Healthcare goals: cost, coverage, quality. Dems, GOP differ on priority

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Senator Kamala Harris (D-CA) made an interesting comment during last week’s Democratic presidential debates. Regarding healthcare policy, Harris said, “For a Democrat to be running for president with a plan that does not cover everyone, I think is without excuse.” Harris, obviously, places coverage as the top policy goal for health care. In this, she follows the current talking points of the Dems, attempting to contrast them with the GOP.

Effective healthcare policy has three goals: cost, coverage and quality. Americans want the highest quality health care, at a reasonable price that covers as many Americans as possible. But to support those goals effectively, one must observe a specific priority.

Historically, the first goal emphasizes providing healthcare of the highest quality. In spite of the passage of the Affordable Care Act in 2010, which seemed to re-arrange the three priorities, Americans still primarily demand the highest quality healthcare. Despite what some studies conclude, the US has probably achieved that goal already, at least for most Americans.

What about the quality of US healthcare?

Studies and surveys usually rank the US somewhere between the 10th and 15th best healthcare system in the world. All countries ranked ahead of the US rely on socialized medicine. The criteria for ranking usually includes data about coverage, mortality rates, patient rights, access, equity and spending as a percent of GDP.

However, what if the ranking criteria focused on the availability of the latest techniques? Achieving the best outcomes in the shortest period of time and gaining quick access to the latest technology would likely stand out. As a result, the rankings would likely change putting the US significantly closer to the top.

Personally, based on personal observation, if I suffered a serious injury or experienced a serious illness, I would greatly prefer living in the US than in any other country.

Matters of cost and the desire for widely available coverage

After quality, the next priority for effective healthcare coverage is to control cost. The third priority requires that as many people as possible covered with health insurance.

The GOP wanst to keep the priority of the goals the same as listed. That means quality tops the list as the primary goal followed by providing the best healthcare service at the most reasonable cost. The third priority, covering as many people as possible, concludes the virtuous sequence.

The Dems prefer to reverse that order. Dems believe the top goal covering 100% coverage of the US population. Apparently, that now includes covering non-citizens for free. Only then they do they want to contain costs. Almost as an afterthought, they want to toss in the highest quality healthcare.

It will be up to the voters to decide which priority ranking is best for the country

In theory, our system benefits the majority without infringing on the basic rights of anyone. But is healthcare a basic right? Presidential candidate Bernie Sanders (Socialist-VT) says that healthcare is a basic human right. Therefore coverage for all becomes his top priority. His Medicare for All plan emphasizes this point.

According to the Declaration of Independence, all Americans have the right to “Life, liberty and the pursuit of happiness.” That document does not mention healthcare as a basic right. Neither does this document mention food, shelter or clothing. While one of the key healthcare goals requires covering as many people as possible, health care is not a basic human right.

Voters can contribute their input into healthcare policy decisions during the upcoming presidential election. Early in President Trump’s term, the GOP had a viable plan to implement a new health care policy. But, due to the intransigence of a former Senator from Arizona, the GOP plan fell one vote short of passage in the Senate. Yet, while that plan would have increased the number of insured Americans, it did not cover all Americans.

The GOP continues to advocate for healthcare reform based more on market principles than government control. The Dems continue to promote a plan that covers all Americans, most likely by removing the private sector and placing health care under complete government control. The Dems claim that not only would their plan increase coverage to 100% of Americans. The claim it can eliminate the $72 billion that companies in the health care industry earn as profit annually. That alone, they claim will reduce the cost.

Harris said, “Let’s talk about the fact that the pharmaceutical companies and the insurance companies last year alone profited $72 billion, and that is on the backs of American families.”

The Dems argue that the GOP plan does not cover all Americans, likely including non-citizens in that number as well. The Republicans argue that removing the private sector eliminates the efficiencies of competition and increases overall cost, no matter what the Democrats say. Why? They rightly note that the government has no incentive to reduce cost. Government is not motivated by profit. But the government would control 100% of the healthcare market.

What should our healthcare priorities be? The Dems want the order to be coverage, cost and quality, but strenuously underestimate cost. The GOP wants quality, cost and coverage, in that proper order. What healthcare coverage you want?

Michael Busler, Ph.D. is a public policy analyst and a Professor of Finance at Stockton University where he teaches undergraduate and graduate courses in Finance and Economics. He has written Op-ed columns in major newspapers for more than 35 years. @mbusler

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