RSS Feed MenuTens of millions of Americans lack health insurance. Extending coverage to them has been a core goal of health reform proposals since the 1960s. President Richard Nixon offered a universal health plan in his first administration, but since then Republicans have hesitated to commit the nation to so costly an undertaking. Is it time to rethink? Should Republicans accept universal coverage as a goal? We posed this question to NewMajority’s contributors.
I believe that universal coverage, while in theory a noble concept, in reality will never work for an extended period of time and thus the GOP should absolutely not endorse it under any circumstances. Why? Here are a few, though by no means all, of the reasons I would oppose such an option were I a representative.
1) No government program ever comes in on budget and the potential for a fiscal runaway train in such a mammoth entitlement is daunting. All one need do is look at Medicare, Medicaid and recently MIMA’s initial projections to see this.
2) The nation is already running record deficits. This is not the time to embrace government activism whose price tag cannot be realistically projected (see above).
3) This is not a winning political issue as there is no overwhelming popular demand for such a program. The majority of Americans do, in fact, have health insurance, and the majority of them are satisfied with their care, although they would like to see reform of costs. As seniors too are both a growing voting bloc as well as consistent voters, they see this, rightfully, as a raid of Medicare to pay for others.
4) As a businessman, common sense tells me that I cannot compete with any entity (in this case the federal government) that both unilaterally decides (regulates) what products we both must offer and then not only need not worry about making a profit, but which can run in effect a bankrupt institution ad infinitum. This is the equivalent of “dumping” by undercutting competitors’ prices, even at a loss, to take market share — but without the hit to earnings that some companies are willing to take. The Democrats see this as an option to “keep insurance companies honest.” I see it as a first step to what Obama et. al. have repeatedly clamored for over the years (new rhetoric notwithstanding). A first step towards an ultimate take-over of the entire healthcare system by the “single payer” entity… Uncle Sam.
5) This goes to 4. This will undoubtedly quell competition and also reduce the level/quality of service. I know of no business that is not driven by the profit motive and also provides superior service/products. It is the antithesis of the capitalist “invisible hand.” Profits drive innovation and competition.
6) The verdict is still out with other nations’ universal healthcare models. This is a long term play.
7) Finally, it is not who we are as a nation. We are not a welfare state. And what better way for the GOP to reclaim its more libertarian side than to oppose such a plan.
No one denies that healthcare costs are spiraling (for a small firm like mine, for example, our co-payments are now $50.00). But the American people do not trust, nor should they trust, the federal government to provide the solution. And remember, once a program is enacted of this magnitude, it can never, ever, be repealed. “Just say no” in this case I think is both good for the party and, most important, good for the country.
To read other contributions to this symposium, click here.
oldgal // Aug 24, 2009 at 12:31 pm
“I know of no business that is not driven by the profit motive and also provides superior service/products. It is the antithesis of the capitalist “invisible hand.” Profits drive innovation and competition.” You might want to look at open source software for innovation that is not motivated by profit. As far as health care goes, you should look at Kaiser Permanante, a non-profit health care provider. They actually developed a health care delivery system (something for-profit institutions have failed to do), that provides high quality service while keeping costs under control. I paid 20%-50% less for my premiums than the other options offered by my employer. There are no bureaucrats making decisions about my healthcare, much more is covered than typical policies (psychiatry, acupuncture, homeopathic medicine…etc.) They have controlled costs, not by denying coverage, but by being innovative in their delivery system – no claims to fill out, proactive and preventative programs, patient education, and introduction of nurse practioners, to name a few. I have always been able to get a same-day appointment, and in one instance was scheduled for surgery the next day in a non-emergency situation.
The assumption that for-profit business always drives the greatest efficiencies is an urban myth – the inefficiencies of business are just not publicized unless they drive the company under.
Raider1 // Aug 24, 2009 at 12:47 pm
Do you equate non-profit with running massive loss like government can? What business can indefinitely spend more than it takes in.
Schaeffer is specific. He is not talking not-for-profit. He is talking losses with no consequence.
“As a businessman, common sense tells me that I cannot compete with any entity (in this case the federal government) that both unilaterally decides (regulates) what products we both must offer and then not only need not worry about making a profit, but which can run in effect a bankrupt institution ad infinitum. ..”
Should Republicans Endorse Universal Health Coverage? // Aug 24, 2009 at 1:02 pm
[...] Schaeffer, Universal Coverage Will Only Lead to a Single Payer System Allowing the government to compete with private insurers would be the first step towards an [...]
sinz54 // Aug 24, 2009 at 4:36 pm
oldgal: There is a huge difference between a private not-for-profit corporation like Kaiser Permanente, versus THE GOVERNMENT.
