Imagine a world where a Death Panel has just decided that it’s too expensive to keep your grandmother alive. A world where the federal government has secretly implanted a microchip underneath your skin for the purpose of tracking your every move. A world where the Founding Fathers have crawled out of their graves to tell the world of our sins while standing arm-in-arm with Glenn Beck singing “God Bless America.” A world where socialized medicine, wrought into existence by Obamacare, has destroyed Western Civilization entirely.
Fortunately, none of the aforementioned malarkey has come to fruition since the passage of the Affordable Care Act. However, this doesn’t mean the law is without its flaws. Obamacare obviously has its critics on the right, but it also has its critics on the left, and while the red-meat conspiracy theories and horror stories spelled out in the opening paragraph did not come true, our national health policy still needs improvement.
The advent of Bernie Sanders’ campaign has breathed new life into the healthcare debate. Though I share Bernie’s understanding that healthcare is a basic human right, I don’t believe that a single-payer system, such as the one he’s proposing, would solve the nation’s problems. Single-payer would completely gut the private sector’s involvement in healthcare, and while some would be happy to see their insurance company axed by a Death Panel, this would ultimately do more harm than good. The private sector provides incentives for medical innovation and quality customer care. A public monopoly on healthcare would be just as detrimental as a private one. So, if single-payer is off the table, what’s a liberal to support? I believe that a strong private-public mixed system, with the intention of making coverage universal, would lead to better outcomes, higher customer satisfaction, greater choice and lower costs.
The first plank of my proposal would be to establish a public option. More specifically, any citizen of the United States should be able to purchase Medicare if they want to. Medicare has high levels of satisfaction with its beneficiaries, and it has the lowest overhead costs when compared to all major, private health insurance plans. Additionally, since the number of beneficiaries on Medicare is roughly 50 million already, the federal government has incredible bargaining power when negotiating with drug companies over prices. More people on Medicare would give the federal government more power to lower prescription bills. Lastly, allowing citizens to purchase a public option would solve one of the major problems our system faces. Since most health insurance plans are tied to a job, if you lose or quit your job, you most likely lose your health insurance. With this public option, citizens need not be as stressed about losing or quitting their jobs, or feel as if they have to accept a less desirable position because it has better benefits. The coverage will stay with them.
The second plank would be an expansion of Medicaid, and perhaps the establishment of another program geared toward providing healthcare for those who cannot afford it. Obamacare provides for an expansion of Medicaid, but it has not gone far enough. Currently, 19 states have refused to expand Medicaid, even though the federal government has offered to pay for it. The federal government should withhold funds from states choosing not to expand this life-saving service, and perhaps it should reconsider transitioning these types of assistance programs to the federal level. Around 15 percent of Americans are currently uninsured, and it’s not because 30-40 million Americans think health insurance is an unwise investment. No person should go without healthcare because one cannot afford it, and we should expand programs for those with lower incomes until the uninsured rate plummets to zero.
My last plank involves creating private healthcare conglomerates that merge insurance companies with healthcare providers. One of the drivers for rapidly increasing costs in the health sector has been the mismatch of incentives. Insurance companies want to make smart decisions using cost-benefit analyses, and health care providers want to make sure all health problems are solved. This often results in higher costs for procedures that do little to help the patient. When insurance companies and healthcare providers, such as hospitals, combine into a single healthcare conglomerate, the incentives align so that the goal of the company is to provide the best quality of care possible for the lowest cost possible. This involves more explanation than I can provide in fewer than 800 words, but I think it’s worth considering. These healthcare conglomerates could potentially save thousands of lives and billions of dollars, and the government should be receptive to this experiment.
My hope is that we can live in a society where healthcare is seen as a universal right, and that any attempt to involve the government isn’t a cause for hyperbolic fear-mongering. We need to get this right. The current law is a good start, but it needs to go further to ensure quality care for every American.