“A Brief History of US Medicine: The Role of Government and the Nature of Insurance”

What have been the unintended consequences (side effects) of government laws and regulations in the practice and delivery of medicine? Do the benefits outweigh the negative effects?

What is the history of health insurance in the United States - and how have regulations contributed to the rising costs of both insurance and health care? How does insurance work - and why is it NOT working in health care the same way that it works in other types of insurance (fire, life, auto, etc)?

Special Guest Speaker: Beth Haynes MD, Executive Director of The Benjamin Rush Institute.

The US is seemingly trapped in an endless upward spiral of healthcare costs.

The ACA was passed with claims that it would solve the problem of the uninsured and bend the cost curve downward. How's it doing?

Halfway through the first official year of full implementation of the ACA, some people have gained coverage while significant number of others have lost coverage. The latest Gallup Poll estimates 13.4% are still without coverage. That's an improvement from a peak of 18% uninsured in mid-2013, but the vast majority of newly covered have been enrolled into Medicaid - a highly flawed program where coverage all too frequently does not translate into actual medical care.

This mediocre success in resolving the problem of the uninsured is coupled with absolute failure in bringing down the cost of insurance and medical care. Much of the failure to bend the cost curve downward is due to a failure to understand what is and isn't insurance. What's being called healthcare insurance , isn't insurance.  Until we get this right, any attempt to lower healthcare costs will be negated by the laws of economics.

The Georgetown BRI Chapter will hold a Journal Club discussion of Dr. Graboyes's article on the "Repeal & Replace" strategy currently working on Capitol Hill. This is in preparation for his lecture on Tuesday, September 16th. Please bring your lunch and join the discussion. Whether you are new to BRI or a long-standing participant, your ideas and participation are welcome. Street parking is available north of campus.

Dr. Robert F. Graboyes

Senior Research Fellow, Mercatus Center at George Mason University

Islands of Innovation

The ACA (Affordable Care Act, or Obamacare) is a destructive law whose weaknesses are well-known. But pre-ACA health care was loaded with damaging laws, regulations, and customs—many of them supported by the same people who fiercely oppose the ACA. For nearly five years, ACA opponents have issued futile promises to repeal and replace the ACA—but their proposals have been hollow and remain politically undeliverable.

Both ACA and pre-ACA institutions are similarly fearful of risks and deferential to insiders, and the repeal-and-replace proposals would do little to alleviate these problems. Fortunately, medicine is about to be slammed by a slew of new technologies that will radically change health care. These changes offer the opportunity to pursue a strategy akin to America’s Pacific Theater strategy in World War II—reform health care island by island by island, taking down hundreds of ACA and pre-ACA obstacles to better health. This talk will cover how this island-hopping strategy can get us past the tedious debate between Obamacare and Repeal-and-Replace.