Decentralization Is Healthcare's Best Hope

The reason both political parties have failed to deliver on the promise of an all-inclusive, less-expensive, world-class healthcare plan is the same reason federal education, retirement, and welfare programs don’t work the way they should. These problems are too complex for a one-size-fits-all solution. So the more we try to create a federal program that will do all things for all people, the worse the situation grows for the person on Main Street.

Think about your own life for a moment. When you come up against a complex, seemingly intractable problem, the first thing you do is try to solve the problem yourself. If you’re like me, you make several runs at it until eventually, you realize you need expert help. And what’s the first thing that expert does? They break the problem down into smaller, manageable parts.

That’s the approach leaders in both parties need to take with healthcare. And education. And while we’re at, throw in welfare reform too. Washington needs to break these highly complex challenges down into smaller parts. Fifty smaller parts to be exact. After all, the burden to implement federal mandates always falls to state governors and legislatures. They’re the ones saddled with figuring out how to make the 11,000-page ACA work. And how did they do it? Following multiple fits and starts, they used expanded Medicaid coverage to shore up ACA’s shortfalls. Sure, it was a stopgap measure that succeeded in getting more Americans covered. But like other stopgaps, that victory was short-lived. The price for covering uninsured Americans is now coming home to roost. And not in Washington. Today, state number crunchers are choosing between exorbitant premium increases, the loss of carriers in state-run exchanges, or subsidies that will plunge them further into debt. Not much of a choice.

For example, in Kentucky — often heralded as a shining example of the ACA’s success — the state Department of Insurance recently approved a 47 percent increase in premiums.  Forty-seven percent! Imagine the outrage if the price of gas, or milk, or a movie ticket jumped 47 percent. And those things aren’t mandatory.

Then there’s the Republican plan — the previously proposed American Health Care Act (AHCA). On the one hand, the CBO claims 24 million Americans would lose coverage. And on the other, under the AHCA Kentuckians would pay $150 a month more for health insurance — which to many sounds a lot better than 47 percent.

The bottom line? Whether it’s the Republican or Democratic plan, Kentuckians pay more.

But not just Kentuckians, according to the National Conference of State Legislatures, “For those buying insurance on an exchange or private market plan for 2017, the average increase before subsidies was a shocking 25 percent.” And that’s just 2017. As you read this article, state leaders are approving similar increases for next year. And on and on it goes.  With no end in sight.

That’s because the antidote to complexity is diversification. Not only diversification in terms of insurance carriers and the types of plans they offer, but also diversification of policy. The reason Washington can’t come up with a national healthcare plan is, this is not, and never was, a job for the federal government.

When both parties finally come to the conclusion that state leaders are better equipped to handle healthcare — when Washington acts to remove barriers which prevent citizens living in one state from purchasing coverage in another — healthcare will not only become affordable, inclusive, and sustainable, it will also become efficient. Competition between insurance companies and between states is the equivalent of doubling down on supply. And by incentivizing lifestyle practices that fend off illness, state leaders can also impact the demand for care in their regions.

And what happens when we increase supply and lower demand?

Wake up Washington! The key to better healthcare coverage in America is decentralization. America doesn’t need a national policy. It needs state-by-state policies designed to address the specific needs of specific demographics. And if the continuing failure of both parties to make good on a viable plan isn’t proof of that fact, then I don’t know what is.

Rebecca D. Costa is an American sociobiologist, author, and host of the syndicated radio program "The Costa Report." She is an expert in the field of "fast adaptation." Costa’s first book, "The Watchman’s Rattle: A Radical New Theory of Collapse," was an international bestseller. Her follow-on book, titled "On the Verge," is scheduled for release in 2017. Costa’s work has been featured in The New York Times, Washington Post, USA Today, SF Chronicle, The Guardian, etc. For more information, visit www.RebeccaCosta.com. To read more of her reports — Click Here Now.