Carte Blanche: The Price of Coverage

The debate over socialized healthcare is not new. Proponents are quick to point out that the U.S. is the only Western nation without one. They cite statistics such as life expectancy and happiness as examples of what Americans are missing out on. While a counterargument about the costs and bureaucratic issues that lead to years of waiting for routine procedures falls on deaf ears, the argument is made that at least people have access to medicine and treatment, compared to none at all. While that point may be fair, it ignores two critical issues. First, it holds that the only alternative to not having everything covered all at once is that the government must pay for everything and require hospitals and insurers to cover anything at all times. Whether or not people need total coverage. For example, people under fifty are less likely to need regular doctor visits than those over sixty-five. While some people are born with serious health conditions that plague them most of their lives, most people aren’t, and lifestyle has much to do with how health declines over time. The government's approach is like taking a cannon to a fly; better safe than sorry. Costs be damned. Secondly, and equally important, it gives the government near-complete control of people's access to healthcare. An important lesson that should be taken from the COVID pandemic. People were regularly denied access to life-saving procedures if they didn’t take the government-mandated vaccine. Taking it a step further, it also allows the government to influence people's daily habits, diet, and favorite vices, and if they don’t comply, they can be denied access to medicines and treatments, as determined by physicians and government bureaucrats. In exchange for individual autonomy and large amounts of taxpayer funds, socialized medicine will provide the care it decides people deserve in a manner and timeline dictated by committee and implemented by those who usually receive qualified immunity.

While there have been multiple attempts to implement it, the 2010 Affordable Care Act (ACA) was the most serious instance. President Barack Obama made it one of the core issues of his administration. The legislation promised, among other things, that costs would decrease, that those enrolled could choose their doctors, that the program's cost to taxpayers would decrease, and that it would help break the hold that a small group of insurance companies has over medical care. There were no tradeoffs or downfalls to be found. Unfortunately, none of what was promised would come true. In fact, there is plenty of evidence that costs have gone up across every category, and insurers have made record profits while the overall health of the nation has declined. Spending on healthcare in the U.S. is already over 16% of GDP. Senator Bernie Sanders (D–VT) and Representative Pramila Jayapal (D–WA) co-sponsored companion bills, H.R. 1384 and S. 1129, the ‘Medicare for All’ legislation, which seeks to fill gaps in the ACA. Some estimates put the program's cost at $32 trillion over 10 years. Senator Sanders puts the estimate at just over $13 trillion over ten years. Adding anywhere from $1.3 to $3.2 trillion a year, and that is just the initial cost estimates. It would require significant tax increases. At the same time, the nation already has a budget deficit of around $2 trillion and a national debt of $38 trillion. Throwing good money after bad doesn’t begin to describe how big a policy failure it would be or how negatively it would impact the lives of taxpayers, regardless of their income levels. Money isn’t everything, but the only option the government is offering is to spend more and hope for better outcomes. If government spending solved problems, then the nation would’ve been liberated from poverty, crime, and homelessness decades ago.

Freedom isn’t easy. It’s a messy and inconvenient virtue to manage more often than not. However, from it come much of life's meanings and value. It cannot be assigned or dictated, and every attempt to limit it for either equal outcomes or greater happiness fails to deliver either. Every American should have access to affordable, high-quality healthcare. Few would debate otherwise. However, having the government dictate what it will be and how much it will cost will only ever decrease access while making it more expensive. Eliminating competition by picking who gets to be an insurer and deciding what they get to charge insures a monopoly that will eventually dictate terms to the government because it has destroyed all other alternatives. Still, many will argue it is better than what exists at the moment. American healthcare is of the highest quality; the problem doesn’t lie there. Instead, it lies with the ballooning costs that follow. Advanced technologies and all-encompassing care drive up the costs. So too does the lack of competition and the endlessly growing regulations and rules that further increase costs and ensure that only the largest insurance companies and hospitals can compete. The problem is not greedy corporations or individuals concerned only with turning a profit, regardless of people's health. Instead, federal and state governments have ensured that these situations persist because of preconceived notions about what healthcare should be and how it should function. If choice were truly in consumers' hands and regulations were based on common sense, fair practices, and informed consent, the landscape would look vastly different. If people want the cost to go down and access to expand, then the answer is simple. Give people the right to choose and enable companies to meet those needs. When people are given choices, they are given their inalienable freedoms, upon which the country was founded. In that moment, we can finally work towards freedom, not forced equality.