Originally published at Real Clear Policy.​

By Deane Waldman & Vance Ginn
October 14, 2024
Seeking to focus the final month of campaigning on healthcare and away from immigration, inflation, and violence both abroad and at home, V.P. “Harris proposes Medicare pay for home health care.” She claims to have a fully developed policy for the healthcare market in contrast to Trump’s mere “concept of a plan.” Never mind she has no idea how to pay for it. What does she have in mind for our future?

Based on her actions, V.P. Harris intends the healthcare marketplace to be under complete federal control, devoid of free market forces or personal choice. As president, she would institute a centrally controlled economic system.

If Medicare “pays for” home health care, that means Centers for Medicare and Medicaid Services (CMS) would dictate both benefit and payment. In market terms, government would determine – balance – both demand and supply. That is the definition of central economic control, the opposite of a free market.

Earlier this year, CMS adjusted the market ratings of insurers Elevance and UnitedHealthcare based on “arbitrary,” “capricious,” and “unlawful” actions according to a lawsuit against the government agency. Together those two companies enrolled more than half of all those who signed up for Medicare Advantage. Obviously, seniors wanted to purchase these policies, but CMS chose to control the market rather than letting consumers decide.

Millions of Americans have purchased short-term health insurance. The Biden-Harris White House labelled these policies “junk insurance,” and “protected” Americans from their own stupidity by instructing CMS to prohibit them. Removing these plans from the marketplace limits consumer choices – demand for services – to what Washington approves.
​
As all providers know, price or charge in healthcare is meaningless as payments are dictated by Medicare “allowable reimbursement schedules.” Harris has also made clear her desire for price-fixing. Recall her solution for what she called “price-gouging.” The Biden-Harris Inflation Reduction Act of 2022 gives Medicare the authority to fix prices for drugs though they call it a negotiation.

Thus, Washington controls supply as well as demand.

Harris says, “her values have not changed.” So, keep in mind her full-throated, in fact passionate, support of Medicare-for-All, H.R. 1384. This is Bernie Sanders’ plan for unabashed total take-over of the entire healthcare market, one sixth of the U.S. economy. The Senator admits his plan could cost up to $40 trillion, one third of the combined GDP of all nations on planet earth – for a healthcare system that doesn’t care.

In addition to bankrupting the U.S., Medicare-for-All will drive more clinical doctors to quit (there will, however, be more bureaucrat doctors like Fauci); will make the wait for medical (health) care interminable; and death-by-queue will become an hourly rather than daily occurrence.

Consider what the progressive, sixty-year expansion of the federal role in healthcare has accomplished. In 1960, the U.S. spent 5.6 percent of GDP on healthcare, you got an appointment within a week, and your doctor knew your first name. Last year, the U.S. expended 17.8 percent of GDP, $4.8 trillion, on healthcare. Approximately half was spent on BARRCOME – bureaucracy, administration, rules, regulations, compliance, oversight, mandates, enforcement – and thus produced no patient care! Despite spending more on its healthcare system than the entire GDP of Japan, Americans can wait more than 130 days to see the doctor and die while waiting.

According to its Trustees, Medicare will be insolvent by 2036. At that time, the program will be unable to pay for in-patient care for seniors.

Trump’s intentions for healthcare may be vague but Harris’ plan for the healthcare market is clear: total central economic control as in the U.S.S.R., Venezuela, China, and North Korea.

Whether you call it Medical-for-All, single payer, or HarrisHealth, the V.P. wants the federal government to make all fiscal and thus all medical decisions for Americans. Judging by what federal control of the healthcare market has done to America and to Americans over the past sixty years, that will be the end of health...care.

Originally published at National Review.​

By Vance Ginn & Deane Waldman
October 11, 2024 6:30 AM

Congress should shift the tax advantage from employers to employees to empower patients.

