Republican Viewpoints on National Healthcare
Republican Views Towards Healthcare Reform From the Republican viewpoint, any form of nationalized or partially nationalized universal healthcare is unacceptable. Any public delivery system will limit ‘for profit’ free enterprise and thus violates our form of government. It will increase taxes and the overall cost of healthcare. Publicly delivered health care will cause the quality of care to go down by directly hindering the quantity of healthcare providers as well as the quality of care rendered by remaining healthcare providers.
Republicans oppose a universal public health care delivery system primarily because of profit – free trade – constitutional issues, fiscal issues and quality of care issues. Further government meddling in the private practice of medicine and healthcare will be detrimental to many Americans. In the 1990’s, universal nationalized healthcare was proposed by the Clinton administration. The proposed law failed due to the fact that the Republican Party had gained control of the house and senate for the first time in over fifty years.
During the 2008 presidential election, one of President Obama’s primary campaign promises was universal healthcare. The proposal has created a new national debate on the pros and cons of a universal healthcare system. Proposals from the House and Senate vary greatly and will have to be reconciled during the legislative reconciliation process. Interestingly, both parties favor some form of health care insurance reform but the concept of universal coverage offered through a single public payer or both private and public payer options has generated controversy.
Republicans have adamantly opposed the public option because it alters the free enterprise ‘for profit’ healthcare system currently and traditionally in existence in the Untied States. The public option will radically alter the environment of the core constituency of the Republican Party. Looking at the constituency of the Republican Party, there are certain positions that the Republicans should put forward on the national healthcare debate to best represent the party’s core constituents. Traditionally, private practice physicians, ‘for profit’ hospitals and pharmaceutical manufacturers have been a core constituency of the Republican Party.
The Huffington Post recently pointed out doctors’ traditional opposition to any form of expanded government health care or socialized medicine. “[The] AMA (American Medical Association) has fought almost every major effort at health care reform of the last 70 years. The group’s reputation on this matter is so notorious that historians pinpoint it with creating the ominous sounding phrase ‘socialized medicine’ in the early decades of the 1900s. The AMA used it to mean any kind of proposal that involved an increased role for the government in the health care system. (The Huffington Post) The American Medical Association has gone on record as opposing various provisions of the House’s current health care reform bill. Doctors, particularly private practice physicians, have long complained about any form of socialized medicine because they know it will substantially reduce the economic viability of the practice. Likewise, for-profit hospitals have a long history of opposing any form of socialized medicine. The American Hospital Association recently put out a formal statement on the house version of health care reform. Specifically, expanding the number of people in Medicaid program to 150 percent of the poverty level is problematic at a time when states are struggling with budget shortfalls and payment rates for hospitals continue to be cut. While a public option with negotiated rates for those above 150 percent of the poverty level is an improvement, we remain concerned that the program would still, in part, be based on historically low Medicare rates. ” (Umbenstock) The American Hospital Association is concerned that any healthcare reform with an expanded public option may lower ‘already’ low payment rates.
Moreover, the American Hospital Association is also concerned that payment rates under an expanded public option will be based on previously minimal Medicare rates. For this reason, for profit hospitals have long lobbied for and sided with the Republican Party knowing that their profitability and ability to compete will be eventually dissolved if the pending ‘public option’ is passed. Pharmaceutical Manufacturers have been a traditional core constituency of the Republican Party because of the Party’s past opposition to any form of nationalized or socialized medicine.
The primary trade group for pharmaceutical manufacturers has also put forth a statement on the house health care reform bill. The Pharmaceutical Research and Manufacturers of American (PhRMA) policy statement says: “The 1,990-page House draft bill, which we are currently reviewing, contains a number of problematic provisions for seniors, patients, and the continued development of new therapies that not only improve or save lives, but ultimately help reduce the burden of health care costs in America” (Johnson).
Democrats have long vilified Pharmaceutical companies for their ‘for profit’ business practices and commercial interests. Thus, Pharmaceutical companies are one of the largest campaign donors to the Republican Party. Many portions of the currently proposed bill will dramatically limit their profit and therefore their ability to participate in and compete with new health care products. Universal health care is inconsistent with the traditional American private, for profit, free enterprise system based health care business model.
