Health care costs in the United States amount to 17 percent of Gross National Product (GNP), and many believe there is little to show for the investment. Both major parties in Congress are calling for reform–with very different ideas of what it should look like.
Painfully aware that government-based proposals enjoy public and media support while market-based approaches are often received with mistrust, participants in the “Conservative Approach to Health Care Reform” panel at the annual Conservative Political Action Conference (CPAC) in Washington, DC discussed ways to better explain market-based health care to the public.
They also lamented the GOP’s near-capitulation on the issue.
The panel was moderated by Colin Hanna, president of the free-enterprise advocacy group Let Freedom Ring, and included Michael Tanner, director of health and welfare studies at the Cato Institute; Grace-Marie Turner, president of the health care reform-focused Galen Institute; Sarah Berk, president of the Health Care America Foundation’s Better Health Project; and Congressman Tom Price (R-GA), a medical doctor who formerly made his living as an orthopedic surgeon.
The topic of the panel’s late-January discussion was both timely and necessary, said Berk, because accessible, affordable, quality health care for patients across America is “the great social imperative of our time.”
Unfortunately, Tanner noted at the panel, “too many conservatives and Republicans believe we’ve lost the fight, and are negotiating terms of surrender.”
Many Democrats, like much of the American public, think “Washington has all the answers,” said Turner. She stressed, “The health care sector should operate more like the rest of our economy, in which individuals have power and freedom to make choices.
“Right now,” Turner explained at the panel, “people get a generous tax break for their health insurance only if their employer buys it for them.” The tax break “is worth $200 billion a year–almost twice as much as the mortgage interest deduction. People don’t even know they get it.
“Make that portable,” Turner recommended. “Allow people to get the same tax break whether they get health insurance from their jobs or whether they get it on their own.
“One in 10 Americans changes jobs every year; tying health insurance to the workplace is just not going to work,” Turner said.
Turner also stressed the importance of “cross-border purchasing,” giving people the ability to choose and purchase health insurance across state lines. The practice is currently illegal, but many experts believe allowing it could open up America’s health care market to beneficial nationwide competition.
“We have entered a new era in the health care debate” for which the driving force is average Americans, said Berk.
“The costs of premiums are rising faster than wages,” Berk noted, and “people are stuck in jobs they hate because they can’t afford to lose their insurance,” while others’ families “are just one medical emergency away from bankruptcy.”
The employer-based system “is not working,” said Berk, pointing out, “General Motors spends as much on health care for its employees as it does on steel for cars.
“In 2001, more than 75 percent of the Americans who went bankrupt because of a medical crisis actually had health insurance when they got sick,” Berk continued. “One-fifth of Americans have medical-related debt.”
“The principles of portability, equity, individual responsibility, competition–they work in the rest of the economy, they’ll also work in the health sector,” said Turner.
Berk concurred, saying, “There is a role for government, but it’s not owning and operating the system.
“Republicans have got to get better at making their case, otherwise Americans won’t trust conservatives to fix the system,” Berk added
Part of making the case might come down to simple-but-critical vocabulary, Price suggested. “Don’t speak of ‘market-driven’ or ‘consumer-driven’ health care,” Price said, because those terms can “scare people off.”
Instead, Price said, call it “patient-centered health care,” a term that “defends what everybody is at some point: A patient.”
On the topic of government-mandated “universal coverage,” Turner pointed out, “You can get to universal coverage if you’re willing to tax everybody enough,” but she noted “a mandate is useless unless you can enforce it.”
Presidential candidate Sen. Hillary Clinton (D-NY), who has proposed an individual mandate that could be enforced by garnishing the wages of those who do not purchase health insurance, “talks about Medicare for all,” Turner noted.
In reality, what she is offering is “Medicaid for all,” Turner said, drawing a distinction between the latter, the tax-funded health care program for low-income Americans of any age, and the former, the insurance program for seniors, with which Medicaid is often confused.
Calling the current Medicare system “woefully flawed,” Price argued, “if government intervention got us where we are, we ought to accept that government intervention won’t get us out.”
Imitation No Solution
No Republican should support big-government approaches to health care, Tanner said, because “we cannot defeat ‘HillaryCare’ [Sen. Clinton’s health care proposal] by offering ‘HillaryCare lite.'”
The four panelists stressed any move toward greater government control of health care would further strip patients of choice and personal responsibility.
Said Price, “The solution is simple. Patients need to own their policies regardless of who is paying the cost”–whether it’s the patient, the employer, or the government. That, said Price, would give power to patients, “because insurance companies have to be responsive to whoever owns the policy.”
“The choice is clear,” said Hanna. “It’s government control or patient control.”
Tanner added, “Will some of the most personal and private decisions that you could ever make in your life [be] made by you, or by someone else–be that your employer, the insurance company, or the federal government?
“In the end,” Tanner said, “this is a debate about freedom.”
Karina Rollins ([email protected]) writes from Washington, DC.