In this episode of Healthcare Americana, Christopher Habig welcomes Dean Clancy, Senior Health Policy Fellow with Americans for Prosperity, for an insightful discussion on healthcare reform and empowering patients in the United States. They delve into the misconceptions surrounding the American healthcare system, the need for reform, and various policy proposals aimed at making healthcare more accessible and affordable.

Dean Clancy shares his vision for the future of healthcare and outlines key initiatives to achieve patient empowerment and choice.

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[INTRODUCTION]

[EPISODE]

Today's episode is going to be dealing with the policy side, mainly on what's happening at the federal level with our benevolent federal government, who has all of our best interests in mind. And there's actually a lot of hope, especially from my side, what we're able to see within Freedom Healthworks through our primary care world. There's a lot of interest in making positive change, and I'm saying this from both sides of the aisle. It's not just a red versus blue type of an argument.

One of the organizations, I will say, and said company. But one of the organizations, more of a think tank, more of a policy expert, that is really leading the charge and advocating for the American Health Care consumer, the patient, and the people, and the doctors, and everybody who's actually involved in it, has been Americans for Prosperity. So, please welcome to Healthcare Americana, Dean Clancy, is Senior Health Policy Fellow with Americans for Prosperity. Dean, thanks so much for joining us here on Healthcare Americana.

Today, we're called Americans for Prosperity. We're much bigger, and we work on many more issues. We work on energy, taxes, trade, finance, regulation. We're interested in AI. I mean, you name it. We're kind of across the board. But healthcare has become very important to us, not just because of the whole fight over Obamacare, the Affordable Care Act. We were engaged in that fight. We were very much opposed to that, we thought misguided federal reform. And we've been proven right.

But instead of just sitting back and criticizing, we've said, “Look, let's make the American healthcare system better.” And that has led us to mount a campaign. It's an optimistic future oriented campaign we call the Personal Option. Our polling shows Americans don't want a government takeover of healthcare. They want more choice and control, more options, more price transparency, less hassle. And our view is that much of what ails American healthcare today can be boiled down to too much meddling by health insurance companies, and too many misguided government rules and mandates.

So, the Personal Option is about removing those. Empowering consumers and removing barriers. And our polling shows Americans favor that kind of approach, two to one, over Medicare for All, or a single payer, government run healthcare system. So, we have folks all over the country, thousands of volunteers. We have paid staff in 38 state. We talk to lawmakers under the dome in the States and in Washington. We knock on doors. We talk to people. We do polling and focus groups. Our political arm does endorse candidates and make political contributions. We're trying to get aligned policy champions into the halls of power so that we can remove these barriers. So yes, healthcare has become a big deal for AFP.

So, when somebody looks at this, and they really want to learn more and say, “Well, wait a minute, if you're telling me that healthcare is not a free market, and you're saying that all these other entities, and insurance, and hospitals are fixing the game against patients, and then the government is coming in to really provide more barriers, rather than the consumer protections”, then they say, “Well, we just need to get rid of insurance companies altogether, and have the government do some type of Medicare for All strategy.” What is the problem with that one? I'm picking on the challenges here, Dean. But when someone says Medicare for All, this is going to solve all of our problems. Again, how do you react? What do you tell that person? How do you educate them?

So, seniors and disabled folks on Medicare have less access to care, and the quality of their care is lower, and they often end up shelling out a fortune for supplemental coverage to fill in the gaps of this poorly designed program. That's not to say that we should get rid of Medicare, but it does suggest that we shouldn't make it the program for everybody. Of course, if you did that, it would be akin to putting the post office, or the Department of Motor Vehicles in charge of your healthcare. It's a bureaucracy. It's a monopoly. They don't have to please their customers. That's why it's inferior.

The Medicare for All Bill proposed by Congress, excuse me, Senator Bernie Sanders of Vermont, a self-described socialist would cost $30 trillion, with a T, more than we're currently spending on healthcare over 10 years, first 10 years. Because the idea is to make everything free. So, it wouldn't even be Medicare. In fact, his bill would eliminate Medicare and replace it with this utopian version of Medicare, that we know from the real world, we know from Britain and Canada and other countries, it's not all it's cracked up to be. I wouldn't want to get sick and be my age in Britain, because they're going to ration my healthcare. We don't have to do that. America doesn't have to emulate those other countries.

So, Medicare for All, bad idea. Instead, let's give folks a personal option.

So, let's talk about the positive. AFP, Americans for Prosperity, has been working on what we call the Personal Option. Give us that 30,000-foot view of really what this does, and why it appeals to consumers?

The second pillar is HSAs for All. Let every American save and pay for healthcare tax free, in an account that they own and control, where they get to decide what to spend on, how much to spend, and let them save that money and build it up into a nest egg for future medical expenses. HSAs exists today, but they have severe limitations, we'd like to remove those. So, that's the second pillar, HSAs for All.

And the third, is remove barriers between patients and the medical professionals they trust. That consists of all kinds of things. Probably the most important one is make sure people have access to direct patient care, as I call it, direct primary care or direct specialist care, direct care at options where there's no insurance middleman. We know those work, we know patients, and doctors, and nurses, they love it. Because it's just real health care on both sides. Your doctor gets to know you as a human being, the doctor doesn't have to fill out insurance paperwork, you have more access, and you know all these things. Then there are many others. Removing state certificate of need laws that restrict access to, or the supply of hospitals and MRI machines. And going to site neutral payment in Medicare, which means that you don't just basically subsidize local hospital monopolies by paying them more if the doctors happened to affiliate with the hospital, rather than being independent.

