Republicans and Health Care
by Richard E. Ralston

At their National Convention, Republicans complained of John Kerry's habit of complicating complex issues with even more complex and mutually exclusive solutions. On the issue of health care, however, the Democratic Platform has clear and straight-forward proposals. Everyone has a "right" to healthcare, no matter what it costs--and the government should expropriate needed funds plus the lives of health care professionals to provide and regulate health care for all. Americans who want to turn ownership of their bodies over to the federal government and trust Uncle Sam to meet all of their needs at least have something to go on here.

According to the "GOP Agenda" listed on the Web site of the Republican National Committee, they have some interesting proposals that would reduce government controls and taxes and provide more free market options. What they have actually done has been in the opposite direction. Americans making their decisions on how to vote in this fall's elections are therefore left without much to go on.

Republicans take credit for the Health Savings Accounts (HSAs) passed in last year's Medicare Prescription Drug Bill. They do not mention how the bill's projected ten-year cost of $400 billion will be paid for--nor the fact that within a few weeks of the bill's passing, the Office of Management and Budget corrected that to over $560 billion, nor that all projections for the following tens years are in the range of $2 trillion. It did create HSAs. That was a minor improvement in tax law and a step in the right direction. But it was rather like the Captain of the U-Boat who torpedoes your cruise ship also providing you with a rubber raft. The deal just wasn't worth it.

The Republicans do advocate some good ideas. These include tax deductions for the cost of high-deductible health insurance premiums in conjunction with HSAs--and tax credits for low-income families buying their own health insurance. Unlike the Democrats, they also support medical liability reform that would reduce the increasing share of our health care costs ending up in the pockets of trial lawyers. Then they praise the largest expansion of government in the last forty years, the Medicare Prescription Drug Bill, as President Bush's primary "accomplishment." Evidently 130,000 pages of Medicare Regulations were not enough. The Bush Administration has just released a draft 1300-page regulation to implement the new bill--and thereby brighten the lives of pharmacists throughout America.

Unfortunately the choice for voters seems to be between bad principles with potentially disastrous consequences (the Democrats), and better--if superficial--principles to be implemented by pragmatists looking for any political excuse to ignore them (the Republicans). No one addresses the root problems.

One problem is that neither the Democrats nor the Republicans have any idea how to pay for what they advocate. They are only a few decades behind the politicians in countries such as Canada, Britain, France, and Germany who now struggle to ration benefits and add private providers to systems whose costs are completely out of control.

What would happen if everyone had the "right" to have the government supply whatever food or housing they wanted? The cost of food and housing would expand exponentially until government controls followed suit, and everyone would find their choice of food and housing determined by the government. Both would become increasingly scarce for everyone except a government-sanctioned elite. That actually has happened wherever it has been attempted. With health care in America we can see this beginning already. The only solution lies in dealing with the other root problem.

Government provided health care can increase only in inverse proportion to freedom. Controls and regulations crowd out individuals who manage their own health and physicians who manage their own careers and the free choices that both make. Until one party figures out that the only sound basis for health care is individual rights and free choice in the market place, we won't have much from which to choose.

Richard E. Ralston is Executive Director of Americans for Free Choice in Medicine.