By By Tray Smith
Although Bill Clinton's universal healthcare plan failed to become law, it succeeded in handing economic progressives the political edge on the issue. Now, Democratic Presidential candidates are attempting to exploit that edge by making universal healthcare the centerpiece of their campaigns. But they are doing so at an interesting time in healthcare politics. The most significant public policy developments relating to healthcare throughout the past year have been put forth by two Republican Governors: Arnold Schwarzenegger in California and Mitt Romney in Massachusetts. Romney is now running a Presidential campaign partly on that success, while his two leading opponents, John McCain and Rudy Giuliani, are said to be crafting plans of their own. These plans may not be as comprehensive in scope as those put forth by the Democratic candidates and they may contain provisions that are not illiberal, but they represent at least a modest departure from the Republican lack of interest in implementing major reforms in America's healthcare system under George Bush's leadership.
That is a welcomed departure. There is no shortage of conservative-oriented cures for the infections that plague our healthcare system, there is simply a shortage of politicians willing to fight for them. Healthcare will be the most significant issue of the upcoming election, and Republicans would be wise to articulate a vision of their own, rather than opting only to deride Democratic proposals. And if by chance they take ownership of the debate over the future of American medicine, they may yet convince voters that medical care can be made accessible to everyone through market competition rather than government intervention.
Unfortunately, matters of practicality may force Republicans to sacrifice principles of ideology. Whether they are an employer barring the burden of increasing employee health insurance cost, a doctor resenting the spike in medical malpractice cases, a member of the swelling ranks of uninsured Americans or a patient at a chaotic emergency room, Americans are disenfranchised with our healthcare system. Some type of reform is inevitable. Republicans, therefore, should be willing to provide more government funding to solutions built around competition and choice least the Democrats lead the country into adopting a more radical government run single payer system. On that note, the current debate on education policy provides us with an unique foray into the debate over healthcare. Republicans support government funded vouchers that will allow parents to choose public or private schools for their kids, yet, entrenched interest and an electorate attached to their public schools make that possibility highly unlikely. Unless Republicans want to be fighting that same battle 20 years from now on, healthcare, with the status quo being government-run hospitals in every community, they should support in the present subsidies that those too poor to buy their own health insurance but too well-off to qualify for Medicaid can use to fund medical care provided by private enterprises.
If the government is going to make medical care affordable for everyone, it has a right to expect everyone to pay for their own medical treatments. That means terminating current laws that allow the uninsured to get free care from emergency rooms and mandating that everyone pay for their own healthcare.
The cost that such a system of subsidies will pose to the government could be mitigated by other free market reforms that will lower healthcare premiums across the board. Those actions include medical malpractice reforms that eliminate the burden frivolous lawsuits place on patients, allowing organizations and small businesses to band together and negotiate for lower health insurance premiums on behalf of their members and employees, just as big businesses currently do and giving consumers the right to buy health insurance across state lines, thus creating a national health insurance market that allows individuals to sidestep burdensome government regulations enacted at the state level. The government should also use its leverage to spur the adoption of electronic health records. Finally, the perverse tax incentives that ties health insurance to employers should be terminated so that employers are freed of the financial burden and employees are given a true choice of healthcare plans, including health savings accounts.
Some experts properly warn of the need to invest in preventive medicine, research and emergency room system reform, and they tout those proposals as a bipartisan route to reforming medical care. Yet, if the creative energy of the free market is expanded in the healthcare system, those reforms will naturally follow. Free market changes can be adopted incrementally with the end goal being a healthcare system that does not necessarily rely on insurance for financing, but instead relies on consumers paying out of their pocket in a completive market place full of affordable choices Thus, achieving universal healthcare does not require a politically difficult one time overhaul of our healthcare system as so many other politicians have sought-and failed-to implement. It just requires Republicans jumping into the debate.
That is the bottom line.
Tray Smith is a sophomore at ECHS and former intern in the Riley administration. He can be reached for comment at tsmith_90@hotmail.com.