The list goes on. That's all under the heading of remove barriers between patients and the medical professionals they trust. That's it. That's the Personal Option in a nutshell.

You talked about quality, affordable insurance, access to your physician that actually gets to know you, not treating doctors and nurses like commodities, building relationships, kind of an old-school approach to medicine. You talked about price transparency, certainty, prescription drugs at lower prices. I mean, this sounds like you're going after everybody. You're going after government interference. You're going after PBMs. You're going after insurance companies. You're going after hospital monopolies. Are you guys trying to boil the ocean? Is AFP trying to boil the ocean and try to grab everything all at once?

South Carolina is con free, as we like to say now. And AFP led the charge on that. We could have focused on other issues. But we decided to target. And at the federal level, we are focused on HSAs for All and we're making good progress. The House of Representatives is very interested in legislating on that issue with a number of ideas that we have supported, including ideas that we've proposed.

So yes, we are trying to fix healthcare generally. But we do pick our spots. You mentioned all those people that were probably annoying, like the hospitals, the insurers, the PBMs. All that's true. But we do ally with them on the occasional issue where our interests and principles are aligned.

The one group that I'd say, most of all, we tend to line up with is physicians. Physicians, we see the world from the point of view of the doctor-patient relationship. And physicians tend to be the victims of all that's happened in American healthcare. So, we ally with them, and that's a very powerful voice. They're the most trusted voice in healthcare debates. Of course, we're also advocating for patients, which is all of us, all Americans are patients sooner or later. So, that's why we're trying to get the word out to help enlist them in achieving the reforms we need.

And AFP is saying, “Look, we're going to give physicians the voice. Let us know what you need, we want to work with you, make you heard”, because so many other things are piling on top of doctors to really push them in the coroner commoditize them and say, “Hey, you got a stethoscope and a white coat. You're all the same. Nobody wants to actually hear from any individuals.”

It’s very scary to me, growing up in a small town, and understanding what impact a community physician can really have. So, I appreciate that side of it, that you are allying with the physician. Dean, we're going to take a quick break here. We're going to hear from our sponsor, FreedomDoc. Then, I want to come back and I want to get a better understanding of what the environment in the atmosphere is on Capitol Hill, and who you're working with and the major players involved in Washington. So, here's a quick message from our sponsor, FreedomDoc.

[BREAK]

[INTERVIEW CONTINUES]

The second thing the bill does is expand on the idea of association health plans. So, businesses can band together, get group discount rates, and it includes the self-employed. Independent contractors, Uber drivers, people who basically work for themselves can band together and get good health insurance benefits. That's the CHOICE Act that passed in June. Thanks to the Republicans.

So, the bill tries to break that down by requiring price publication. It also moves towards a site neutral payment and Medicare which is a wonky term, that means you won't pay the hospital-based physician two or three times as much as the independent community-based physician for exactly the same item or service. It's a stupid policy and it strengthens the grip of those local hospital monopolies. They're incentivized to buy up the local doctor groups and bring them in house so they can charge higher reimbursements. It's terrible.

That bill is also something good moves us in the right direction. There is a third bill in the offing that would expand and improve tax free health savings account. And we have been conversing with folks on the Hill about that legislation. We're very excited. I don't know exactly when it's going to come up for a vote. It hasn't been unveiled yet. But it includes some great ideas for making HSAs more available, and more useful, including, I will say this much. I know it's going to make HSAs usable with direct primary care, which is really needed, and is very exciting.

Healthcare issues are polarized, unfortunately. So, what Biden said in his threat letter was, this takes away important protections for American patients and workers. Well, what protections? It just gives them another option, another way to get healthcare assistance from their employer. This is crazy, this polarization. I think that over time, you'll find that the people will see through these kinds of arguments, and we'll find common ground.

But in terms of special interests, obviously, the hospitals tend to oppose these changes. The insurance companies tend to oppose them. The PBMs and drug makers. And yet, as I said, on some issues, we find ourselves in alignment, like we oppose price controls. So, we're on the same side as the drug makers on that issue. But we're against them on some of the patent reform, FDA exclusivity issues, where the drug makers just want to promote and prolong their monopolies.

Now, the progressives are attacking them, as you know, subpart covers. They call them junk plans. But the fact is, many of them are just as comprehensive as an Obamacare regulated plan, except that they're much more affordable, like 50% to 80% more affordable, and each state can decide on its own how much it wants to regulate these plans. The prudent states, which happily as a majority, have basically said, “We're going to let the market work in that area.” And it is working, and now Joe Biden is trying to take health insurance away from three million Americans simply because it doesn't fit the ideological template of what he and his coalition think is the right kind of care.

Again, it's not pushing people off cliffs, like you said. There's a safety net. The safety net exists. But if everybody relies on a safety net, then it's a longer safety net, and it's going to just crumble, as we are seeing in other countries taking place today. You look at the NHS over in the UK, and it's crumbling. If you have a heart attack, you're not going to see a doctor for over three hours. Same thing with strokes. Guess what happens to people? They don't make it.

Dean Clancy, Senior Health Policy Fellow, Americans for Prosperity. Dean, thanks for joining us here on Healthcare Americana.

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