Chances are, if you have followed any sort of political discourse throughout the past two years, you have heard heated debate about what to do with healthcare in America. This discourse has spawned anger, accusations, and animosity between politicians and constituents alike. Frustrated by rising healthcare costs, many have turned to government programs in hopes those costs can be reduced or covered and that, although more expensive for some, it would be the compassionate thing to do. However, stricter government control of our healthcare would prove disastrous for a multitude of reasons.
To begin, we need to understand where healthcare stands today. What is the Affordable Care Act, or “Obamacare”? The Affordable Care Act (A.C.A.) was created in 2009, when bureaucrats from the Obama administration sat down with lobbyists and executives from the insurance industry to create healthcare plans that the American people would be mandated to buy. If American families didn’t like these options, they would be forced to pay a penalty through something called “the individual mandate.” This law was so unappealing its authors had to lie about its contents and, in their own words, “...rely on the stupidity of the American Voter..” to get it passed [1]! The basic idea was that if lots of healthy, young, middle class families (by coercion) paid into the exchanges by buying their ineffective and expensive plans, they would be able to subsidize basic health insurance for low-income Americans. If you overlook the grotesque deception promoted to pass the bill, this may sound somewhat altruistic [2]. However, when we take a closer look, that is not the case. For most middle class families, the Affordable Care Act was neither affordable nor did it provide adequate care.
Take for example Melissa Borkowski, a nurse practitioner from Florida. She is a hardworking mother of four who purchased insurance on the A.C.A. exchanges. Under this plan her deductible is $13,000, which means up until her costs exceed $13,000, the insurance company covers nothing. Her monthly premium payments add up to about $25,000 a year. Moreover, her costly premium only covers the most basic general healthcare needs. [3] Why should she be forced to pay for an insurance plan that doesn’t provide anything for her? Not surprisingly, of the thousands of families who chose not to buy these types of plans and instead pay the penalty imposed by the A.C.A., 80 percent were in households that brought in less than $50,000 a year, including 34 percent in households that made less than $25,000 a year [4]. That doesn’t sound affordable or compassionate to me.
Despite the colossal failures of the Affordable Care Act, some Democrats think this policy doesn’t go quite far enough! Many, such as Senators Bernie Sanders, Kamala Harris and Elizabeth Warren (declared and likely 2020 presidential candidates) and Representative Alexandria Ocasio-Cortez (NY-14) all endorse socialized healthcare—also known as “single-payer” or “Medicare for All.” “Medicare for All” is seriously problematic for reasons of finance and efficacy.
Currently, our federal government spends over $700 billion on healthcare costs. This number is rising fast and many experts predict the Medicare trust fund will run dry in 7 years at the latest [5]. It’s seriously concerning that in the face of this fiscal cliff fast approaching, many Democratic politicians insist we should double down. If we can’t afford Medicare for some, “Medicare for All” would surely lead to financial ruin. Just to put the numbers in perspective, an analysis of “Medicare for All” conducted by the left-leaning Urban Institute estimated that it would cost $32 trillion over 10 years [6]. In other words, it would increase federal spending by 3.2 trillion dollars a year. Our country’s entire budget last year as a whole totalled 4 trillion. The fiscal consequences of essentially doubling our already out of control budget are unimaginable.
No matter how you spin it, government-run healthcare does not magically give poor people access to the best healthcare on the market. Study after study overwhelmingly shows those enrolled in government healthcare programs (e.g. Medicare, Medicaid, Veterans Affairs hospitals) have far poorer outcomes than those on private insurance. A recent study published for the National Institute of Health found that “...Medicaid patients were more likely than any other type of patient to die in the hospital. They were also more likely to have certain kinds of complications and infections. Medicaid patients stayed in the hospital longer and cost more than any other type of patient. Private insurance outperformed Medicaid by almost every measure” [7]. Forcing millions of people into low quality healthcare doesn’t sound compassionate to me.