Employers are projected to face a nearly 8 percent jump in costs for providing health insurance to employees in 2025, marking the highest increase in their health-care spending in over a decade. Since 2017,  the costs of employer-sponsored health insurance have increased by a cumulative 50 percent, driven by inflation, rising prescription drug costs, the increasing burden of treating chronic conditions such as cancer and cardiovascular disease, and the cost of regulations.
These costs hit workers and consumers hard.

The out-of-control health-care spending spotlights the flaws of federally-facilitated, employer-sponsored health insurance, which limits competition and inflates health-care prices for everyone.

The employer-sponsored insurance system, a relic of World War II-era wage freezes, continues distorting the U.S. health-care market. Tax-advantaged employer payments for employees’ insurance were implemented to circumvent wage controls, and to attract and retain workers. After the war ended, wage freezes were repealed — but the tax advantage for employers was not.

With the wage freezes gone, health-insurance payments should have been restored as employee compensation so employees could choose how to use their hard-earned money. However, with the tax advantage to employers remaining intact, the funds continue to go to insurance and not to the workers. The system has ballooned into an inefficient approach that inflates costs and reduces consumer choice. If the tax advantage were transferred from employer to employee, this would expand the usefulness of these funds to pay for medical expenses. 

Employees believe “employer-supported health insurance” is a benefit provided by the employer, not what it truly is: Money rightfully theirs that is denied to them. About 165 million Americans rely on employer-sponsored health insurance, but workers have few choices beyond what their employers offer. Employer-sponsored insurance ties up at least $1 trillion in annual health-care spending that could be paid directly to employees, or placed pre-tax into Health Savings Accounts (HSAs) for workers to control themselves. 

As of 2023, employers’ average cost of family health insurance reached a whopping $23,968. While this exclusion saves workers from paying taxes on this amount, it also forces them to accept plans that may not meet their needs. It also disallows them from shopping for better, more affordable options. Put simply, a worker paying a 33 percent tax rate avoids paying about $7,910 in federal taxes on a family-plan premium. This tax break hides the reality that employer-sponsored insurance stifles competition, driving up costs across the system, and is really compensation denied.

Employers must absorb ever-increasing costs, along with employees who pay co-pays and elevated deductibles. In 2025, these costs are expected to rise by 8 percent, with much of the increase driven by pharmacy spending, particularly for GLP-1 medications used to treat obesity and diabetes. This pharmaceutical spending has grown to consume 27 percent of health-care budgets, up from 21 percent in 2021. While these medications could reduce health-care cost over time, we don’t have evidence of it yet.

This system inflates health-care costs by encouraging over-insurance, where employer-sponsored plans cover more than workers need, and limits the free market’s ability to drive competition and lower prices. A free-market approach would allow individuals to shop for health insurance as they do for any other product or service. 

Moreover, while employers try to manage these rising costs through plan adjustments, cost-containment strategies, and vendor partnerships, these efforts barely address the underlying problem. The employer-sponsored insurance system keeps workers from making health-care decisions and forces them into federal one-size-fits-all plans that may not provide the best value or coverage for their needs.

Congress should shift the tax advantage from employers to employees to empower patients and allow them to place these pre-tax dollars directly into their HSAs for expenses related to health care. This would introduce market competition, since workers could control their spending.  Individuals could shop for care and insurance, forcing sellers to compete for their business. Introducing competition would drive down prices, improve care service, and allow consumers to make informed choices that reflect their needs.

This would bring true transparency to health-care pricing as individuals spend their money, creating downward pressure on prices. Empowering patients to make health decisions would help cure America’s critically ill health-care system.

By restoring American workers’ right to spend their money, we would increase choice, lower costs, and further incentivize health-care providers and insurers to improve services. Shifting to a consumer-driven model through no-limit HSAs is a crucial first step to fix the system.

Employer-sponsored health insurance is increasingly unsustainable. As employers (and many employees, too) brace for a large increase in health-care costs in 2025, the need for reform is critical and immediate. By giving workers control of their $23,968 hard-earned money, we can unleash the power of the free market to empower patients and revitalize a failing health-care system.

