October 9, 2020
At the recent vice presidential debate in Salt Lake City, the candidates spent most of their time on their own talking points rather than answering any of the moderator’s specific questions. A unified theme that cropped up in competing news coverage illustrated just how many questions Vice President Mike Pence and Sen. Kamala Harris left unanswered during the debate.
In healthcare policy, this typical electoral dynamic is the manifestation of a real problem when it comes to governing: Healthcare solutions require a seriousness about the problems at hand and the tradeoffs involved – neither of which can be addressed by the slogans we too often get from politicians.
As Harvard University and University of Chicago scholars so aptly described the situation in an essay published in the New England Journal of Medicine (NEJM):
“Medicare for All” appeals to preferences for universal coverage, but sidesteps necessary trade-offs over which Americans may disagree. “Repeal and Replace” may appeal to skepticism about government’s role in health care, but leaves voters to imagine what the “replacement” might be.
If we are to address the real issues in our healthcare system – prescription drug affordability and access, insufficient competitive market pressure in medical services, and critical questions regarding the cost and quality of health insurance – policymakers and interested citizens will need to move beyond ideological slogans and talking points. Finding healthcare solutions requires thoughtful discussion of ways to address problems and their associated tradeoffs.
Scholars in NEJM’s essay said:
Implementation of a single-payer plan as envisioned in some proposals would involve trade-offs between coverage features and costs. Similarly, free-market competition could drive down prices for some Americans, but leave care unaffordable for others. There is no single right answer to these questions, and slogans can’t tell us how to prioritize.
So as we go into the closing stretch of the 2020 election season, remember that slogans are not solutions. Remember that there are important tradeoffs to consider in any major healthcare policy proposal. If a candidate is promising to greatly expand public healthcare programs or government insurance options without detailing the significant taxpayer costs, or is arguing that they will significantly scale back government healthcare programs without negatively impacting anyone, they are probably not being forthright.
Expanding government healthcare programs costs a lot of taxpayer dollars. By the same token, you cannot significantly reform or reduce those programs without disrupting the lives of many Americans who rely upon them. The sooner we can move beyond debate points to serious consideration of healthcare policy realities and problems, the sooner we’ll actually get to the business of finding healthcare policy solutions.
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