Kaiser Permanente may be not-for-profit, but they are still competitive. They have to compete with other medical delivery companies. They cannot FORCE their competition out of business, nor can they FORCE you to do business with them. And they have to run efficiently; they have to balance their budget or else go out of business. (Kaiser Permanente had tried to expand into the South and Northeast. There they did not do as well, and by 2000 they had closed their operations there.)
None of that is true of Government agencies. Take the U.S. Postal Service, which Obama mentioned in his own town hall meeting. For 40 years, United Parcel Service had to engage in costly litigation to be allowed to be treated by the ICC as a common carrier for package delivery alongside the Post Office. If UPS had failed in the courts, they would be gone, and FedEx would never exist.
The Post Office could never compete with UPS and FedEx on an equal footing for package delivery. The Postal Service makes its real money on the delivery of first-class mail (letters, bills, etc.), for which they have a legal monopoly.
UPS and FedEx are prohibited by law from delivering first-class mail. In the 1970s, a small startup company, Brennan Delivery, tried to get into the delivery of first-class mail in their own town. The Postal Service successfully sued them and forced them out of business.
Despite their legal monopoly on first-class mail, the Postal Service still can’t turn a decent profit. They are totally dependent on Federal subsidies, paid from general revenues.
That’s how a public “option” really operates: Via laws and regulations that will artificially hamstring its competition, and Government subsidies that keep it afloat long after it should have flopped.
Kaiser Permanente, being private, can’t do any of that.
debs // Aug 24, 2009 at 5:04 pm
It’ll flop–you mean like single payer has flopped in Canada, France, and Taiwan? Or the way the NHS has flopped? Or the Medicare in the US, whose costs are increasing *more slowly* than private sector insurance? Or the VA in our country, which provides great health care for America’s veterans on, yes, a pure socialist model–public hospitals, publicly paid doctors. You want to make criticisms, make empirical ones, not dogmatic ones.
As for the Post Office–of course, it can’t make a profit, nor would UPS or FedEx wish to enter its market. Why? That market is every small town and hamlet in the continental United States–places where it’s entirely inefficient to deliver mail and only a public service, in effect, would ever do it, not a profit making business. You can privatize the post office, as some European countries have done–oh the irony–because they are much smaller. But if you privatize postal service in the U.S., you have to eliminate door to door delivery, six days a week, to town like Forest, Mississippi or New Hampton, Iowa. Maybe we should do that, but the entire issue has nothing to do with whether the USPS or UPS is more efficient–UPS would never take over that business in a million years.
debs // Aug 24, 2009 at 7:41 pm
Moreover, both the contributor and commentator are missing what going on in the actually existing American private health care insurance market, not the free market fantasy of their dreams. In the actually existing market, the major companies are hemorrhaging customers–we’re in a recession, remember? The only customer they can count is….yes, the federal government. It’s the government that keeping the private sector health insurance afloat, not the other way around. So, save the babbling about UPS and FedEx, and fear about a “welfare state” when Americans over 65 already have their own version of Canada and love it, and look at the world the way it actually exists. You can start by reading the article below:
http://www.slate.com/id/2223936/
And, btw: Have you noticed any GOP politicians terminating *their* government coverage and wading into the private sector health insurance market? Especially some of the older ones? John McCain likes to joke about being under North Vietnamese government coverage for a few years, but the truth is he’s gotten first class *American government* coverage his entire life. Wonder what Aetna would charge a 74 year two time cancer survivor for health insurance? That, too, falls under the free market–fortunately, McCain doesn’t have to make that choice. He just doesn’t want anybody else to have the (public) option he has.
ottovbvs // Aug 24, 2009 at 8:12 pm
“I believe that universal coverage, while in theory a noble concept, in reality will never work for an extended period of time…… 6) The verdict is still out with other nations’ universal healthcare models. This is a long term play.”
……….It just somehow, magically, seems to have worked for over 40 years in the entire advanced industrial world from Japan to Germany….and at half the price…….those Swiss and Swedes we’ve always known they were prone to acts of craziness in pursuit of Nobility
NM Symposium Part 2: Universal Coverage: Right Goal, Wrong Principle? // Aug 25, 2009 at 7:28 am
[...] Schaeffer, Universal Coverage Will Only Lead to a Single Payer System Allowing the government to compete with private insurers would be the first step towards an [...]