Originally published at The Freemen News-Letter. 

​Would you ask a hungry fox to guard the henhouse? Of course not. For the same reason, Americans should be very wary when “Congress debates solutions to soaring [healthcare] bills.”  

Most people do not believe that the mainstream media reports honestly and objectively. Some still do, likely due to some residual credibility that may cling to the highly partisan, opposite-of-objective misinformation masters called the legacy or complicit media. 
Consider the facts. 

Reporter Samantha Manning of CMG Washington News Bureau announced that Congress will discuss how to solve the problem of unaffordable healthcare prices. “Unaffordable” applies to both individual Americans and the nation.

Last year, the U.S. spent $4.8 trillion on its healthcare system, an amount greater than the entire GDP of Japan, which added $2.24 trillion to a Biden-Harris record debt of $33.17 at the end of 2022. The average U.S. family healthcare costs in 2023 were equally unaffordable, a staggering $31,065. 

To call healthcare bills “soaring” is no exaggeration. Where is the money going? Are the doctors responsible for “price-gouging,” to use V.P. Harris’ phrase? Data shows that payments to doctors – “allowable reimbursement schedules” released by Centers for Medicare and Medicaid Services (CMS) – pay only a small fraction of physicians’ published prices. In many cases, physicians in their offices are paid below the cost of doing business, which is why solo practitioners have been driven out of practice. 

If not to physicians or hospitals, where is the money going? Studies estimate that between 31 percent and more than 50 percent of U.S. healthcare spending does NOT pay for patient care! It pays for BARRCOME – bureaucracy, administration, rules, regulations, compliance, oversight, mandates, and enforcement. In other words, Washington pays its bureaucrats $1.5 trillion to $2.4 trillion “healthcare” dollars, taking those dollars away from patients, taxpayers, and health care providers.

For proof, look no further than the Affordable Care Act (ACA). To pay for all the BARRCOME, such as 50 state Health Exchanges (Dr. Deane was a Director), the ACA took $716 billion from the Medicare Trust, money intended to pay for seniors’ in-hospital care. 

When most people read about a congressional commission to curb healthcare fraud, new rules to activate price transparency, or the recent legislative effort to reduce healthcare spending, they think price lists just appear. Recouping fraudulent medical bills is not free, and we’re already paying the salaries of members of Congress, so how can a new commission cost money? 

When the government does anything, it costs taxpayers and people in the marketplace lots of money and other resources. The Mueller investigation into the Russia Collusion scam by the Hilary Clinton campaign cost $32 million plus 2 ½ wasted years. Washington paid $80 billion to Pfizer for a self-styled CoViD “vaccine” that didn’t work and harmed the health of millions. 
The ACA cost $2.6 trillion. Bernie Sanders admits his Medicare-for-All plan could cost $40 trillion, which represents one-third of the combined productivity of all nations on Earth. 
Imagine how much more care providers could have given patients with $32 million plus $80 billion plus $2.6 trillion, or how much more money could stay in people’s pockets.

Every time Congress legislates a fix for our failing healthcare system, three things happen. First, they move us closer to national insolvency by spending trillions of more dollars we don’t have. Second, they worsen the doctor shortage and make it more difficult for families to pay expenses by taking money from paying care providers to compensate bureaucrats.  Third and worst, with each new regulation, access to medical care goes DOWN – the seesaw effect. Paraphrasing an old beer commercial, spend more, less care. 

This is why the old aphorism applies. Would you ask the fox to watch the henhouse? That is the same as expecting Washington to reduce healthcare spending.

Originally published at The Freemen News-Letter. 

​Vice President Kamala Harris, the current Democratic presidential candidate, has proposed price controls for food and groceries—a destructive idea that should be rejected. However, the current administration has already imposed price controls harming Americans, particularly seniors, by controlling healthcare prices under the Inflation Reduction Act (IRA).

