Imagine selecting your own health plan, rather than simply
accepting the one your employer picks for you. Picture a plan that
you own -- that follows you from job to job and place to
place. Envision a plan that reflects your moral beliefs and doesn't
force you to pay for anything that violates your conscience.
A pleasant daydream? For now, perhaps. But if policymakers act on the principles outlined in a major new paper from The Heritage Foundation, "Patients' Freedom of Conscience: The Case for Values-Driven Health Plans," it could become reality.
In short, it's time to put the patient in charge. Heritage experts Robert Moffit, Jennifer Marshall and Grace Smith demonstrate how the current, employer-based model of health care is ill-equipped to give Americans the freedom they need to make ethical health-care choices in a world of troubling biomedical advances, from cloning embryos to genetic engineering.
Why? Because many of the decisions made about our health care remain out of our hands, made by individuals whose top priority is saving money, not lives. Not that this should surprise anyone: It's how the system works. The government gives each American a tax break for health insurance -- but only if you get it through your job. Change jobs? Better hope your new employer has a good plan. And if you get any choice at all (many workers don't), it's probably between just two or three plans -- none of which may be right for you, and all of which may violate your ethical beliefs.
As the Heritage experts note, "Many Americans do not realize that their insurance premiums are financing medical procedures that violate their moral convictions. These could include abortion, in vitro fertilization, sterilization, and contraception, all of which are practices and procedures that many Americans, in varying numbers, consider unethical or incompatible with their religious convictions."
This is crazy. Americans have long debated issues such as abortion and physician-assisted suicide. Yet do we debate, or even question, the rules that prevent us from choosing health-care plans that reflect our moral values? We demand freedom of choice in almost every area of life, from the cars we drive to the food we eat. Then we passively accept whatever we get on something as fundamental as health care. Something is seriously wrong here.
You may recall the "four freedoms" that FDR used to inspire the World War II generation: freedom from want; freedom from fear; freedom of speech and freedom of worship. Well, Americans deserve the following four freedoms in healthcare:
- FREEDOM to choose our own doctors. Health care
is very personal, and no federal or insurance bureaucracy should
interfere. Each American should be able to secure the services of a
doctor who respects his moral beliefs.
- FREEDOM from an impersonal and bureaucratic health-care
system. The regulatory systems governing health care
should be simplified to allow more choices for more people.
Individuals should have greater access to more health-care plans,
and health-care dollars should be controlled by individuals and
families, not employers or the government.
- FREEDOM to choose health plans that reflect their moral
beliefs. Ethical and moral issues are inseparable from
healthcare. All Americans have a personal stake in these
life-and-death decisions, and they should have financial control
over these decisions so that they may act in accordance with their
- FREEDOM to pick a plan without government penalties. State and federal governments should stop using the tax code to play favorites between health plans. If every person had a refundable, individual health-care tax credit, he would be truly financially free to choose the health plan that's best for him.
The Heritage experts also recommend replacing the highly
regulated state health insurance markets with a single statewide
market. Through it, employers could contribute a defined amount to
the health plans their employees designate, and plans would compete
for these dollars. Congress could allow Americans to buy health
insurance across state lines, just as they buy many other goods and
In addition, policymakers should let values-driven health plans participate in public programs. Health plans sponsored by religious organizations should be allowed to participate in Medicare, Medicaid and the State Children's Health Insurance Program, just as they do in the Federal Employees Health Benefits Program.
"Conscience," says David Stevens, executive director of the Christian Medical Association, "is the most sacred of all property." It's time we changed our health-care system accordingly -- and made ethical, consumer-driven insurance a reality.
Rebecca Hagelin is a vice president of The Heritage Foundation and the author of Home Invasion: Protecting Your Family in a Culture that's Gone Stark Raving Mad.