Dr. Walter Zelman argues that there is a conservative case for the individual health insurance mandate, the cornerstone of the Patient Protection and Affordable Care Act.
As he states at the beginning of his article, Republican opposition to the law has been "vigorous and consistent." Unlike the current Presidential administration, which has mismanaged the public relations campaign to legislation that no one in the country wanted, the GOP has staked a case for the repeal of this outrageous power grab into American citizens' daily lives.
I applaud Dr. Zelman for his accurate portrayal of the conservative moment as favoring "limited government" and "individual responsibility". However, to argue that the conservative argument for repeal is "murky" is uninformed and distorted.
For example, Zelman cites the support of well-known RINO (Republican in Name Only) John Chafee in support of individual mandates. This Republican, like a number of his ilk from the North East, are moderate on everything, including their stance on the role of government in the private lives of its citizens. His son Lincoln Chafee was as liberal as he, eventually campaigning vigorously against George W. Bush in 2006 to keep his Senate State, yet refused to switch parties. Former Presidential candidate and majority leader Bob Dole was an establishment conservative, more interested in pressing the interests of the party than his constituents or the country. I believe the nation was better off that Bill Clinton, more conservative on fiscal issues than his Republican challenger, eventually won reelection, instituting welfare reform and a balanced budget.
Contrary to his broad and bold assumption, the conservative case does not begin with "any responsible adult" buying health insurance. A more free market reform would be to do away with a third-party payer in the first place. One hundred years ago, even fifty years ago, individuals went to the hospital, received the care they needed, then paid of the medical bill in installments. That arrangement assured that the hospital would be compensated, and that medical costs would not spiral upward out of control, as they do now.
Currently, most "responsible adults" do not buy their health insurance individually, but receive it through their employers, a costly venture which state governments are now forced to rethink in the wake of dwindling tax revenue and growing dependence on states growing increasingly dependent on Washington for handouts to defray day-to-day costs.
If this country wants to assist individuals with pre-existing conditions who cannot afford health insurance, the solution is not to force everyone else to pick up the tab through an enormous health care mandate, as government has a consistent reputation for shoddy and wasteful allocation of resources.
I find it laughable that the writer claims that ObamaCare has extended Medicaid benefits, even though ObamaCare cuts out $500 billion from Medicare already.
Those who choose not to buy health insurance choose to take responsibility for their health care -- that principle is in concert with one of conservatives' core values.
Zelman posits a false dichotomy when he argues that conservatives are appalled by one of two conflicting options: the government's forcing individuals to pay for health insurance, or the government forcing medical facilities to care for patients who have no health insurance.
In reality, patients without health insurance routinely leave emergency rooms against doctors' orders, refusing medical attention. County facilities provide care, but patients have to wait. There are clinics throughout Los Angeles County in which residents can seek care, paying a higher fee. Doctors throughout the country have refused to accept insurance, yet they offer better care more efficiently and at less cost to the patient, though he or she has to pay out of pocket.
I do not find persuasive Dr. Zelman's point that none of the Republican candidates responded effectively to Moderator Wolf Blitzer's question regarding the proper action to take for a person who needs care but has no insurance. Dr. Ron Paul responded effectively that such an individual could seek out care from private charitable causes. These institutions, unfortunately, have been forced out of providing care because third-party distribution and disbursement has arbitrarily and artificially raised the cost of health care. Free market mechanisms, with competitive bidders, would bring down health care costs without limiting access for patients. As for those who could buy health care but choose not to, county facilities and private charities would put those individuals on a sliding scale for reimbursement. Harbor General in Torrance does this every day in their emergency and psychiatric clinics.
In conclusion, I would like to respond to the three questions which Dr. Zelman posed to conservatives at the end of his editorial:
1. Why is it so troubling that the government is requiring responsible individuals to purchase what they would purchase anyway? Why should individuals buy insurance in the first place? Why not permit free market forces to bring down the cost of health care? Free Market Economist Milton Friedman submitted that by ending licensure laws for medical professionals, more individuals would be able to practice medicine. Cutting down the regulations and red tape that inhibit quality care would also assist hospitals and personnel in providing better care at a better price. Third party disbursers like insurance companies have caused the cost of care, facilities, personnel, and technology to sky rocket because a growing number of the insured request care for light and transient needs, when they would do just as well to seek help without resorting to a doctor's assistance.
Instead of insurance programs and premiums, why not permit employees to invest in Health Savings Accounts and receive a tax credit for maintaining optimal levels in reserve? Barring the outright end to insurance compensation for healthcare, why not permit individuals to purchase health care across state lines? Why not cap the damages that one can collect after suing a negligent or reckless medical provider? The punitive damages are driving capable men and women out of the medical profession, which creates fewer professionals helping a large number of patients, driving up costs and further eroding quality health care.
2. Is it fair or appropriate to make the responsible pay more in order to protect the rights of the irresponsible?
No, it is inappropriate, and it is for this reasons that ObamaCare is so problematic for conservatives, as well as independents and liberals. It is unconscionable to force every able-bodied American to pay into insurance or a general government fund, which will inevitably be forced to defray the health care costs of a growing number of individuals who will be exempt because they cannot afford health care in the first place.
3. What should be done when the principle of limited government clashes with that of individual responsibility? The principles of limited government do not clash with individual responsibility, per se. However, this question is so broad as to be meaningless, as there are different roles that the government plays in the lives of the citizenry, for better or for worse.
Rather than defining "responsibility" in terms of whether one purchases health insurance or not, let us free up the market place for medical care, which will allow individuals to exercise their responsibility in searching for the best care at the best price, without hindering the availability of professionals, facilities, and communities to provide and be compensated for the health care they offer.
No comments:
Post a Comment