Initially promoted as a solution to rising healthcare costs, the IRA has become a financial albatross, especially for seniors. With a staggering price tag of over $1.2 trillion, the IRA was sold as a necessary measure to curb inflation and lower healthcare costs. It has only exacerbated the financial strain on the people it claimed to help, however.

One of the IRA's most glaring failures is its sweeping changes to Medicare’s drug benefits. These changes were intended to make the benefits more robust by eliminating beneficiary cost-sharing at a much lower out-of-pocket limit. Instead, this policy shift has inadvertently transferred significant financial risk onto health plans, leading to unintended consequences, the most notable being a sharp increase in premiums.

The IRA was supposed to save patients money by allowing Medicare officials to set drug prices. However, this provision primarily reduces government expenditure rather than lower costs at the pharmacy counter. This has resulted in immediate premium hikes, with the promise of savings deferred to years later—a classic bait-and-switch. Seniors are paying more now for future benefits that may never materialize.

This surge in premiums is directly linked to the government’s increased involvement in setting drug prices. By imposing de-facto price controls, the IRA has reduced the funding available for developing new treatments and has inserted more bureaucracy between doctors and patients. This interference disrupts the healthcare market's delicate balance, where supply and demand should dictate prices and innovation.

Moreover, the IRA’s impact extends beyond just premium hikes. Medicare beneficiaries are now facing the lowest level of plan choice ever, with many plans exiting the market. This reduction in options and higher costs leaves seniors with fewer and more expensive healthcare plans. The promise that the IRA would make healthcare more affordable rings hollow as seniors are forced to navigate a market with diminished competition and escalating costs.

These poor policy choices have contributed to Medicare Part D premiums increasing by 21% this year, with expectations of a 50% rise next year. This stark increase directly contradicts the IRA’s initial promises and places an undue financial burden on seniors who can least afford it. Furthermore, the number of available prescription drug plans has plummeted, with nearly 100 plans disappearing last year alone. Medicare Advantage recipients may face an additional $400 per year in costs, a harsh reality as inflation erodes the purchasing power of seniors and all Americans.

The consequences of these policies are not confined to the healthcare market. The IRA’s expansive scope and high costs are emblematic of government overreach that stifles economic freedom and burdens taxpayers. The act misallocates resources by funding unreliable green energy projects at taxpayers’ expense and imposing hefty new taxes on businesses, further straining the economy. The IRA’s Medicare policies are hitting seniors hard, despite the administration’s claims of lower costs.

A free-market approach offers a viable alternative to this heavy-handed government intervention. The healthcare system can become more innovative and affordable by reducing regulatory burdens, allowing market forces to set prices, and promoting competition. Policies should focus on removing obstacles for Medicare Advantage plans to negotiate better prices and increase the number of healthcare providers by eliminating unnecessary regulatory barriers like certificate-of-need laws.

Ultimately, the solution lies in embracing economic freedom and limiting government intervention in healthcare. History shows that government solutions often exacerbate the very problems they aim to solve. The IRA’s failures underscore the need for market-based policies that prioritize individual choice, innovation, and quality patient care over bureaucratic control. By doing so, we can ensure that seniors receive the care they need without the prohibitive costs imposed by misguided government policies.

Originally published by Real Clear Health.

By Vance Ginn & Deane Waldman
August 27, 2024

Affordability of health care in the U.S. has been declining, reaching its lowest point since 2022, with no signs of improvement. This stark reality underscores the urgent need for a healthcare system that prioritizes timely access to affordable, high-quality care. To achieve this goal, the government needs to step aside and empower We the Patients.

In fact, Americans need exactly the opposite of what Candidate Harris intends to do if she gains the oval office. She plans to expand Washington’s role in Americans’ health (medical) care.

The U.S. spends an astonishing $4.8 trillion annually on healthcare. But here's the truly shocking part: more than half of that huge expense produces NO patient care! It does not pay for essential services like doctor visits, hospital stays, medications, mental health care, and home health care!

