Here we have the champion issue of the Democrat Party, the Holy Grail of leftism, President Obama’s “Waterloo;” it is the quintessential form of federal government control over the lives of Americans in a modern world. This issue has recently been the centerpiece of mainstream, left-wing reporting, and every day we hear the latest propaganda supporting the so-called “healthcare reform” proposals circulating within congress. This is a large topic, so I will break the left’s arguments down in to its components of philosophy, and statistical rationale.
The ideological foundation for this debate is the question “Is health care a right?” The Democrat Party’s proposals rely on an affirmative answer, but in taking a closer look beyond its emotional appeal, we find that the question must first be broken down into two more basic questions: (1) What is health care? (2) What is a right?
Most people seem to have a good concept of what health care is. When patients are administered medicine, they are receiving a tangible good. When a patient visits a doctor or nurse, they are receiving the tangible services of those professionals. Regardless of what the particular good or service is, health care is something that professionals in the field own and provide at a cost to themselves.
Defining a right is a little bit trickier. The conservative perspective holds that a right is a product of natural law; natural law is based on morality, and morality is based on human nature. Still, the concept of rights seem nebulous and intangible, so it’s best to start with its most basic characteristics. Most people would agree that in order for something to be a right, it must be inalienable from an individual, undeniable to them by both other individuals and by government. If rights are inalienable from individuals, then the rights of one individual necessarily cannot contradict the rights of another. Given these stipulations, let us consider the example of health care.
If health care is declared a right, then the rights of those without health care must necessarily contradict the rights of those with health care. If I walk into a hospital and demand treatment, claiming it as my right, I am actually claiming as my right the service of whoever provides the treatment–if they are unable to refuse, it would render the health care provider a slave. Because this would contradict the rights of the health care provider, health care cannot be a right. The same is true for all other goods and services, such as food, clothing, and housing. These things are produced by individuals at a cost to themselves.
Rights are not something that can be granted or confiscated by government, but goods and services are. In its endeavor to provide health care for all, government has fostered a sense of entitlement in people that causes them to view goods and services as a right. The irony is that the government’s reforms aren’t even focused on health care, but rather health insurance coverage. Health insurance coverage is a promise, and nothing more. Promises are something the government has an abundance of.
I also want to address the left’s use of the word “reform.” Its adoption for this context is no accident, though the way they use it is dishonest. There are two types of large scale change: Reform and Revolution. Edmund Burke, known as the founder of modern conservatism, knew from his observations on the French Revolution and the surrounding time periods what the characteristics and effects are of each. Change through reform is a healthy practice to amend and refine current systems which are believed to be effective, but inefficient. Change through revolution (also referred to sometimes as change through innovation) radically alters a system to the point of being unrecognizable (or does away with a system altogether), based either on the assumption that the current system is horribly inadequate, or that the new system will be so wonderful that continuation of the current system in any way is unacceptable. The two types of change are mutually exclusive, with reformation producing results opposite to those of revolution, which often have unintended consequences, and as Burke put, “A spirit of reformation is never more consistent with itself than when it refuses to be rendered the means of destruction.” The healthcare proposals originating in the U.S. House and Senate are not reform. They are a complete short circuit and doing-away-with of the current healthcare system of America, including its positive aspects. It is revolution, and if implemented, will be disastrous.
The Problem According to the Left
Dearth of Insurance Coverage
By now, there’s no doubt you’ve heard the figure thrown around by Nancy Pelosi, Barack Obama, and several media pundits that there are at least 47 million uninsured Americans in this country. According to them, there is a crisis in the United States of such magnitude that you wouldn’t be able to walk down the street without seeing uninsured Americans sprawled out on the sidewalk, or spilling out of emergency rooms. They would have you believe that unless a great, new, federal government insurance agency is created, there will be a profusion of sickness, injury, and death in America for which we would all share blame.
The first problem with this is that I don’t see uninsured Americans sprawled out on the street. I assume this is because I live a very sheltered life, but still, one must be at least a little bit skeptical. 47 million Americans is over 15 percent of the current United States population, so one would think that this crisis would have been all over the news for years up to this point. 47 million uninsured Americans don’t just appear over night, but I seem to recall only hearing about this figure during the 2008 election as one of the Democrat Party’s talking points, so where did this figure come from? It turns out, the figure originates from the 2006 U.S. Census Report. As with most statistics, these require more than a face-value appraisal. In his book, Liberty and Tyranny: A Conservative Manifesto, Mark Levin digs deep into the report and points out a few problems with the Democrats’ conclusions:
“In 2006, the Census Bureau reported that there were 46.6 million people without health insurance. About 9.5 million were not United States citizens. Another 17 million lived in households with incomes exceeding $50,000 a year and could, presumably, purchase their own health care coverage. Eighteen million of the 46.6 million uninsured were between the ages of eighteen and thirty-four, most of whom were in good health and not necessarily in need of health-care coverage or chose not to purchase it. Moreover, only 30 percent of the nonelderly population who became uninsured in a given year remained uninsured for more than twelve months. Almost 50 percent regained their health coverage within four months. The 47 million “uninsured” figure used by Pelosi and others is widely inaccurate.”
