Three things must happen if the American people are to take back their healthcare system in order to optimize cost and quality through private-sector reforms.  First and most importantly, the financial impetus for federal intervention must be minimized or eliminated by limiting federal liability for healthcare costs.  The Ryan plan can do this, and something akin to it should be adopted as soon as possible.  Second, ObamaCare must be repealed to prevent destruction of the private healthcare market before it can be properly reformed.  Third, Congress must stop the degradation of the quality of care by prohibiting the federal government from regulating medical decision-making.

This last point is critical but nearly absent from public discussion.  Neither approval of a Ryan-type plan nor the repeal of ObamaCare, though both are widely recognized as essential and require no further comment here, will do enough to eliminate the massive regulatory regime already in existence and under which we will soon have socialized medicine in all but name.  To do that, Congress must go beyond cost and halt the ongoing centralization of regulatory control over healthcare quality, something most readily done by halting Washington’s ongoing annexation of the power of the individual states to regulate the practice of medicine.

Section 1801 of Title XVIII, the very first words of the original Medicare law, states:

Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided[.]” [Emphasis mine.]

Federal responsibility for the cost of care must be minimized to save us from bankruptcy, and ObamaCare must be repealed in order to save the private healthcare infrastructure.  The best way to preserve the quality of healthcare is to insure that doctors, not bureaucrats, continue to be the arbiters of quality, and that your doctor continues to work for you and not the government.  Given the manifest inability of the Congress to effectively purge every troublesome item in the thousands of pages of existing regulations that now give Washington the power to decide your future care, perhaps the only practical solution is the simplest one: make it illegal for the federal government to regulate the practice of medicine.  This might be as straightforward as having the Congress mandate that HHS enforce already existing law in Section 1801 as noted above.  This would protect both the quality of medical care and the freedom of doctors to put the welfare of their patients first.  It would be a boon even to those who believe that the federal government has a role in improving quality, since once an effective prohibition is in place, Washington can continue to support improvements in quality without the threat of bureaucratic interference in the doctor-patient relationship.  Finally, it would also reverse the transfer of yet another important regulatory power from the states to Washington, rejuvenate the moribund medical profession, and set an example for future regulatory reform.

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