Health Care as a Battle between Small versus Large Government

There is a lot of misunderstanding and improper critiquing of the strain in American politics that fears Universal Health Care, so let’s try to set the record straight.

Conservative versus Leftist

The term conservative as it is applied by conservative Americans to their political and social beliefs is far different than how the term is used elsewhere in the world.  American conservatism is a political philosophy of self-government in which the actual government is not needed for most decisions or policies.

Conservatives believe that government is needed only for the really big issues where individual initiative is insufficient to bring about an efficient and equitable solution.  This includes the military and police, highways and bridges, courts, and, it can reasonably be argued: health care.

To mitigate the damage a government can do in these areas, the military is run by civilians, police forces are all local, highways and bridges may be built by the central government but are then turned over to the states for their maintenance, the courts are prevented from becoming domineering by the jury system and the constitutionally guaranteed right not to incriminate oneself.

The news business is not a governmental responsibility and the US constitution guarantees a free press.  Police are not to be considered the first line of self-defence so there is a constitutional guarantee of the right to bear arms.  Education is not necessarily a government responsibility which is why home-schooling is a growth industry in the United States and is fought primarily by entrenched government education interests.  Gambling is considered a private decision, not a governmental one, which is why conservatives support the idea of freedom to gamble at a Vegas online casino. There are many other examples.

Health Care Quo Vadis?

There is a natural inclination in the American soul to distrust any initiative that might enlarge the size of the government.  This is still the case even though the small government advocates have lost many battles in the past 100 years.

Americans instinctively are afraid of Universal Health Care because they have seen its effects in other countries.  Canada, for instance, has long lines for tests and procedures that are basic in the American system.

Health Care or Health Insurance

The latest iteration of Universal Health Care in the US is called Obamacare.  It is more a plan to guarantee that all Americans should have health insurance rather than to guarantee that all Americans would have the best health care. 

As a plan to guarantee that all Americans would have health insurance, it simply made it part of the law: that all Americans must buy health insurance.  This plan has failed as many people have chosen to pay the fine for not owning health insurance rather than pay the huge premiums which have gone up by huge percentages every year since Obamacare went into effect.

Pre-existing Conditions

The problem with forcing insurance companies to issue insurance to customers that will cover pre-existing conditions is that it incentivizes people to buy insurance only when they get sick or are injured.  As a result, the insurance companies have to raise their premiums every year.

This is one of the ways single-payer insurance is presented to the American people: one payer means no insurance companies to raise premiums.  Americans who oppose this solution understand that a single-payer system is really a single insurance company system in which premiums are paid by consumers and government.  Thus, the bulk of the premiums can be hidden from public view as they are part of the general government budget.

Basic Insurance

Insurance companies are not allowed to offer catastrophic care insurance to cover expensive care for illness or injury.  They are forced to include many provisions that drive up the cost of insurance but may not be needed or wanted by the consumer.

Take Your Insurance with You

If you have health insurance through your employer, the employer is the real owner of your policy.  So, if you leave the company or are laid off or fired you lose your insurance and have to buy insurance in the individual insurance market where the premiums have become stratospheric.  The simplest solution is to allow people leaving a group health insurance plan to be able to take their insurance with them.

Interstate Insurance

Insurance companies are not allowed to sell policies across state lines.  This guarantees that the competition between companies that would naturally keep prices down is not allowed.

Keeping One’s Doctor

Even though Obamacare passed a Democrat dominated Congress, it passed without a single vote from Republicans in Congress.  Some of these Republican are actually liberals but on the issue of government-run health care they understood that it couldn’t work and wouldn’t work.

Many Americans instinctively thought that Obamacare was a bad idea but were unable to articulate their objections.  Surely, everyone felt that prescription drugs were too expensive in the US but few knew why.  So Obamacare offered relief on that front.  The fact is that prescription drugs are so expensive in the US because the government, through the Food and Drug Administration (FDA) makes it so.

Drugs are subsidized in other countries but that comes at the cost of machines such as MRI’s that are far more prevalent in the states than elsewhere.

Americans feared being unable to see their family doctor after Obamacare was passed so President Obama reiterated time and again that Americans would be able to keep their doctors.  However, the first thing many Americans lost after Obamacare began was their doctor.  So, Americans are now even more leery of any health care system that puts more power in the hands of bureaucrats. 

Many Americans Want Universal Health Care

Certainly, a lot of Americans would disagree with the basic points made here.  They would say that single-payer or Universal Health Care is simply progress.  It is certainly difficult to argue against those beliefs.

Some of the problems with the American health care system pre-Obamacare have been discussed here very briefly.  The situation is more complicated than can be fully fleshed out in such a short article.  But the instinctive wariness of still many Americans against anything “government” is still strong and grows every time someone spends a hapless few hours at the Department of Motor Vehicles.

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