Health Care Financing
The Core Solutions
Robert P. Nirschl MD, MS
I. Tax Equality for the Purchase of Health Benefits
A. Tax deduction for all persons who purchase health benefits, or
B. No tax deduction for any purchase
II. Individual Ownership or Control of Health Benefits Package
A. Eliminates portability problem
B. Eliminates hassle factor for employer (i.e., simply transfer the employer's cost of benefits program into the employee's salary)
C. Requires government help to ensure that health benefits are actually purchased (incentives vs. regulation)
D. Establish group buying through church groups, fraternal organizations, etc.
E. Direct subsidy to the truly disadvantaged for the purchase of health benefits (private vs. government program with adequate precaution to prevent abuse)
III. Restore Free Markets and True Insurance to the Health Benefits Market
A. True insurance is coverage dedicated to unanticipated or catastrophic events and is less expensive. Current health benefits are, in general, not true insurance
products and have not been since the 1960's.
1. Individual or direct pay for anticipated services (e.g., immunizations, pap smears, mammograms, routine physicals, etc.). Premium savings from less costly true
insurance will finance these services. Note: The pre-payment for anticipated services (e.g., managed care) is not insurance; in addition, a third party payer system
increases administrative and profit costs without increasing health care value.
2. Establish a true free market by allowing patients the freedom to determine and seek value from any competing medical provider.
B. Free market competition is the most effective way to control costs and supply value. Free market competition is not privately owned managed care companies
competing for contracts. Free markets in healthcare can only occur, if the user of the service (e.g., the patient) has control of physician and treatment choice
(e.g., the physician is the competitor).
Dr. Nirschl is a practicing orthopedic surgeon in Arlington, Virginia; Director of Orthopedic and Primary Care Sportsmedicine Fellowship programs in conjunction with
Virginia Hospital Center Arlington; Associate Clinical Professor of Orthopedic Surgery, Georgetown University; and Chairman of the Jeffersonian Health Policy
Foundation.