Two point four trillion “healthcare” dollars are wasted on administrative costs and regulatory compliance. This useless spending not only inflates costs but also diverts resources away from patients, contributing to delays in care and, tragically, to what is known as "death-by-queue," where Americans die while waiting for care they desperately need.

Many healthcare providers find themselves trapped in a system driven by perverse incentives. The third-party payment structure rewards dollar efficiency over medical effectiveness, and volume over value. This misalignment leads to unnecessary tests and procedures, over-treatment, and a general focus on quantity rather than quality of care.

We need a shift to value-based care, where the definition of value is determined by patients and providers—not by an externally imposed financial metric. When patients have control over what is considered valuable, providers are incentivized to focus on their patients rather than following federal rules. The result is better health outcomes at lower costs. This approach aligns patient well-being with financial rewards, promoting preventative care and chronic disease management, which can reduce hospitalizations and improve overall health.

However, a significant obstacle to achieving this vision is the heavy hand of government regulation. The regulatory environment in healthcare dramatically increases costs and restricts access to care by siphoning money away from patients to fund bureaucratic overhead. Streamlining and eliminating unnecessary regulations could foster a more competitive market, driving efficiency, effectiveness, and innovation.

Restoring financial control to patients is crucial. While price transparency is often touted as a solution, it won't lead to real savings unless patients—not third parties—control their health care spending. Currently, third-party payers make most of the medical decisions, stripping patients of their autonomy and resulting in frustration and poor outcomes. Eliminating restrictions on Health Savings Accounts (HSAs) and other consumer-directed health options can empower patients with financial control, incentivizing them to seek cost-effective care.

The employer-supported health insurance model is another area ripe for reform. This system, a relic from World War II when wage freezes forced companies to offer health insurance as a benefit, is outdated, limits patient choice, and increases costs. Today, the average cost of employer-provided health insurance is $18,328 per employee. This money would be better spent if given directly to employees, still tax-advantaged, and made available for deposit into an unlimited Family HSA. With these funds, Americans would have the financial freedom to shop for direct-pay care, creating competition among providers and driving prices down.

Technology also holds great promise for revolutionizing healthcare delivery. Telemedicine, for example, was a critical lifeline during the COVID-19 pandemic, providing access to care while reducing the strain on traditional healthcare facilities. It has also proven invaluable in reaching rural and underserved urban areas, where access to healthcare is often limited or non-existent. By fostering technological innovation, we can further increase the effectiveness and efficiency of healthcare delivery, lower costs, and expand access to those who need it most.

The U.S. healthcare system is plagued by a "cancer" of ever-expanding bureaucracy and a third-party payment system with misaligned incentives. To cure this, we must reduce government over-regulation and return financial as well as medical control to We the Patients. This shift will instantly align incentives, reduce wasteful government spending on bureaucracy, and deliver timely, affordable care to many more Americans.

The path forward is clear: give control back to the patients and doctors. Let them decide what care they need and how they want to pay for and provide it. For the medically vulnerable, state-created and -run, not federal one-size-fits-all, safety nets. By doing so, we can finally achieve the goal of delivering high-quality, affordable care to everyone.

Vance Ginn, Ph.D., is president of Ginn Economic Consulting, host of the Let People Prosper Show, and previously chief economist of the Trump White House's OMB. Follow him on X.com at @VanceGinn.

Deane Waldman, M.D., MBA is Professor Emeritus of Pediatrics, Pathology, and Decision Science; former Director of New Mexico Health Insurance Exchange; and author of 12 books, including multi-award winning, Curing the Cancer in U.S. Healthcare: StatesCare and Market-Based Medicine. ​

​Join me for Episode 108 of the Let People Prosper Show to learn how removing government obstacles in the healthcare system can improve patient care with Deane Waldman, MD, MBA, author of Curing the Cancer in U.S. Healthcare and other books, as well as more than 250 articles and monographs. Subscribe, share, and rate the Let People Prosper Show, and visit vanceginn.com for more insights from me, my research, and ways to invite me on your show, give a speech or other opportunities.