The existence of 10-15 million truly uninsured people is no small problem, but when we honestly consider all the facets of the data, we must seriously question the exigency of overhauling our entire health care system. The coverage of non-citizens and people who, for whatever reason, abstain from purchasing health insurance, all in hopes of helping a small percentage of truly disadvantaged Americans, is not wise, and we must give fair examination to less drastic policy alternatives.
The Insurance Companies
How did this problem start? If and when one accepts the “47-million-uninsured-Americans” figure as accurate (ignoring the facts mentioned earlier), one must wonder where all these uninsured Americans came from and how they got to be in their current situation. The talking heads on the left, including politicians such as Barack Obama, Nancy Pelosi, and Harry Reid, seem to have decided upon private insurance companies as the culprit. They constantly re-iterate the horror stories of how people cannot acquire health insurance through their employer, or how skyrocketing health insurance premiums are preventing individuals and employers from purchasing a policy or prescription drugs, or how they are denying coverage to people with pre-existing conditions, etc. The fact is that some of these stories have some elements of truth to them, and there are a few cases in which people more or less fall “victim” to these situations. The health insurance system in this country is far from perfect, and it could stand to be reformed in many ways.
However, this leaves out an important aspect of the debate, and fails to explain the behavior of the insurance companies other than through words like, greed, malevolence, and selfishness. The purpose of health insurance is not to act as a buffer zone for the entirety of a population. As much as it pains some people to hear, it was never designed to provide for all people and cover all medical conditions. The way all insurance works is that the participants pool against risk–in this case, the risk of sickness or injury. When an individual requires treatment for some affliction, the insurance company is required by contract to pay out the premiums it collects according to a payment schedule. We are most familiar with such schedules through car and home insurance. When accidents occur, certain damages are covered, whereas others are not. Even compensation for similar damages may vary depending on other circumstances, such as who was at fault.
There is a big difference with health insurance, however, in that participants are not always pooling against risk. Since the advent of health insurance, the coverage of most insurance plans has grown to grotesque proportions to the point that insurance companies are no longer insuring only against risk–regular check-ups and procedures, weight-loss surgeries, and prescription drugs are but a few of the litany of covered treatments today (this is the main reason health care costs are so high). Given this overabundance of coverage, it would not make sense for a healthy person to participate, because instead of paying only for the unlikely, occasional, catastrophic illness or injury–which health insurance was originally designed to cover–their premiums would instead be going to pay for the near constant claims of people looking to fund their own lifestyle. The system would basically become a transfer payment. As a result, we have 18 million young people who wisely choose not to buy health insurance.
Given the lack of premiums from healthy people to subsidize perpetually sick people, insurance companies have to be discriminatory in deciding whom to cover. An insurance company would go broke if it had to provide for every single sick person or every pre-existing condition because there simply are not enough healthy people to pay for them all, and this would ultimately defeat the purpose of having health insurance in the first place. This is the sad, ultimate truth about the current health insurance system, and although it is sometimes a painful truth, it is the only way the insurance system can function to provide for the truly needy.
The Solution As They See It
Nationwide Private Insurance Mandates
Here’s what the Democrat politicians plan to do about the problem: Because they believe the insurance companies to be acting out of greed, selfishness, and discrimination, denying coverage purposefully because it would diminish their profits, they intend to solve this problem by punishing the insurance companies in a variety of ways. First and foremost, they intend to use the law to prevent insurance companies from denying coverage based on pre-existing conditions in individual insurance markets. The problem with this proposal is not hard to understand. I just explained why insurance companies do not cover all people and conditions, and to force them to do so would be to force them out of business. Besides, the federal legislation HIPAA which was passed in 1996 already mandates insurance companies to sell coverage for groups such as businesses regardless of the health of its employees. They also wish to prevent insurance companies from dropping coverage of those who become sick, but this problem is pretty much imaginary, as HIPAA already prevents this for groups as well as individuals, and no business in their right mind would charge for a product and not deliver the goods. They would go out of business in an instant. They also plan to prevent insurance companies from “watering down” plans and paying only for a limited supply of drugs and medical procedures. Although I actually believe this to be a noble endeavor, I also believe an insurance company that did this would not last long in a free market, and it is because of current federal law that these companies are able to perform such practices and still retain consumers, but I’ll address this subject later. They also intend to disallow “arbitrary cap[s]” on coverage after certain time periods. Again, in a free market, this would not occur, and it is because of federal law that this problem occurs, though it even sounds preposterous in itself. They also want to limit how much a person can be charged for “out-of-pocket expenses,” which I’ll assume to mean co-pays for medicine, check-ups, and non-covered expenses. This has less to do with insurance coverage (although it does revisit the problem of forcing coverage for everyone) than it does with simple economics. You cannot limit the price of those health services and medical supplies through law without causing vast, negative repercussions for the companies and clinics that provide those commodities.
