Republicans may have convinced the public that President Obama’s national health care law will make things worse, but they have yet to adequately explain how they’d make things better.
Even if the health care law gets fully repealed, the U.S. medical system will still generate skyrocketing costs that will place an unsustainable burden on families, businesses and budgets at every level of government.
As the 2012 election year approaches, Republicans won’t be able to rely on the unpopularity of Obamacare to avoid articulating an alternative. Just because Americans are unnerved by Obama’s massive health care overhaul, that doesn’t mean they’d tolerate a return to the old status quo.
In every other aspect of their lives, Americans enjoy a vast array of choices, as businesses vigorously compete for their dollars. Yet the health care system doesn’t function anything like this.
Ninety-four percent of Americans with insurance receive their coverage either through government or their employers. This means that they’re locked into policies chosen for them. And those who are satisfied with the insurance they receive through their employers can’t keep their coverage if they switch jobs. This is problematic in the modern economy, in which it’s typical for workers to change employers frequently.
This reality also affects the thinking of insurers. Because individuals are generally stuck with whatever decisions their employers make for them, insurers have less reason to cater to policyholder needs. And insurers are also less interested in individuals’ long-term health. When it comes to car insurance, carriers create incentives — such as lower premiums for safer drivers. That’s because they want to hang on to their customers for life. By contrast, because most Americans are likely to change health insurance every few years as they switch jobs, insurers don’t have as much reason to provide incentives for individuals to lose weight, quit smoking, exercise or take other actions that would drive down their lifetime health care costs.
People accept it as a given that medical breakthroughs will trigger higher spending. Yet in other areas of the consumer economy, such as home computers, technological innovation has improved quality and reduced prices over time. The difference is that when it comes to health care, government policies have removed choice, competition, and normal price signals from the equation.
Because Americans don’t control their own health care dollars, they don’t search for value, which drives up prices for everybody. And even if they were motivated to seek better deals, they’d be hard pressed to do so. American consumers have more information about good restaurants than about good doctors.
This wasteful system is for those lucky enough to have employer-based insurance. Those who are left on their own face a highly regulated market and a discriminatory tax code.
Over the years, Republicans have unveiled a hodgepodge of ideas on health care. But they have yet to communicate a broader vision to the general public.
Republicans need to paint a vivid picture for Americans of a world in which they’d be able to choose among many health insurance policies; spend their health care dollars as they see fit while retaining any money they save; have easily accessible information on doctors and hospitals providing the best outcomes at the lowest price; and be rewarded for pursuing healthier lifestyles.
In such a system, they’d also be able to take their health insurance with them if they move from job to job. And if they’re self-employed, they’ll be able to purchase health insurance with the same tax advantages as those who get coverage through their employers. Such changes would not only help those with health insurance, but the lower costs and better regulatory environment would improve access for those who currently lack coverage.
A number of policies could help the nation make the transition to a modernized system geared toward the sensibilities of the American consumer. The most important of these would be ending the discrimination in the tax code against individuals who purchase insurance on their own.
But the only way Republicans can win this argument is if they start having it.
Philip Klein is senior editorial writer for The Examiner. He can be reached at [email protected].
