As health care has moved to a lower-tier issue, it can be hard to generate enthusiasm to persevere for change that is so badly needed.
While far too many political leaders find healthcare complicated and boring, in our wonderful circle of colleagues in the health policy community, health care is a passion. We know this is the front we are defending in the never-ending battle to guard our cherished freedom.
We have been on the front lines many times, starting with the fight against HillaryCare in 1993-94 and more recently in trying to give patients choices and more affordable options instead of Obamacare.
Yes, we are out gunned. More than $4.5 trillion will be spent in the United States this year in the health sector. Half of that is paid directly by taxpayers to finance care delivered through Medicare, Medicaid, the ACA, the Children’s Health Insurance Program, state programs, and so many more. As the work of Wharton’s Mark Pauly for AEI has shown, most of the rest of the private health sector also is controlled indirectly by government through mandates and directives “not leaving much in the unfettered, market-based category.”
It may seem that we are past the tipping point and should just retreat. But there is new generation, and new energy, in the battle.
Our efforts to this point have not been unfruitful. Most people in the United States still have private health coverage they value and want to preserve.
But patients are frustrated with the high and growing cost of their premiums and out-of-pocket expenses, with long waits to get appointments with doctors, with the need for “approval“ from some third-party entity so doctors can provide needed care, and on and on.
On the national scale, the extraordinary burden on federal and state taxpayers to finance all of this presents a very real risk to government solvency or crushing tax increases. Changes in policy are vital; we can’t leave the system on autopilot.
The other side continues to advertise “free stuff,” with access to any doctor or hospital anytime, no co-payments or insurance premiums…nirvana.
In arguing for change, our task is harder. We have to explain that everything has a cost and that spending must be contained to avoid catastrophe. The other side quickly cries: “They are going to cut your Medicare! They are going to take away your Social Security!” Too many politicians cower.
So it is up to us in the policy community to start the conversation about the need to protect Medicare (and Social Security) by making responsible decisions today.
The fear that people individually will lose something cannot help but prevail politically over saving a program for future generations or avoiding government insolvency.
Yet we are closer than ever to those realities.
Yes, there is a suffocating amount of minutia in healthcare – legislative details and regulations that require armies of lawyers to slog through and decipher. But there are big issues involved here:
- Government solvency
- The role of government in our lives
Those are the issues that drive our passion for healthcare. These much larger goals are what keep our passions alive.
This is the battle for freedom of our time. Without freedom over healthcare, others literally control our lives.
We all have had experiences where we had to drop everything when our health or especially the health of a loved one is threatened.
When that happens, who do you want to make the decisions about care, you or the government? That’s the ultimate question. If the government controls all of the financing, it will also control all of our choices.
Stay tuned for Part II next week. We all need a pep talk, including me, and a reminder about the huge store of human ingenuity that can solve many of the problems in the health sector.