By REP. ROGER MARSHALL
R-Kan.

No matter the road this country takes to replacing the Affordable Care Act, one thing is for certain: We must bend the healthcare cost curve downward.

As the newest physician in Congress, I believe our legislative purpose is to create an environment which results in all Americans having access to higher-quality, lower-cost healthcare.

Right now, healthcare in this country is almost like a house sliding down a muddy hill in a landslide, and everyone is screaming about saving the sofa.

Congress cannot just save the sofa, or rearrange the furniture. We need a bold and disruptive plan that starts with a new solid foundation.

Its cornerstones should be built on consumerization, or in other words, how to deliver healthcare that is focused on and driven by each individual patient.

The first cornerstone is innovation.

We must create an environment that fosters innovation, not government regulation. Overregulation squashes every creative mind in healthcare, which has become one of the most regulated industries in America. We now have federal and state laws and regulations that don’t allow for new technology and new ideas in the delivery of healthcare.

While our universities and researchers do great work, we must truly unleash them to accomplish bold disruption: like how Uber changed how we commute in urban areas, how
Microsoft brought us the home computer, and how cellphones revolutionized how the world communicates.

Simple yet big ideas and innovations are being held back by antiquated roadblocks and regulations.

The second cornerstone is competition.

Like all industries, overregulation has created uncertainty and consolidation in the healthcare industry. These rules and laws protect the status quo. Only the large, multibillion-dollar corporations can take on the mass of new regulations, decreasing competition.

When these regulations are pulled back, entrepreneurs will thrive, and new entities that you and I have never thought of will fight to get in the game.

As long as we keep track of quality as determined by the healthcare industry and consumers — not necessarily by the federal government — American consumers will figure out what is best for them.

The next cornerstone is transparency.

Finally, and most importantly, we must create an environment to allow the patient to become a true, free-market consumer. Value and cost transparency must be the new norm, not the exception.

Transparency of price, outcomes, and patient satisfaction must be publicly shared.

Whatever the next generation of healthcare purchasing looks like, we must allow incentives to be put in place that allow the patient to make a decision with value-based purchasing.

It must be easier for folks to get new, innovative medicines to the market. Right now, the Food and Drug Administration stifles growth with a long, cumbersome process which often discourages and disallows advancements.

It is our challenge and our responsibility to unleash innovation in healthcare and to put the doctor and patient back in charge.

With premiums and deductibles skyrocketing under the current system, many folks don’t have meaningful coverage. More than ever, our healthcare debate must be framed around the patient.

All providers, whether commercial, employers, individuals, Medicaid or Medicare, must keep consumerization — innovation, competition and transparency — at the forefront.

Marshall represents Kansas’s 1st District. He is a member of the GOP Doctors Caucus. This column originally was published in The Hill.

Two high-profile elected executives, President Donald Trump and Governor Sam Brownback, have stimulated a long dormant itch I need to scratch. I first felt this sensation nearly fifty years ago as a graduate student. At that time international politics interested me. We were in the midst of both the Cold War and the Vietnam War. Fidel Castro had overthrown Cuba less than a decade earlier and then turned the island into a Soviet client state. Guerilla war was common, especially in restive European colonies around the world. Movements and governments led by “strongmen” were quite the thing to study, prompting me to take up the topic of charismatic leaders in developing nations for my thesis.

Disappointingly, my graduate education was delayed for another two decades, but I never really forgot my interest in demagogues. Now, in allergy season, that itch is back. Trump and Brownback cause me to ponder what has gone so terribly wrong with the premises and conventional wisdom of American democracy that these two very odd ducks – perhaps not so odd, if we scan the whole of the contemporary American political landscape – could be holding power at this time. Have the American people decided to succumb to strongman rule?

One universal characteristic of those earlier demagogues was their ability to persuade a sufficient portion of the people that their problems came from oppression by internal elites, or external ‘masters’ whose power came from corruption and deceit. In each case the ‘people’s hero’ delivered the message: revolution would free the people of their oppressors, and acceptance of the Great Man’s vision would lead to a new golden age — often recalling an earlier time of national or cultural glory before the era of oppression.

We now confront conditions that have become eerie and alarming. What has happened to American society that can account for this new yearning for political tyrants? Whole segments of our society classified by demography, employment, race, social status or a number of other characteristics seem to have lost faith and tolerance for everybody else. Of what have they forgotten, or become fearful? In Kansas, the external master is the federal government, and for the billionaire in the White House it’s the bureaucracy, foreign governments, fake news and liberal elites.

Perhaps of equal importance, how have so many, including the main players – Trump and Brownback – come to the belief that a strongman autocrat could be legitimate? Consider how little of substance has come of the nearly innumerable orders and tweets of the president. For our smilingly uncooperative governor, all the real power he appears to retain is his constitutional veto.

Why have we come to rely on the trivialities of social media and the inaccuracies of 140 characters to define our social, cultural and political differences? Critical thinking and reasoned conclusions on life values and choices are practically extinct in our society. Instead, many accept baseless claims of deterioration and generalized badness without any objective evidence to support the view. Many of these same citizens then embrace irrational, unsustainable and thoroughly improbable solutions and promises that supposedly will make America or Kansas great again, typically without any verifiable proof.

Over this past year a positive change seems to have occurred in Kansas. New polling shows a super-majority of Kansans have rejected mental confusion and reapplied their wits and their reason – 66% in a recent poll dislike the governor’s policies and leadership. Nationally, for the president the poll numbers continue a steady downward path. Yet ardent minorities for both men continue to provide intense, vitriolic support. What surprises me fifty years on, is that America’s democracy has been an ineffective deterrent, even if only temporarily, to the collective will falling for the fantastic claims of the supremely egotistical.

Dr. Mark Peterson teaches political science at the college level in Topeka.