Bernie Sanders and company are wrong when they talk about free healthcare–there is nothing free about it. Someone has to pay for it. Raising taxes to cover all Americans under our current healthcare system would be a disaster. Here’s the problem: heath care does not meet market criteria: you cannot comparably shop for it. Insurers and providers play cat and mouse with cost and benefits to the benefit of themselves and their shareholders. Consumers are played for more money with few of the conventional powers they wield when paying for other goods and services. If the government tried to provide healthcare for all under this market rigged system, prices would balloon as corporate health care saw an opportunity to fleece even more tax dollars than they do now. To date, free healthcare has been a slogan, not a serious policy, and the left have fallen victim to its siren song.
As a conservative principle, healthcare is a matter of individual responsibility. As a market principal, healthcare costs are kept low by everybody buying insurance, especially when they do not need it. An individual mandate with a hefty penalty is a good way to ensure that everyone purchases healthcare. The idea originally came from the conservative Heritage Foundation and was put into practice by then Governor Mitt Romney.
The individual mandate has increased enrollment and substantially slowed insurance cost inflation. For years the idea was rejected by the left (until the Affordable Care Act). Once the left embraced this conservative position of individual responsibility, it was rejected by the right. Presidential candidate Mitt Romney was forced to perform intellectual gymnastics to reject his signature accomplishment as governor because it had now been co-opted nationally by the left. With the emergence of the Tea Party in 2009, and Senate Minority Leader Mitch McConnell’s declaration that the Republican’s main objective was to make president Obama a one term president, the policy idea was now Republican enemy #1. Nothing ideological about the policy had changed, nothing practical about the policy changed, what changed was who supported it. The objective was no longer: What can policymakers do to help Americans afford healthcare? It now was: How do we make sure the Democrats fail?
Democrats are also part of the problem. Instead of coming up with comprehensive changes to the Affordable Care Act that would make it stronger, they have embraced the idea of a single-payer system. No serious single-payer system has emerged from the left. They currently have a good bumper sticker, not a good idea.
Republicans are right when they say healthcare should be sold across state lines. Democrats are right when they say there must be guidelines that don’t allow trash insurance policies to be sold, making healthcare a race to the bottom. Republicans are right when they say there must be market incentives for drug companies and others to innovate. Democrats are right when they say those incentives should have limits. I imagine any sophisticated and moral person would agree with the fundamental assumption that essential life-giving medicine and procedures should be made readily available to those who need it–that It would be morally wrong to view maximizing profit on life-saving drugs over saving lives. Republicans are right when they say employers should not be responsible for providing healthcare, individuals have a responsibility to purchase healthcare. Democrats are right when they say the government has a responsibility to help people afford healthcare. If you are a free-market capitalist you understand the need for people to have reliable and affordable healthcare—it will increase productivity, marketability, mobility and innovation. The current system is rigged in favor of shareholders over those who need healthcare. It is flawed logic, however, to assume that market incentives do not drive innovation or efficiencies.
There are models to look at, policies to try, and new innovations to discover when it comes to healthcare. Our current path is unsustainable. We spent almost 50% more on health care than other nations and have worse outcomes. We pay for a new Mercedes and drive a used Kia. Why? Are we not smart enough to come up better incentives? Better policy? Better outcomes? Why not try a federal public option that sets prices and encourages competition among private insurers? Why not move heath care from employers to individuals? Why not sell it across state lines, yet still maintain federal standards of cost and care? It’s not a policy problem, it’s a political one. It’s not a money issue, it’s a moral issue. It’s not about resources, it’s about resolve. The United States of America has lost the ability to do big things! Big ideas and bold moves take statesmen, not politicians; patriots, not partisans. Partisans lust for small victories, patriots yearn for lasting change. Partisans see things in stark terms of winning and losing, patriots know that the lack of broad vision and compromise makes us all losers.
No doubt America is sick and the only cure in sight is an end to our bitter partisan tribalism. No substantive, lasting improvement has, will, or can come from one side of the political spectrum. It will take a nation working together to make healthcare better and more affordable for everyone. If we don’t fix healthcare, we will continue to lose our competitive edge around the globe. We need some strong medicine now! The question is, who will write the prescription?