Public Health Insurance Entity
Here is the tricky part of the Democrat plans in congress: The “public option,” as the politicians evasively describe it. It has had many names over the months and been talked about by many people. It has been called names like “government co-op,” “public option,” “health insurance exchange,” “universal healthcare,” oh, and don’t forget “Hillary-Care.” As much as the left wants to deny it, they are all means to the same end: socialized medicine. Every name, every government plan described, takes the power of health insurance away from the private sector, and gives it to a government entity. Here’s what will happen: The government plan, if it doesn’t immediately become the only insurance provider by law, will gradually become this. It may start out as a “government co-op,” or a “health insurance exchange,” both of which are designed to compete with the private companies in the free market. Eventually, the private companies will go out of business, as they will not be limitlessly funded by the federal or state governments, and they will not be able to compete with something that is. This is simple economics. Anyone who says that people may retain their private coverage in this newly created, government monopolized environment with no negative consequences are simply lying. If the government does not immediately force people to sign on to the government plan, then those people who retain their private coverage will see dramatically increasing premiums, and soon their plan and their company will cease to exist.
But what will this new government insurance entity look like, and how will life change with it? Most likely the newly created entity will be a bureaucratic agency, far away in the distant realm of Washington D.C. It will be large, of course, and inefficient as most bureaucratic agencies are, and it will be expensive to run. Many people have listened to the president’s rhetoric, and come away thinking such a system would be benevolent, down to earth, and even cost effective. The biggest misconception today, however, is that the government can actually provide healthcare for us at all. The government does not produce anything; it only rearranges things. The politicians will say they have achieved “healthcare for all,” but what does that really mean? When you go to the doctor for a checkup, you’re not getting the insurance you bought. You’re getting the tangible services of another human being. When you buy and use a pharmaceutical drug, it’s not the health insurance that makes you healthier, it’s the tangible effect of medicine. Of course the government will provide free health insurance coverage to all people in America (including illegal immigrants), but what will we really be getting? The only thing the government can deal with is money–your taxpayer money: You will be using it to buy health insurance once again, only this time there won’t be any private insurance companies to blame for lack of care. There will only be the government. You won’t be paying for your own health insurance, nor will you be paying for the insurance of a group of people associated with a private business. No, this time, you will be paying for the insurance of everyone, whether they be sick or well, whether they pay taxes or not. The government will not discriminate in providing coverage. Everyone will get it, but only a few will pay for it. If you are healthy and don’t feel the need to buy insurance, that’s too bad. You have to pay taxes, and taxes are not a selective matter.
Now, it’s bad enough having to pay for the care of others in a totally cost-ineffective system, but what if you’re sick? The proponents of government run healthcare tout the excellent quality of socialized medicine. But what happens when the only window you have to obtaining state of the art healthcare is a cost-ineffective system? As the number of people who would require healthcare treatment by law would increase exponentially, and as healthcare costs continue to rise due to inflation, the government will inevitably be forced to ration care. This is where the “death panels” you hear about come in to play. The left-wing media uses that term to mock the opponents of socialized medicine, but when there is only so much healthcare to go around, and too many people to be treated, someone is going to be neglected. The bureaucracy, in its unending quest to be cost effective will have to start cutting healthcare options from the plan until costs can be met. This means the people with the most expensive ailments will be neglected first: People with heart conditions, trauma disorders, cancer patients, mental disorders, asthma patients, etc. These are the people that the far off bureaucratic agency in Washington D.C.—with no regard for the thoughts of the patient, the doctor, or the spirit of life that each patient holds—will cut first. These are what the “death panels” are for. They are to decide who is the most inefficient; who has the least bang for the buck. It doesn’t stop there, though. Coverage will continue to deteriorate until there truly are millions of people (most of them being senior citizens and the disabled) without healthcare in America. When there is no one else to blame but the government, it will be too late. Private insurance will be long gone, the deficit will have ballooned, and millions will have suffered.
