I’m not an expert on health care, and given how complicated the system is, I would guess that few people could actually say that they are. What follows are not researched proposals but simply reactions to what I am seeing on TV and reading in the news. If anything I say here is inaccurate, please let me know because I am eager to learn.
Proponents of the recently passed health care reform seem to think that the reform is not perfect, but that there are no better ideas on the table. They may be correct in the sense that mainstream Republicans have not stepped forward with their own ideas of health care reform. Instead they have simply fought to resist the Democrats’ reform proposals at all cost. If Republicans had a consistent position against all government interventions into health care, then dogged opposition to any expansion of government intervention would be respectable. But Republicans appear to espouse internally inconsistent positions. For example, one criticism of Obamacare has been its reduction in Medicare spending. Republicans have passionately lambasted government-run health care and then decried a reduction in government-run Medicare in the same breath. And didn’t Bush expand prescription drug benefits to seniors when he was in office?
I guess it should be no surprise that political opposition to health care reform has often been more political than principled. But it disturbs me that some jump to the conclusion that if mainstream GOP leadership does not propose an alternative to Obamacare, then no alternatives exist. Are the only two options to expand government health care or do nothing? Have we really reached the point where government is the only option?
Such a conclusion would be especially ironic given the extent to which government is already involved in health care. I sincerely wish I had the time and the resources to research all of the ways in which doctors, hospitals, and insurance companies are regulated by the government, but alas I do not. I think it is safe to say, however, that health care is one of the most heavily regulated industries in the country. For someone like me, with libertarian leanings, it is easy assume that regulation causes the industry to malfunction. But even if you aren’t versed in the perils of market distortion, the situation with health care regulation and reform should at least seem a little odd. When a government-controlled industry breaks, shouldn’t we first ask if the government broke it? You may do some research and come to the conclusion that the government is not the cause of the system’s problems. I would probably disagree with you, but at least you asked a logical question and looked for the answer. It seems that in the recent health care debate, little attention has been paid to what the government is already doing.
Again, I’m not an expert in all these regulations, but I can rattle off a few examples of government interventions into health care. For one, I understand that insurance companies are not allowed to compete across state lines. That is an artificial government restriction that is bound to increase the price of insurance and decrease the quality of coverage. Why can’t they compete nationally (or internationally) like other businesses? Employers are usually required to provide insurance to their full time employees. Why is that a good idea? Why don’t we want individuals shopping around for their own health insurance? Then they could get the coverage they need and want and wouldn’t lose it if they get laid off. And the insurance companies would face more intense competition for customers. We see lots of competition in car insurance – I see Geico and Allstate and State Farm are duking it out on TV at every commercial break. Why are health insurance companies exempt from that competition?
And what about medical licensing and prescriptions? Do I really need someone with four years of medical training, plus an undergraduate degree and four years of residency to tell me that I have strep throat and write me a prescription for antibiotics? The government seems to think that I do. What if I want to open up a new, innovative hospital that provides alternative treatments at a fraction of the cost of traditional hospitals? Frankly I have no idea what regulatory hoops I would have to jump through but I have a hunch that someone from the government would tell me I can’t do that. Then there is patent protection for pharmaceutical companies. Would all innovation really cease if patents were weakened and the price of medicine dropped?
I don’t have well-researched answers to any of this, but I wish these kinds of questions would get asked more in public health care debate. I have a feeling that Republicans don’t ask them because they are too disruptive. Too many people have too much invested in the system as it is now for a politician dare suggest that it all be upended. Insurance companies don’t want to have to compete with each other, new doctors who are $100k+ in debt don’t want to have to compete with alternative treatments, and pharmaceutical companies want to milk their hard-earned patents for all they’re worth. So I’m not surprised that politicians don’t bring more ideas to the table. But for those of us who are not bound by the interests of our constituencies, let’s not be deluded into to thinking that an expansion of government is the only solution out there. Let’s look at what the government is already doing before we demand that it do more.
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