From a physician’s perspective, a system of universal health care could be compared to indentured servitude. The government would be in complete control of whom the physician treats, what modalities they use to treat the patient, and how much they are paid. Moreover, for the individual health care worker, limiting or mandating the service contracts would limit the workers freedom to do business in a free market. The New England Journal of Medicine recently conducted a survey of physician views on new public insurance option and Medicare expansion.
The survey was a statistically randomized sampling based on 5,157-physician questionnaire responses. The survey presented three methods of expanding coverage, including expanding the current public provider Medicare along with private options, private options only and public options only. Ninety-two percent of private practice physicians (practice owners) oppose socializing all health care into one single public option. Thirty-two percent of private practice physicians (practice owners) favor abolishing all public options which would presumably include Medicare.
Over half of all of the physicians in the study favored expanding care through private options and the, “… expansion of Medicare to include adults between the ages of 55 and 64 years” (Keyhani). The randomized physician survey demonstrates that physicians are extremely skeptical of any public option beyond expanding Medicare. Physicians fear a public option will reduce their personal income as well as their ability to recommend and deliver a full range of medical services. Physicians are well aware of the longstanding low Medicare reimbursement rates and limitations of coverage.
Physicians do not want to see more of the same with a public option that will further lower the amount paid for care and limit the amount of care that the government will pay, despite a patient’s actual medical needs. Pharmaceutical Manufacturers and ‘for profit’ hospitals also are strongly concerned that any public option beyond a slight expansion of Medicare will effectively put them out of business. PhRMA says that, “…the Congressional Budget Office (CBO) has warned that the House bill … would ultimately lead to a 20 percent increase in Part D premiums paid by beneficiaries.
What’s more, according to CBO, imposing a mandatory rebate on Part D prescription drugs would reduce incentives to invest in the research and development of new discoveries for diseases…” (Johnson) Simply put, pharmaceutical manufacturers will not invest if it is not profitable. For-profit hospitals are also concerned that a public option will ultimately translate to less coverage and lower reimbursement rates. The American Hospital Association, which has over 5000 member hospitals, has stated that the bill will further cut reimbursement rates. “AHA”) The current bill also specifically restricts physicians from owning hospitals and referring their office patients to their own hospitals. This directly affects their profit as well as raising free enterprise and trade issues. Historically and culturally, the United States health care system has been based on a ‘for profit’ private enterprise. The public option puts government in what has traditionally been a private ‘for profit’ enterprise. Just fifty years ago, Americans would have screamed communism at the concept of national socialized medicine.
In 1961 when the idea of Medicare came along American Medical Association spoke out against it through Ronald Reagan. Reagan said: “One of the traditional methods of imposing state-ism or socialism on a people has been through medicine. It is very easy to disguise a medical program as a humanitarian project. Most people are reluctant to oppose anything that suggests medical care for people who possibly can’t afford it. ” (The Huffington Post). Essentially, he was stating that the most common way of inflicting socialism is through a government run healthcare.
Legally, restrictions that limit the free market may be interpreted as a violation of the constitution. The American Bar Association states, “Whatever President Obama and the Congress decide to do with health care reform, they must do within the constitutional limits off their respective branch – and our nation’s courts will ensure that those limits are respected” (Lamm). Although health care insurance companies are not subject to antitrust (monopoly) laws as state laws govern them, a ederal option, which is included with universal health care, may create unfair competition and violate anti trust laws as well as the commerce clause of the constitution. Interestingly, the proposed bill mandates that every American must pay a tax for ‘free’ health insurance even Americans that don’t want health insurance coverage. The Wall Street Journal says that, “the requirement in the plan laid out by Max Baucus, that every American have health insurance, makes current proposals unconstitutional. Not just unconstitutional, mind you, but profoundly unconstitutional” (Jones).
Republicans must do all in their power to preserve constitutional rights that will be affected by a public healthcare option. The way that national health care is set up could be financially damaging if the bill, H. R. -676, were to be passed. As Avery Johnson states in the Wall street Journal, “TennCare runway costs show that the public health-insurance proposal by House Democrats could bankrupt the federal government. ” (Johnson, “Tennessee”). Tennessee’s arranged a public insurance program that was similar to a statewide health care to insure those without insurance.