Then there are always those proponents of socialized medicine that refer to the success of government plans in Britain, Canada, and other countries. I don’t understand exactly how they would define success, but if they mean substandard care, long waiting lines, and higher mortality rates than the U.S., then yes, I would say they’re successful as well. Here are a few examples of the many “success” stories coming out of those countries:
Even though we actually have the best healthcare system on the face of the Earth, and many people from other countries flock here because they are prevented from even purchasing privately state-of-the-art medical care, herds of drones on the left still rant about revolutionizing the healthcare system here. There are plenty of countries around the world with socialized medicine. If those countries are the wonderful utopias that they are purported to be, why don’t huge quantities of Americans flock to nations like Great Britain and Canada? Just leave here, and stop trying to ruin our system for generations to come. Here’s something for those who say that the healthcare system in terms of quality here in America is miserable:
The Problem As We See It
Misguided Federal Regulation
As for the proponents of new federal laws and increased federal regulation to solve the problems with America’s healthcare system (mostly Democrats and soft Republicans), it seems that the 1996 law HIPAA would be at least mostly satisfying. It provides for nationwide guaranteed issuing of coverage in group/business cases, and guaranteed renewability of coverage for groups/businesses and individuals. But apparently this doesn’t go far enough, hence the need for government run healthcare, and the inevitable destruction of the private insurance market. What most people fail to realize is that the laws of HIPAA already existed in many of the states to varying degrees. For example, by the mid 1990’s, 36 states had laws requiring guaranteed issue, and 46 states had laws requiring guaranteed renewability. I would see this as another strength of federalism, as it should promote national competition and give insurance shoppers more choices when it comes purchasing affordable plans that work for them, no matter their geographical location. Unfortunately, many states also have laws and regulations restricting which policies can be bought where.
The Solution As We See It
Offering federal tax credits to individuals and families would significantly reduce the number of uninsured United States citizens, with a decreased risk of illegal immigrants or anyone else less inclined to pay taxes getting a free ride. It would also increase insurance participant pools overall, offsetting the spikes in premiums due to expensive, pre-existing, or other specifically designated conditions.
National Insurance Market
As of now, the tangle of state and federal regulations prevent individuals from shopping for insurance across state lines. Some policies and packages are only available in certain geographical areas. Reconciling state regulation through federal law could open up a national insurance market, increasing competition, driving down prices, and increasing levels of customization among plans.
If federal subsidies for insurance are absolutely necessary, they should be issued through block grants that allow states to control how much money goes to individuals and companies, and not waste money when it’s not needed.
One of the biggest factors in the rise of healthcare costs in the United States is a plethora of malpractice lawsuits against doctors, hospitals, clinics, and HMO’s. Most of these cases are frivolous. Some experts say that 10-15% of the increases in healthcare costs are due to frivolous lawsuits, and federal law needs to be changed to limit them.
Where are the Republicans?
Although the left-wing media would have you believe that all the Republicans in Congress are a bunch of stubborn naysayers who only oppose real healthcare reform because they hate the president and want him to fail, the Republicans between June and the present day actually have had three pieces of legislation introduced in Congress (all three of them combined are smaller than any of the Democrat bills, and add to the deficit much less as well). None of them are really going anywhere, and they likely won’t because the Democrats have the majority in Congress. At least the rapid push to ram the government run healthcare bills down the throats of the American People is being slowed by the Republicans (besides Olympia Snowe and a few others), right?
I guess what the debate boils down to is this: If you support a destroyed private health insurance market, a government run health leviathan, rationed care, “death panels,” a ballooned federal deficit, substandard quality of care, long waiting lines, coverage for illegal immigrants, and higher mortality rates all for the sake of 10-15 million long term uninsured who will end up worse off than now anyway, then the Democrat proposals fit your bill. But if you believe that the system we have here, albeit imperfect, is the greatest healthcare system on the face of the Earth, and can be made better in a low cost and efficient way, without endangering the lives and prosperity of Americans for generations to come, while preserving and streamlining federalism, and while preserving coverage and quality of care for the most people possible, then not only do the Democrat proposals need to be opposed, but the Republican proposals need to be championed.
We do not elect our representatives or our president to authorize a cost-benefit analysis on the lives of their constituents, the American People. We elect them to preserve our freedom to choose the best path for our own lives.