Let me start by saying that I had no idea about US healthcare till I co-founded my current company in 2009. However, in last two years I have spent some time talking to some very smart people who work with health insurance companies as well as government departments that are responsible for regulating them.
Like most highly regulated industries, these companies and departments are filled with bureaucratic processes and a large number of people are dedicated just to ensuring how they stay on the right side of myriad local, state and federal regulations. On the flip side, precious little time is spent on innovation. I have also met and heard about many capable investors and entrepreneurs who see the opportunities in the healthcare sector and want to build creative solutions for the domain but are frustrated by too much government interference.
This has led to some rather perverse consequences on how healthcare is delivered or paid for in this country.
- Its not an accident that most states and regions in this country have only one or two prominent health insurance plans and only one or two hospital systems that serve the community
- Its also not an accident that most unions and employees in this country consider healthcare a key benefit that their job should/would give.
- Its not an accident that the health commissioner of a state is the most powerful position in most states after the governor and the attorney general. This last point is worth repeating. The most important person in a state after the State Governor and the-Person-Who-Prosecutes-The-Crimes is the-person-who-regulates-health-insurance-companies. How fucked up is that?
And yet, we take that all this for granted. No more than a simple nod is given to these observations when we discuss healthcare in our legislatures and newspapers. No solutions are suggested on how we can decrease the power of regulators here (and I am not just talking about state commissioners. I am talking about Medicare and Medicaid too; where federal CMS agency essentially controls and pays for the entire industry.)
When I hear the political debates in the media about what troubles the healthcare sector – very little attention is usually directed towards about how over-regulated the sector is, how much power is in the hands of government and how by just creating a more free market we can solve many of the ills.
Where are my capitalists who want end users to become consumers? And pay real money and get real choice instead of getting it for “free” in Medicare and Job Market?
Where are my business advocates who want to create free market? Why we do not hear of proposals to create a health care market so a small startup can thrive and an innovative big company can bring in new ideas without involving army of government lobbyists?
Where is my tea party that can liberate healthcare from government control?