Sally Pipes, the president of the Pacific Research Institute for Public Policy, has been one of the most visible players in the U.S. health finance policy fight for decades.
Sir Anthony Fisher, a British businessman, set up the institute and sister think tanks, including the Manhattan Institute, to publish analyses based on the principle that strengthening economic freedom helps increase personal and political freedom.
Pipes has fought against the health system change proposals promoted by Hillary Clinton in the early 1990s; a series of “single-payer” and employer “play or pay” proposals in California; and, in recent years, the Patient Protection and Affordable Care Act (PPACA).
An institute economist estimated in October 2010, for example, that defensive medicine adds $191 billion per year to U.S. health care costs.
So, what gets her op-ed juices flowing these days?
For three hot topics she talked about last week in an interview, read on.
1. Network gaps
This issue is dear to Pipes’ heart, because she grew up in the single-payer health care system in Canada.
Pipes believes the difficulties her own mother had with getting a referral for a colonoscopy may have affected the quality of care her mother received for what turned out to be fatal colon cancer.
Healthy people usually buy health coverage based on monthly premiums, not on network quality issues, Pipes said.
“They don’t think they’re going to get sick.”
Similarly, she said, when the government gets involved with health care finance, it may try to compensate for waste and inefficiency with misguided efforts to limit spending, such as caps on the percentage of gross domestic product that goes to pay for health care, or rigid efforts to keep hospitals from readmitting too many patients too often.
“That’s when you get shortages,” Pipes said.
When moderate-income people sign up for unrealistically low-premium exchange plans, or the government puts low-income people into poorly funded Medicaid programs, at some point, “they can’t find doctors,” Pipes said.