View from the Other Side
Senator Bernie Sanders says that if the GOP Health Care Plan passes, “…thousands will die.” [1] Congressman Mo Brooks says that “…people who lead good lives…” don’t have to worry about pre-existing conditions.[2] The Congressional Budget Office says that that 15 million people will lose their insurance if the plan becomes law.[3]
Some of these statements are true, some are hyperbolic, but they are all part of the incredibly heated rhetoric that surrounds the Senate vote on the GOP Health Care Plan. As a “liberal” I find it hard to imagine that any Senator would vote for this Plan with the clear impact it will have on their constituents’ lives. And it’s easy to fall into the trap of saying all of the Republicans are “bought out” by the insurance companies, or the billionaires who look to make vast amounts of money on tax breaks, or really believe that the “virtuous” won’t need insurance.
Part of believing in “civil discourse” means that I believe that folks of good faith can have differing views, reasonably held. So in the interest of being civil, here is what I believe are their reasons to change health care (though I find none of these reasons persuasive!!)
- Conservatives believe that the free market will do a better job of providing insurance rather than one controlled by government regulation. Competition will ultimately drive the cost of insurance down, making it more affordable. Then it will then become more attractive to younger, healthier people who are not now inclined to buy expensive insurance, expanding the market and therefore create a broader base paying insurance and lowering costs.
- They also believe that medical care is a simple ‘supply and demand’ equation. By putting government money into the market (by the increase in Medicaid payments) it creates more demand for care, and, as the supply of care cannot easily expand, the cost of medical care goes up for all.
- They also don’t believe that “people will die” if the GOP Health Care Plan becomes law. There are already laws in the books that require public hospitals to treat everyone who comes in the door, and while that treatment is folded into the overall cost of health care, it doesn’t come out of the government pocket.
- Conservatives believe in personal responsibility, as Vice President Pence has made clear.[4] Personal responsibility means that folks have to deal with their own issues, whether it’s pregnancy (men shouldn’t pay for pre-natal care) or diabetes. Others shouldn’t have to pay more on their insurance to cover it.
- Conservatives don’t believe that Government money should be paid through Medicare to solve “social” problems: most notably drug addiction. Either drug addiction should be treated through “stand alone” programs, or, echoing the personal responsibility idea, addicts did it to themselves.
- And perhaps most importantly, conservatives believe that the current government cost of health care is unsustainable, that it will increase the National Debt to the point where the value of the US Dollar will begin to fall from inflation, and ultimately will require future generations to pay a huge cost.
The ARE multiple problems with the Affordable Care Act (Obamacare). It was based and passed on the concept that ALL states would expand Medicaid, and therefore expand the number of healthy individuals in the insurance pool. The Supreme Court ruled that states could opt out of the expansion, and therefore reduced the size of the pool.[5]
The IRS has stopped collecting the “penalty” for not having insurance. This removes the incentive for healthy individuals to enter the insurance pool, and it reduces the amount of tax brought in to back the rest of the ACA. Meanwhile, insurance companies are getting out of the individual state marketplaces, often because they have no faith that the laws of today will be the laws of tomorrow.
The ACA was an attempt to bridge the divide between the free market view of health care and the more liberal “single payer” system, which is most easily thought of as Medicare for everyone. But even for a single payer system to work, the US must also step onto the other side of the equation in health care, price control. Medicare already does this by restricting the amount that can be charged for a given procedure, but drug costs have been specifically EXEMPTED from control. While the argument is made the Pharmaceutical companies won’t do research if they don’t make a big enough profit (the famous “first pill” cost,) it’s hard to imagine that the excessive profits big pharma makes now are just used for research.
In the end, health care support from the government is a choice. It is a spending choice, just like building a wall at the border, putting more bombers in the sky, and improving roads and bridge. It shouldn’t (and doesn’t have to be) a choice that bankrupts the nation, but it does raise the question: what is the role of government to the people’s health? Does the Constitutional admonition to “…promote the general welfare…” include their health, or is that a “personal responsibility?”
[1] http://thehill.com/blogs/blog-briefing-room/news/339234-sanders-thousands-will-die-under-gop-health-bill
[2] http://www.salon.com/2017/05/02/alabama-congressman-people-who-lead-good-lives-dont-have-preexisting-conditions/
[3] https://www.nytimes.com/2017/06/26/us/politics/senate-health-care-bill-republican.html
[4] https://twitter.com/mike_pence/status/878669323929341952
[5] https://www.washingtonpost.com/news/wonk/wp/2012/06/28/the-supreme-court-surprise-medicaid-ruling-could-reduce-coverage/?utm_term=.e20eff9e530e
A brilliant piece, Marty. Some of the positions attributed to Republicans are to the Right of me, but I think you have captured the debate well, in particular, trying to pay due heed to those who don’t entirely triangulate with you. Great job.