Give Me Liberty; I’ll Provide My Own Health Care
A conservative vision for health care in the 21st century
Our health care system in the U.S. is broken.
This is essentially what politicians have been telling us for a long time. When we accept this mantra, we also accept the notion that we expect Washington to do something about it. But what does it mean to say that the system is broken? Can we even expect our federal government to fix the system?
There are three primary indicators that politicians have used to show us that the American health care system is broken:
- Too many uninsured
- Rising costs
- Inconsistent quality of care
These are natural areas of concern for many Americans, regardless of political persuasion. I certainly want high-quality health care at an affordable price, and I doubt that anyone disagrees. I don’t want anyone to be denied health care. On the surface, the aforementioned indicators make sense for determining the effectiveness of a health care system.
I’m skeptical when I see health insurance being substituted for health care. Having health insurance does not automatically mean having access to quality care. As a veteran, I’m afforded a certain level of basic health care, but I don’t need to prove to you how bad care can be at VA clinics. The problems we’ve seen surrounding the VA aren’t unique to veterans’ care. In the private sector, with employer-provided insurance, I’ve also had difficulty getting appointments in a reasonable time. I’ve sat in doctor’s appointments in which it was obvious to me that I was just a number and not a patient.
Going beyond my personal experience, I’ve never heard a convincing argument that there is a systemic problem with gaining access to health care. There have been exceptions, but in general, it is a tenet of our healthcare system to care for everyone with an acute medical need, regardless of their ability to pay. This tenet, supported by the 1986 EMTALA law, was reaffirmed during the Clinton administration. The data support that Americans have always had access to this acute care.
I wholeheartedly believe that all Americans should have equal access to quality health care.
The reality is, though, that having health insurance does mean better health care for those with some types of insurance. Unfortunately, this divide falls right along the line between government and private insurance. Much of the “evidence” used to push for universal health care is based on Medicaid data. But in an indictment of public health insurance, studies have shown that there is almost no difference in quality of care for those who are uninsured versus those on Medicaid. Yes, you read that correctly: there is no difference in quality of care between having Medicaid and being uninsured! Studies that try to put a positive light on the quality of Medicaid make no mention of health outcomes, but rather talk about access, cost, and personal experience. Should I believe that Medicaid is producing superior health outcomes and that the studies ignored it? I think not.
But what about stopping Medicaid expansion, or blocking grants, or any of that other nasty stuff conservatives want to do? Won’t that mean that more people will be uninsured? Not exactly.
I want costs to go down and quality to go up. I want doctors to be free to practice without being afraid of frivolous lawsuits. I want an environment in which great doctors can take risks and act based on their best judgment. And I want an environment that allows me, as an informed patient, to make my own medical decisions without seeking government approval. I want a health system in which the administrative costs for practicing medicine don’t drive impossible patient loads. And I want not-so-great doctors to get better or find other careers.
I want to bear the burden of my aging parents’ health care and not pawn them off on “the taxpayer.” I want to show the love of Christ through volunteer work and charitable giving, thereby sharing the cost of my community’s health care.
I want to be able to buy health insurance like I buy home or life insurance — to decide for myself what my family can afford, what risk is acceptable, and what special care we need. I understand that health insurance is more complicated and has more risk factors than home insurance, but insurance companies work by pooling risk and spreading the cost of that risk among large groups. Today, those groups are mostly drawn along state lines and within employers’ payrolls. I want a health insurance market that is flexible and free enough to have options for everyone.
When I need a health service, I want to know what it will cost my family beforehand. And I want that cost to be the same for me as for any other patient. Right now, the cost for services depends on your health insurance coverage. How does that make sense?
What do I want most of all? I want to be free. I don’t want a government that thinks it knows better about me, or about my life, than I do.
This op-ed is a part of FRAY, a thrice weekly email written by a team of liberals, moderates, and conservatives dedicated to separating fact from opinion. Subscribe below and we’ll send you a new issue with perspectives from all sides of the political debate each Monday, Wednesday, and Friday.