Affordable Healthcare for All

There are over 486,000 people in Nevada who lack health insurance, which is nearly one-fifth of all residents. I believe we can provide affordable healthcare to every Nevadan if we invest wisely. But we cannot reach that goal through overregulation and over-taxation. We must address root causes that limit choices, create powerful industry cartels and drive up health care costs.

The financial and economic incentives in our healthcare system are broken. We cannot have a system that financially rewards the Endoscopy Center of Southern Nevada for exposing as many as 40,000 Nevadans to hepatitis B, hepatitis C and HIV by using dirty needles and then not carrying the proper amount of malpractice insurance. We can fix these broken incentives by:

1. Enabling individual choice

Nevadans need an effective mechanism to evaluate the price, quality and suitability of different health insurance and health care provider options. If we can provide people virtually unlimited choices for most every product and service in the economy, why not healthcare?

Most people who have health insurance receive it from their employers. These are one-sized fits all plans that seek to minimize premiums and strip you of the ability to customize your health plan to your particular health care needs. That needs to change.

We need to give consumers more bang for the buck from their health care dollars by changing medical billing practices to require upfront disclosure of price and services to allow for competitive shopping and by allowing individuals to have affordable customized health plan options and not be forced into rigid, choice-limiting employer-sponsored plans.

2. Break the powerful industry cartels

Big health insurance companies, managed care companies and hospital chains have become powerful industry cartels with the power to determine what care you receive, who you receive it from and how much you pay. These powerful industry cartels exist because State Insurance Commissioners create artificial barriers to competition by using state boundaries to draw lines. Current state-based regulation of insurers and healthcare providers effectively prohibits most employers with multi-state locations from realizing cost savings by creating one larger health insurance pool with increased power to bargain down prices. This is very intentional and hurts us all. As a small business owner whose company operates in Nevada and two other states, I have felt the negative economic effects of this first hand.

To break up this anti-competitive, choice-limiting, price-gauging cartel system, the state legislature needs to direct the State Insurance Commissioner to explore working with other states to allow group plans across state lines in order to have larger pools at lower costs. The Building Trades unions have enough legal and technical resources to overcome the obstacles and create regional multi-employer health and welfare plans. The large casinos have just given up on the health insurance industry all together and self-insure their employees. That leaves small business owners and individuals forced to by health insurance on their own out in the cold. That's just wrong.

3. Lowering healthcare costs

Rapidly rising costs of health insurance and healthcare delivery jeopardizes the security of every family and business. I understand this first hand because as a small business owners, I write the checks for my employees' health insurance premiums every month.

As a Certified Public Accountant, I work with many families that are one severe illness or horrible accident away from bankruptcy. I work with potential entrepreneurs who cannot afford to leave their current jobs to follow their dreams because they cannot afford to lose their healthcare coverage for their family. I work with many small companies struggling to take care of their employees and their families.

Enabling individual choice and breaking up health care cartels are important aspects of lowering health care costs, but there is more to be done. Beyond state based solutions, we need leadership from the President and the Congress. I believe a long-term solution to our healthcare crisis is to enable the federal government to auction off national health insurance licenses to allow companies to more easily create pools across state lines and then create a national "secondary market" for health insurance policies. This will help lower cost and improve affordability, just like it has in the mortgage industry since Fannie Mae was created in 1938.

This federal approach, in combination with state policies for enabling choice and breaking cartels, would create a new set of financial and economic incentives for keeping you healthy, customizing health care to your particular needs, and allowing the non-profit to thrive by allowing them to sell of policies into this broader market. This puts us on the path to a model of universal healthcare that is not dependent on taxation and government management.