JOE DEHN FOR CONGRESS

The advances are coming from the work of our biotechnology and other high-tech companies (many of them right here in Silicon Valley), the researchers at our universities, and of course the many dedicated and skilled health care practitioners. But the benefit of these advances is being held back by the way health care services are managed, delivered, and paid for.

Some say this is a failure of the free market, and call for more government involvement. But we do not currently have a free market in health care. This is one of the most heavily regulated industries in our entire economy! Almost everybody in the United States has their health care paid for either directly through a government program or through insurance programs that have their current form because of regulation, subsidies, and tax policies. At the same time, government policies limit the supply of medical professionals, and drive up the cost of equipment and drugs. And individuals are powerless to control any of this, because they don't even understand what they are paying. Yes, it's a complicated mess that needs to swept away. But "single payer" or "Medicare for All" isn't the answer -- and in the long run would make things even worse.

The right answer is to get the government out of the way so that the basic economic principles that have led to lower costs in almost every other industry are allowed to function.

• De-couple health insurance from employment by eliminating the special tax treatment of health insurance, while at the same time increasing the standard deduction by a similar amount. This will enable consumer choice, make the market for insurance more competitive, and eliminate the need to switch providers when switching jobs. Employers will be happier too, not having to worry about any of this!
• Increase supply of services by cutting back limits imposed or enabled by government policy. More doctors, more nurses, allowing medical services to be offered by new classes of providers enabled by new technology, eliminating "certificates of need" that limit competition among hospitals -- these and other steps will create a competitive environment that will drive down costs.
• Introduce real competition in the pharmaceutical industry too, by repealing laws that limit the ability of patients to purchase drugs across state lines and from other countries.
• Clearly separate the "welfare" aspect of government health policy from the rest. There will always be people who need help paying for health care, just as there are people who need help paying for food. But decreasing costs for everybody through competition will help these people too, and make it more practical for those who want to provide such help through private charity to do so.
• Whatever remains of government programs to pay for health services for specific segments of the population -- the poor, the elderly, veterans, etc. -- those should not be confused with, and should not be allowed to distort, the market for the entirely separate service of "insurance". Health insurance should be left to the private sector and deregulated so that individuals will be better able to select the kind of coverage that fits their needs, and not forced to pay for services that they don't want.