10 Sep Health Care: Applying Principles to Issues
If you look at any nationwide poll, health care always ranks at or near the top of the “biggest issues” facing the United States. Sure, there always is the economy, too, and “jobs.” Racial issues are huge in America, also. But when Covid-19 struck, every American was reminded how health issues are central to our daily living, and to the well-being of our country as a whole.
Health care (particularly covid) dominated the news for more than a year. It devastated our economy, as the GDP dropped significantly in 2020 and businesses closed. The coronavirus caused lives and lifestyles to change dramatically and, in many cases, traumatically. Our 2020 elections were altered. In fact, with the virus reaching America during an election year, everything about it became political, in a bad way.*
*In the view of Principle Based Politics, the declining health of our political system in 2020 was one of the saddest consequences of the pandemic.
Yes, health care issues do impact America heavily. It is with such vital issues that principles—not partisan politics—must tell our federal leaders and government what decisions to make and actions to take.
Healthy Principles, Healthy United States
What exactly is the political issue (or issues), though, when the subject is health care? Affordability of health care—is that something for the government to solve, or will economics and competition control prices? Citizens with personal health problems—how can the government do anything about that? Curing cancer? As with all policy topics, the first step for health care is to define the problem we want our government to solve. Then, we apply principles to the issue.
Using this principled approach, we will focus the issue on which aspects of health care the federal government should and should not prioritize for budgeting and attention.
The principles that help us find the proper federal role in health care are protecting the vulnerable, limited government, and the related concepts of freedom and free enterprise. Clearly, some of the most vulnerable among us are those with actual or potential health care needs. Equally clearly, the government cannot pay for all of the health care desires of everyone in the country, and our principle of limited government requires strong justification for federal involvement. Freedom and free enterprise act as another counterweight against federal control and funding of all things related to health care. Many health needs could be better met through the private sector, and many people would rather not receive their health care from government agents or have the feds control their options.
All three of the applicable principles must be balanced against one another in analyzing each specific public need. The government should jump in when (and only when) it is the single entity capable of providing an essential service. By this standard, some of the strongest cases for federal funding and action are as follows:
- Disease prevention and control. The Covid-19 outbreak, if nothing else, taught us that America must have someone preparing for plagues and pandemics. The Centers for Disease Control and Prevention can do that, assuming it is run competently and is not political. Given the huge amount of money the United States spent on “stimulus” payments and a plethora of other pandemic remedial measures, attention and funds paid to the CDC would be well spent.
- Research. Grants to universities and others who perform medical research also fill an important need that often struggles for private funding. Cancer, mental health, heart disease, obesity, and similar health concerns fall into this category, as well as rare diseases that never will generate a large enough “market” to be filled by private enterprise.
- Safety net for the poor. Medicaid combines the resources of the federal and state governments to pay for the health care of those without the means to do so themselves. The Children’s Health Insurance Program and the Affordable Care Act also help additional people by making health insurance more available, including to people with pre-existing conditions. A “safety net” is necessary; the only question is who should be eligible. Those living in poverty, especially children, are the vulnerable “least of these” who most deserve protection. The federal government should continue as the funder of last resort for those needing health care.
- Mental health. So many of our nation’s problems stem from poor mental health. Drug addiction (including opioids), suicide, obesity, gun violence, and other evils come to mind. Mental health is too significant for the federal government not to be involved, thus great federal resources should be devoted to funding and coordinating research, treatment, education, and prevention efforts.
In most other areas, the federal government should defer to private businesses, individual choice, charities, and the states to do what is necessary to care for the health of our country. For example, we do not need our federal government (and us as taxpayers) to pay for the health insurance of everyone in America. Through an employer or otherwise, many already have the kind of health coverage and medical providers they want. When this can be funded privately, not only does it alleviate the need for government involvement, it also probably results in better, lower-cost care with more choices than if the government were in control. And, it results in more overall freedom, because those who take good care of themselves may incur fewer health care costs than those who do not, and thus they enjoy fewer copays instead of paying an overall higher tax rate to fund the health care of others.
Back to the Basics
By the way, there is a Constitutional basis for federal involvement in health care, particularly regarding the kinds of topics discussed above. First, the Preamble to the Constitution sets forth a federal duty to “promote the general Welfare,” and that seems to include promoting good health. Then, by the intellectual property protection clause in section 8 of article I, Congress was given power to “promote the Progress of Science…,” which also is closely linked to health.
Health care indeed is among the biggest issues facing our nation, and that was true centuries before Covid-19. Following the principled approach outlined here will best allow our federal government to prioritize its resources for addressing this critical area.
Written by Quentin R. Wittrock, founder of Principle Based Politics.
Look for his posts twice each week, as this blog will explore and promote the idea of principle in politics, both as to individual elected leaders and our federal government as an institution.
Our next post will be on foreign relations. Other political issues we have analyzed under our principle-based method include: taxation, nomination of federal judges, guns, national defense, immigration, climate change and the environment, regulation, abortion, education and student debt, benefits programs (including Social Security), law enforcement, and racial and criminal justice.