Socialized healthcare is the furthest thing from safe or compassionate. Handing over healthcare decisions to the government does not allow doctors or administrators to make humanitarian decisions based on charity or benevolence. Instead, decisions are based on economic baselines and black and white risk/reward analysis. The heartbreaking case of Charlie Gard, an 11-month old child in England who had a rare disease, demonstrates this cruelty. In February of 2017 his condition worsened and he was dying quickly. Charlie’s parents wanted to take him to the United States for a unique experimental treatment that had some chance of success. However, the U.K. government, not Charlie’s parents, was in charge of his healthcare decisions. Despite assistance offered by prominent figures such as President Trump and Pope Francis, the government healthcare court ordered little Charlie to be taken off life support. They didn’t want to pay for a “maybe” treatment. Tragically, Charlie died the next day.
No one wants hospitals to be run like the DMV. Long wait times, low-quality care, and staggering expenses already facing smaller countries who have socialized healthcare surely would be amplified in our population of 327 million. So here is the dilemma: it is clear that government-run insurance is fiscally unsustainable, extremely restrictive when it comes to choice, and delivers severely poor quality results. But what good does private insurance do for families who can’t afford it? Do we just say to heck with them, take our hands off the wheel and say good luck? Of course not.
Here are some ideas suggested by Republicans to reform healthcare and fix our current system!
- Repeal the individual mandate: Instead, offer a competitive tax credit to families who enroll in qualifying insurance. This empowers the diverse families across this nation to sit down at the table and see what works best for them. This is a stark departure from Obamacare, which coerced families to buy insurance plans they didn’t want with money they didn’t have.
- Reform malpractice litigation: Skyrocketing healthcare costs over the past few decades owe much to medical malpractice lawsuits. As malpractice suits become more commonplace, and claimants receive huge settlements for millions of dollars, patients inevitably have to swallow some of these costs through higher insurance premiums and doctor’s fees.
- Keep the safety net a safety net: Saying “Medicare for all” is like saying “Welfare for all.” Our safety net is already available to all who need it! Medicare is a safety net program meant to be used only by seniors in circumstances of need.
- Prohibit insurance companies from dropping patients who contract chronic illness or pre-existing conditions: This practice is unethical and undermines patients’ decision to buy insurance.
- Completely overhaul the F.D.A. approval process: As it stands today, it takes about three billion dollars from start to finish for a company to get a new drug approved [8]. This type of bureaucratic red tape overwhelmingly favors big businesses over smaller companies, eliminating any sort of market effect that would lower prices through competition.
It’s definitely time for serious healthcare reform. Many criticisms of the “free market” system ring true for many Americans. Out of control prescription drug prices, Americans with pre-existing conditions being dropped from coverage, and astronomically high insurance costs have plagued our healthcare system for too long. Many times poor people have no viable option when faced with catastrophe or chronic illness. These issues have true moral weight. But the answer clearly does not lie in ceding complete control of healthcare to the government. It’s time to go beyond catchy taglines, show up for the people of this great nation and truly create a more fair, equitable, and effective healthcare system for all Americans.
[1] https://www.cbsnews.com/news/affordable-care-act-architect-on-camera-bashing-american-voters/
[2] https://www.washingtonpost.com/blogs/post-partisan/post/pelosi-defends-her-infamous-health-care-remark/2012/06/20/gJQAqch6qV_blog.html
[3] https://www.youtube.com/watch?v=Bapp45Vx0UE
[4]https://www.nytimes.com/interactive/2017/11/28/us/politics/obamacare-individual-mandate-penalty-maps.html
[5] https://www.beckershospitalreview.com/finance/medicare-trust-fund-to-run-out-by-2026-7-things-to-know.html
[6] https://www.forbes.com/sites/sallypipes/2018/07/09/choking-on-the-cost-of-medicare-for-all/#28737fe56f3c
[7]https://journals.lww.com/annalsofsurgery/Abstract/2010/09000/Primary_Payer_Status_Affects_Mortality_for_Major.16.aspx
[8] https://www.policymed.com/2014/12/a-tough-road-cost-to-develop-one-new-drug-is-26-billion-approval-rate-for-drugs-entering-clinical-de.html