Health-Care Nonsense Goes On and On: "A government big enough to give you everything you want is a government big enough to take everything you have".

• Author: Singleton, Marilyn M.
• Position: MEDICINE & HEALTH

THE DAYS of trusting your legislators to have your best interests at heart are in the rearview mirror. Apparently, their main interest is parroting the buzzwords of the moment to get elected and then being too busy banking lobbying money to listen to the voters. Our legislators have become spectators who wait for the perfect moment to pounce on their political "enemy" and then go on cable news shows to boast about it.

The "us against them" attitude, punctuated by hyperbolic, apocalyptic rhetoric closes the door to finding solutions. Our interests would be better served by having town hall meetings where voters could state their concerns, air their differences, and learn what legislators are doing about their issues. Caution: meetings at 9 a.m. on Wednesday when paid activists are guaranteed to outflank the working general public are prohibited.

There are strong differences of opinion on how to attain a healthy citizenry. Educating potential patients about what drives up medical care expenditures can start the conversation. Well-informed patients would demand solutions based not on corporate interests or government or political agendas, but on a fair, competitive market that maximizes choices and achieves lower costs.

Eight years of the Patient Protection and Affordable Care Act have borne out Congressional Budget Office predictions that abandoning basic principles of insurance--which compensates only for events beyond the insured's control and is priced according to the degree of risk--would lead to higher and higher premiums, fewer participating insurers, and unsustainable government expenditures to subsidize insurance premiums.

The data in three recent Centers for Medicare and Medicaid reports on PPACA exchanges show "individual market erosion and increasing taxpayer liability." The average monthly premium for coverage purchased through the exchanges rose 27% in 2018, and Federal premium subsidies increased 39% from 2017 to 2018.

A less-frequently discussed cost driver is the disturbing trend of private doctors' offices being scooped up by hospitals, health insurance companies, and venture capital groups. Prices tend to rise when health systems merge, because of decreased competition--and not only do hospitals and health systems generally charge more than private physicians' offices, the government compounds this problem by paying more to hospitals than independent offices for the same service.

A review of 2015 payments shows that...