It started in 1994 and by 2005 Tennessee was forced to shut the program down due to high expenses. Basically, Tennessee tried to have a statewide health insurance system similar to national health care and they went bankrupt. This is a reasonable model of what would happen on a more widespread scale. There are multiple financial reasons that cause a universal health care system to not work. To achieve the amount of money to make it possible to have a universal health care system there are many sacrifices that must be made. Payroll tax, which is a 7% social security tax that we pay when we buy something, will go up.
Income tax will also go up dramatically, affecting many lives. In fact, there may have to be new taxes set into place just to be able to maintain the universal healthcare or the required payments will go down. This will in turn affect the doctors by decreasing incentive. Another factor that will affect their incentive is coverage benefits. Coverage benefits will be decreased as a result of universal healthcare. For example, insurance will not cover elective care treatments, such as breast augmentations, cosmetics, chiropractics, etc.
Payment to the specialists, such as brain surgeons, heart surgeons, etc. , will be lowered dramatically. Progression in the field of medicine will dwindle due to a lack of money for clinical research. A physician to learn more about a procedure or to experiment usually does clinical research. It takes a lot of money and time and is not funded by the government; it comes from the physician’s pocket. If the physician’s pay lowers by so much they will not be able to do research. All of this will lead to a diminishing rate of medical progression that may ultimately come to an absolute halt.
Furthermore the government will provide us, if the bill passes, with inexpensive generic drugs. This will cause the name brand companies to lose customers and money and will prevent them from developing any new prescription medicine. When funding inevitably runs low, rationing of people will begin to occur. Old people won’t get care because they are old, and smokers won’t get lung surgery because they are smokers. This rationing is unethical in many different ways but would be unavoidable. Even more unethical, is that insidious rationing, that happens in Canada, would come into play.
Insidious rationing is ‘hidden rationing’ where, for example, a cancer patient would wait for treatment because they were about to die. The cancer patient would wait long enough that death occurred before the needed chemotherapy. Sadly, this often occurs in Canada, due to their system of universal health care. If this happens in the United States, it would be too late to take back the legislation. However, if properly informed, there would be less supporters of the health care bill because the general populace would be unwilling to commit to a plan that denied them needed coverage.
Likewise, instituting torte form will partly generate expenses for this costly health plan. This is a lawsuit cap used in some other countries. If a drunken doctor accidentally cuts a healthy patient’s leg off, the doctor will only be able to be sued for a low set amount of money. This will save the government a minute amount of money that would be used to support everybody’s health care, while that patient would be handicapped forever without adequate compensation.
Even so, Tim Foley has stated “the nonpartisan Congressional Budget Office in 2004 conceded that the legislation for tort reform, even if it instituted a federal cap, would barely dent health care costs” (Foley). The cause and effect impact on health care worker profitability including nurse pay, private practice physician pay, for profit hospitals, for profit health care insuring systems, pharmaceutical companies and other health care workers and entities will be enormous. No doubt lawyers will litigate for years the constitutionality of various healthcare reform provisions.
Another concern from the Republican viewpoint is the fiscal issue of how to pay for either universal health care or a public option. Simply put, where will the money come from to pay for healthcare particularly given the current economic crisis? Next, how will a universal public option effect access to care, quality of care and cost of care. As the financial aid towards funding universal health care bottoms out, the quality and accessibility of health care would go down. With government in control of health care and providing insurance for all they will have less money to spend on better quality hospitals.
In the TennCare experiment it showed before and after pictures of the work places that were used. Hospitals had turned into rundown trailers barely big enough for an examination room with outdated computers and equipment. Lowering the Quality of facilities means the lowering of quality of care given to the patients thereby increasing the number of people who go to a doctor and are unable to receive quality treatment. Thus quality of life becomes worse, and one would hope proper treatment came quickly enough to evade more serious conditions and/or death.
