shift in priorities radically alters the policies available to lawmakers. Most notably: It precludes an omnibus-style bill akin to ObamaCare, which will always be riddled with bureaucracy, special interest handouts and other cost-increasing and quality-reducing provisions. Instead, the GOP should focus on targeted reforms which fix specific problems in health care. This is also the party's best path forward while President Obama is in the White House, as he would veto any bills which make major changes to ObamaCare.

There are numerous possibilities, many with bipartisan support. Legislators can reform the Food and Drug Administration to increase access to new and revolutionary treatments. They can break down federal barriers which prevent patients from utilizing "tele-medicine." They can repeal regulations, such as ObamaCare's ban on new physician-owned hospitals. They can establish a "blended" funding rate for Medicaid, which would give states the freedom to tailor their health care programs to their citizens' particular medical needs. They can allow for "site neutral payments," which would reimburse independent providers at the same rate as hospitals. They can allow for competitive bidding under Medicare to incentivize providers to cut costs and innovate. They can protect people with pre-existing conditions by promoting "health status insurance." The list goes on.

Reforms along these lines — and many more exist — can instigate a cost and quality revolution which bureaucratic control never could. Other medical fields demonstrate the possibilities — e.g Lasik, dentistry, cosmetic surgery and alternative medicine. With innovation allowed to flourish and patients allowed to choose, quality has increased, prices have plummeted and access has increased.

Which is exactly what Republicans should aim to bring to the rest of health care. Unfortunately, they will fail to achieve this goal with the Patient CARE Act. For all its positives, it is still predicated on the notion that expanded health insurance is the solution to America's health care woes. This well-intentioned yet ultimately harmful idea will taint their final bill — and it will do little to make health care itself more affordable, more accessible and more effective for the American people.

Nancy Pfotenhauer, a former chief economist for President George H.W. Bush, is a senior policy adviser at Freedom Partners Chamber of Commerce, where Nathan Nascimento is the health care policy director.

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