​Watch this interview that I did with Dr. Deane Waldman on the costs and benefits of mandating price transparency by hospitals and whether it will result in anything productive at the Third National Health Care Transparency & No Surprise Act Summit, This interview was aired at https://www.hctransparencysummit.com/.

Originally published at Daily Caller. ​

Soaring health care spending continues to spiral up, tightening the financial noose on households and government coffers. Families are forced to make difficult choices between paying for essential medical care and meeting basic needs while the federal government struggles to rein in spending amid mounting debt.

These soaring health care costs must be addressed with market-based approaches before it’s too late.


When the Affordable Care Act (ACA) was passed in 2010, it was heralded as the panacea for reining in healthcare costs. However, the law’s complex regulations and mandates have contributed to administrative bloat and increased overhead costs, ultimately driving up premiums and out-of-pocket patient expenses.

Unfortunately, since then, subsequent politicians have failed to correct course. In 2024, federal spending on Medicare, Medicaid, and ACA subsidies will likely exceed the discretionary budget, posing a significant threat to long-term fiscal sustainability.

Compulsory spending on health coverage in the private sector infringes upon household earnings. This exacerbates economic challenges for families whose purchasing power is already reduced, as inflation-adjusted average weekly earnings are down 3.1 percent since Jan. 2021. 


Moreover, the growing burden of health care spending poses a significant threat to long-term fiscal sustainability, as rising debt levels raise concerns about future economic prosperity.

The Congressional Budget Office (CBO) recently released its annual Budget and Economic Update, painting a grim budget picture. The trajectory is alarming, with expenditures expected to be $6.4 trillion this fiscal year before soaring to a staggering $10.1 trillion by 2034. Also, net interest spending is poised to balloon from $1 trillion to $1.6 trillion by 2034. 

These projections underscore the urgent need for meaningful reforms to rein in healthcare costs and put the federal budget on a more sustainable path.


To address these challenges, policymakers must prioritize fiscal responsibility and adopt measures to remove government as much as possible from healthcare. This would help to quickly get healthcare back to a relationship between a doctor and patient. Today, too many middle layers rob time between the doctor and patient and raise healthcare prices. 

Policymakers should make market-based reforms. It won’t be done overnight, so there will need to be some steps to get there. 

It would be great if just making healthcare prices transparent would solve the problem. But the healthcare system is much more dysfunctional than that, unfortunately. 


Many reimbursement rates are set between doctors and private insurance companies or government programs like Medicaid and Medicare. Those reimbursement rates are so different depending on which entity is negotiating that the prices won’t tell us much, other than how screwed up the system is, but we already know that. 

A market-based approach should remove obstacles on the demand and supply sides of the market. 

This should include ending the tax exclusion for employer-sponsored health insurance. There’s a long history of this exclusion, which started during WWII. But while it had good intentions, the result has been a major distortion to the healthcare market. There should also be consideration of a voucher program for Medicare and block grants to states for Medicaid with limited growth each year. These would help reduce the moral hazard and over-subsidization on the demand side. 

On the supply side, the federal and state governments should remove rules that restrict the supply of doctor offices by removing certificate of need laws. They can also boost the supply of physicians by reducing or eliminating occupational licenses.

Unleashing supply and imposing market forces on demand will result in more innovative, affordable, and accessible care for everyone. 

The resulting reduction in government spending and improved timely access to quality care can help support more prosperity. This would reduce the need for people on government safety net programs. It would also help mitigate higher prices, alleviate strain on household budget burdens, and safeguard the nation’s economic future. 

These steps will require difficult choices and bipartisan cooperation at the federal and state levels, but the stakes are too high to ignore the issue any longer.

​Today, we discuss:
1) How U.S. health care evolved away from a free-market system and the importance of restoring consumer control;
2) How to reduce health care costs and improve quality by reducing regulations and subsidies; and
3) The importance of reining in health care costs of Medicare and Medicaid to reduce government spending and balance the federal budget.