I challenge anyone here to explain what the conservative/ Republican position on health care really is.Opposition to Obamacare is clear. Beyond that, I hear many Republicans say they favor medical savings accounts, “doing something about pre-existing conditions”, allowing purchases of health insurance across state lines and other ideas.
Yet I have never heard a Republican member of Congress say what I consider to be the most obvious and purest statement of principle: "Let’s do nothing about health care." It’s not a federal responsibility. Leave it to the states. Some, like Massachusetts, will enact sweeping laws requiring everyone to buy insurance. Others, in the South and West, will do very little. We should welcome that.
Once you concede, there should be a federal program to deal with any problem apart from core constitutional functions like defense, you lose to the progressives. All federal programs are big, expensive, and in the modern computer age, likely to be played out in horrifying detail like the Obamacare rollout. Conservatives should not concede the need for federal solutions.
We should think long and hard about any problem and take our supposed small government principles seriously. Politicians essentially created the modern healthcare mess with federal laws mandating hospitals treat all comers regardless of ability to pay, tax preferences for employers to offer coverage as an employment benefit, liberal immigration, subsidies to universities to develop medical sub-specialties, and creating the expectation that the federal government will never allow anyone to go untreated. Roughly half the Republicans in Congress voted for Medicare and Medicaid in 1965. That was disastrous.
I have yet to hear any Illinois Republican (or possible presidential candidate) utter the words we should all want to hear: "We should not federalize health care."
Stop looking to us for solutions. We basically caused this mess! Yet, the automatic response of the public is to look to federal officials to solve everything. I think if Mitt Romney has said something along these lines during his campaign, rather than to pay lip service to the national Republican talking points about tax credits and “doing something about pre-existing conditions” he would have earned some grudging respect for candor.
“Doing something” is shorthand for passing a federal law, and doing something about pre-existing conditions means forcing insurance companies to insure sick people- anathema to us conservatives. Let’s acknowledge the truth, people with pre-existing conditions must pay more for insurance or have exclusions for their conditions. Everyone instinctively knows this is true and that any argument to the contrary is essentially a welfare payment.
Health care is a huge mess, an intersection of decades of misguided federal policies and economic trends which have raised costs. Conservatives must face it with what we say is a sort of primer on life: the federal government makes things worse. Second, problems should be solved at the state and local levels. Third, politicians are basically contemptible, power-hungry narcissists who will say anything to acquire and hold their offices. Let’s solve this without them if we can.
Howard W. Foster is a Chicago attorney.