By Lee Vliet, MD – http://www.herplace.com

Since 1943, the Association of American Physicians and Surgeons (AAPS) has led the fight for medical freedom. Our first concern about presidential candidates is what their administration would do to your medical care.

Sen. Ted Cruz was the only one of four invited candidates who accepted an invitation to speak in person at our recent 72nd annual meeting, which focused on the U.S. Constitution. Dr. Ben Carson prepared a 10-minute video.

Sen. Cruz, like AAPS, has been a forceful proponent of total repeal of Obamacare, saying to the physicians in attendance: “The stage is set for meaningful change. Six years ago, reasonable minds could talk about whether Obamacare is a good idea. Now, well into its implementation, we see millions of Americans have lost their jobs, millions of Americans forced into part-time work, millions have lost their doctors and face skyrocketing health insurance premiums. It is the essence of reasonableness and moderation to see that this thing is not working. We need to repeal Obamacare and start over.”

Cruz outlined his core principles for reforming the delivery of medical care, which are consistent with principles outlined by AAPS over decades:

• More marketplace competition is needed.
• Patients, in consultation with doctors they trust, must make medical decisions – not government or “health plans.”
• Government intervention and regulation in medicine – which has increased costs, removed treatment options, thwarted innovation and decreased efficiency – must be reduced.

Democrats and liberals have claimed that Obamacare was needed because the U.S. “health-care system” is “broken.” AAPS and Sen. Cruz have maintained that it is NOT American medicine as a whole that is “broken” – at least not yet. Cruz and AAPS have consistently pointed out that it is the payment system that has been “broken” by government intrusion and over-regulation. The senator pointed out: “Just last year on average non-group insurance premiums increased by over 50 percent. October 1 marks the first day of ICD-10 coding manual, costing doctors’ practices tens of thousands of dollars, dollars that could better be spent on medical care for patients instead of mindless government bureaucracy.”

U.S. medical care has remained tops in the world for quality, accessibility, innovation, variety of medications, available diagnostic and treatment procedures, longevity for the major diseases and cancer survival.

But true “free markets” in U.S. medical care and health insurance have not been allowed to operate since the 1940s, when the federal government mandated a freeze on wages during World War II. Labor was scarce, and creative employers offered health insurance as a “benefit” to attract needed employees. More people got health insurance through jobs and didn’t experience the true cost of medical services as they do in a free market. Democrats used this employer-based insurance as another “reason” for the necessity of Obamacare, to prevent people from losing their health insurance if they changed jobs.

But as Sen. Cruz and AAPS have both pointed out, there are simpler ways to solve this problem. Cruz said in his speech: “People don’t lose their home insurance or their car insurance when they change jobs. Why should they lose their health insurance due to a job change? We must de-link health insurance from employment.”

Sen. Cruz’s position mirrors that of AAPS: People should own their health insurance policies individually. Such policies should have the same tax deductibility as those provided through an employer. They should be portable from job to job over a person’s career. And people should be able to buy health insurance across state lines.

Free markets in medical services were eroded further by passage of Medicare and Medicaid in 1965. These put the federal government in charge of setting prices (“allowable charges”), deciding payments to physicians and hospitals, and determining “covered” services. Sen. Cruz, in agreement with longstanding positions of AAPS, plans to remove these government price controls and restore free-market principles. He used the example of dramatic reductions in the cost of Lasik eye surgery with free-market competition.

Cruz clearly understands the fact, which AAPS has been explaining for decades, that if a third party pays for your medical care, the third party will decide what you get. As the old German proverb says: “Whose bread I eat, his song I must sing.”

This is Obamacare’s fundamental flaw: Government bureaucrats are in control, not patients or doctors.

Sen. Cruz pointed out the ominous trend happening under the mandates and increased regulatory burden of Obamacare: “In 2005, two-thirds of medical practices were doctor-owned. Today that is less than one-half, as more and more doctors are selling their practices and becoming salaried employees of hospitals. For example, the number of hospital employed cardiologists more than tripled from 2007 to 2012. And it is not just hospitals that are consolidating: The big five insurance companies are now the big three insurance companies. The shift away from physician-run practices to giant hospitals and corporate conglomerations is not a good development for the practice of medicine and not a good development for caring for patients. But it is the inevitable result of more and more government control and mandates.”

The senator made it clear that he supports repealing Obamacare and starting over, not just “tweak and replace” as many Republicans advocate. Sen. Cruz made clear his goal is to create true reform that puts real free markets back to work and patients back in control of their money, their insurance plans, and their choice of physicians and hospitals.

As one physician who has consistently advocated for patients to have more control over their medical treatment options and their health insurance, I strongly approved Sen. Ted Cruz’s articulate and patient-centered positions on effective medical care reform.