There are good laws, there are bad laws, there are debatable laws, and then there the type of actions that a first term President before a tough election will take. And, it appears that President Trump is getting ready to unveil one of these terrible ideas on Thursday while in North Carolina. While the exact details are non-existent in the public – behind closed doors the rumor is that President Trump is going to propose banning physicians that are enrolled in Medicare from balance billing. In other words, as a condition of working with the government – the President wants to dictate what doctors can do in the rest of their private sector business. 

This is like the President proposing a law stating that if you use the road – then you have to paint your house red. This would be the biggest step toward Medicare for all since Obamacare, and arguably, might even be considered a bigger step. 

The policy goal of the President is to end surprise billing, which almost everyone agrees should end. A surprise bill occurs when a patient receives treatment – believing that everyone is in their network – and then receives a “Surprise Bill” from a physician that was in fact out-of-network. The physician can be out-of-network for several reasons, but it is normally because the insurance company doesn’t want to pay the doctor what they are worth – forcing the doctor to bill the balance of their charge to the patient. 

Often the anger for these bills is directed at the doctor, but the anger should really be with the insurance company that sold the patient that their product would cover more than it did. Either way, this is understandably frustrating to the patients and can often add up to a lot of money and is a problem that should be ended. 

The problem for the President is that insurance companies have dominated the lobbying on the issue and the proposal that was moving the fastest was so weighted toward them that the bill has stalled in Congress. The insurance industry’s solution was to have Congress let them set the prices that they pay doctors – and at least some in Congress seemed to agree putting forward a bill that set the price that an out-of-network doctor can receive to the median in-network rate. Fortunately, there were enough in Congress that saw through this that the bill currently has a murky outlook for moving forward. And, for a President that promised reducing healthcare prices – reducing surprise bills would be a big step and something important that he could talk about on the campaign trail, but not having something is a failure that might turn some away. 

From the healthcare economics point of view the whole debate is frustrating. First, surprise bills are a symptom of a broken system and merely mandating that they stop is no more than a band-aid on a mortal wound. Second, while the proposals developed by the insurance industry are like those small band-aids in the box that can’t actually cover anything and fall off as soon as you put them on, there are a few solutions that have been proposed (and implemented in a few states) that actually do a good job at both stopping the problem and not further breaking the market – including arbitration and truth in advertising language. 

For a President, working with Congress is hard. In fact, it is rumored that the Treasury building was built where it is – in the line of sight between the White House and Capitol Hill – because the President at the time was so tired of being reminded of Congress. However, our legislative system was set up this way, specifically to slow down the creation of legislation. When a President, any President, goes outside of this system they can quickly move laws in a way that Congress would never agree to – and often for good reason. 

While I understand the President’s frustration – moving ahead with a pen and paper is a bad idea. It was a bad idea when President Obama did it, and it is bad if President Trump does it. If the rumors are correct, and President Trump intends on dramatically changing the role of government in healthcare he should reconsider before making the mistake. If the rumors are incorrect, but he still intends on using his pen instead of working with Congress to pass a law that might last for decades or longer – he should reconsider. 

Healthcare needs less government, not more. Free the doctor. Free the patient. And, watch the market flourish.

Charles Sauer (@CharlesSauer) is Editor of US Policy. He is president of the Market Institute and previously worked on Capitol Hill, for a governor, and for an academic think tank.