Access to patients is denied as the quality and quantity of health care providers is decreased by the inadequate organization and funding of a public option. One such thing noted about doctors faced with a decision to participate in a public option is that “…often the ones who care for our most vulnerable patients are the most severely impacted. In communities across this nation, physicians are faced with early retirement or leaving patients that need them. The bottom line: access to care is compromised. ”(“AHA”). The Health Care Associations of America view this is as a topic of controversy that would indeed change lives greatly.
Many associations including the American Hospital Association, American Heart Association, and even the American Bar Association have spoke out against health care reform including universal health care and a public option. In Conclusion, the Republican Party views the aspects of a system of universal healthcare from a cynical viewpoint. It seems that free healthcare is to good to be true and they say it is. Universal healthcare or a public option is unconstitutional by violation of the free enterprise system. With the economy in its current recession it is believed, by reforming ealthcare, the government will financially cripple the United States permanently. Also, almost like reverting back to a primitive state, quality of care and the access thereof could decline to unbearable standards. Now the republicans uphold the struggle against any bill passing through senate. Works Cited “AHA : Issues : Liability Reform. ” American Hospital Association. American Hospital Association, 15 Oct. 2009. Web. 3 Nov. 2009. . Foley, Tim. “Avoid Tort Reform in the Health Care Bill at All Costs! | Universal Health Care | Change. org. ” Universal Health Care | Change. rg. 17 Mar. 2009. 28 Oct. 2009 . “GOP Health Care Talking Points. ” GOP. gov – The Website of Republicans in Congress. N. p. , 11 May 2009. Web. 3 Nov. 2009. . Huffington Post, The. “American Medical Association Trying To Torpedo Health Care Reform Again. ” http://www. huffingtonpost. com/. N. p. , 11 June 2009. Web. 28 Oct. 2009. . Johnson, Ken. “PHRMA – PhRMA Statement on House Tri-Committee Health Reform Bill. ” PHRMA – Home. N. p. , 14 July 2009. Web. 3 Nov. 2009. . Jones, Ashby. ” Is Health-Care Reform Unconstitutional (Part II) – Law Blog – WSJ. WSJ Blogs – WSJ. The Wall Street Journal, 18 Sept. 2009. Web. 3 Nov. 2009. . JOHNSON, AVERY. “Tennessee Experiment’s High Cost Fuels Health-Care Debate – WSJ. com. ” Business News & Financial News – The Wall Street Journal – WSJ. com. 17 Aug. 2009. 28 Oct. 2009 . Keyhani, Salomeh , and Alex Federman. “NEJM — Doctors on Coverage — Physicians’ Views on a New Public Insurance Option and Medicare Expansion. ” The New England Journal of Medicine: Research & Review Articles on Diseases & Clinical Practice. N. p. , 1 Oct. 2009. Web. 3 Nov. 2009. . Lamm, Carolyn. Our Constitution, Debate it, Discuss it, Understand it. ” ABAnow. N. p. , 16 Sept. 2009. Web. 27 Oct. 2009. . McArdle, Megan. “Why I Oppose National Health Care – The Atlantic Business Channel. ” The Atlantic Business Channel. 28 July 2009. 29 Oct. 2009 . “National health insurance – Wikipedia, the free encyclopedia. ” Wikipedia, the free encyclopedia. 6 Oct. 2009. 28 Oct. 2009 . Shear, Michael D.. “Obama Pushes Insurance Reforms – washingtonpost. com. ” washingtonpost. com – nation, world, technology and Washington area news and headlines. 15 Aug. 2009. 8 Oct. 2009 . Umbenstock, Rich. “AHA : Press Release : AHA Statement on House Health Reform Proposal. ” American Hospital Association. American Hospital Association, 29 Oct. 2009. Web. 3 Nov. 2009. . Time Magazine. “Medicine: Debate Over National Health Insurance – TIME. ” Breaking News, Analysis, Politics, Blogs, News Photos, Video, Tech Reviews – TIME. com. 12 Oct. 1970. 28 Oct. 2009 . Wall Street Journal. “The Public Option Makes a Comeback – WSJ. com. ” Business News & Financial News – The Wall Street Journal – WSJ. com. 22 Oct. 2009. 28 Oct. 2009 .