The Conservative’s Place in Healthcare Reform

By: Rachael Marsik

Healthcare reform seems to have become the buzz word of the summer and the Democratic Party seems to have become the champion of yet another massive government overhaul that plucks the strings of every bleeding heart in the United States.  A horrific picture of healthcare in this country has been painted to rally support for this unprecedented step towards Socialism.   They have imprinted in the minds of the people an image of the huddled, uninsured masses standing outside of a doctor’s office being refused treatment while the rest of the insured population enjoys the fruit of some of the most advanced medical treatment the world has to offer… well they are a little right.

There is a portion of the population that does not have health insurance and there are people who cannot be seen by a doctor even though the treatment that they could receive is arguably the best they could hope for in the world.  According to the World Health Organization the United States spends more on healthcare on a per capita basis than any other country in the world and still ranks only 37^th in the industrialized world, but what can the Republican Party champion to improve this ranking without compromising core principles of individual freedom and limited government intervention?  Several solutions to the healthcare crisis have been put forth.

One of the largest problems in this predicament is the lack of access to healthcare practitioners due to a crippling shortage, especially within minority and underprivileged communities.  This shortage has several causes that could be solved through the investment of hospitals in the education of doctors, nurse practitioners, physician assistants, and nurses who are committed to serve in those areas that qualify as “underserved.”  Even the insured can encounter trouble when trying to access healthcare because while the population grows exponentially the numbers of graduating practitioners remain relatively constant.  Compounding the issue is the statistic that the average medical student graduates owing more than $140,000 in loans and so working in an underserved community often results in loan defaults and substandard living for an individual who has invested at minimum a decade in his or her education.

A possible solution to this problem reaches back to a practice utilized by hospitals that has been long abandoned.  Up until the mid 1970s it was common practice for hospitals to educate nurses on site with contracts ensuring that after graduation the nurses would practice in that hospital for a given number of years.  Currently Kaiser Permanente offers similar loan forgiveness programs and scholarships that repay medical student debt provided that the new doctor practices in one of Kaiser’s designated or underserved communities—the military offers similar programs that have proven popular amongst debt fearful medical students.  Kaiser’s program has proven quite effective, especially in the field of Primary Care, which has the potential to provide a paradigm shift to preventative care that could result in a drastic decrease in annual healthcare spending.

Chronic disease accounts for 78% of the annual healthcare spending according to an article released by Dr. Gerard Andersen from the Johns Hopkins School of Public Health.  By increasing the number of Primary Care physicians and encouraging a system of preventative treatment, it is estimated that 60% of early deaths–which have been shown to be a result of behavioral influences such as obesity, lack of exercise, smoking, and living conditions—could be averted, and the dollars spent on end of life care for these individuals could be freed up for a myriad of purposes.  Current models like that of Kaiser Permanente have demonstrated that the healthcare system can be reformed by the private sector and without drastic government intervention like that currently proposed by those in Washington whose interests are vested in the expansion of the federal government and not actually fixing the problem.  Healthcare reform in the form of a “single payer” system, or “insurance reform” as it has now been coined, has been an unsuccessful cause historically, and probably will never be with the “no compromise” attitude being brought to the table by the Democratic leaders in Congress who have not learned from the example set forth by our own state of California in 2007.

Comprehensive healthcare reform failed in California in 2007 because Republicans saw the cost that it would have on California taxpayers—since paying your fair share can only apply to those who make money—and because Democrats were not willing to allow a Republican governor to steal their thunder on a social issue that they have traditionally claimed as their own.  Even the California Medical Association opposed a 2007 proposal that included a 2% fee on physicians to be returned in the form of higher MediCal payments, because they believed that these payments would never come to fruition.  They also believed that increased government responsibility for cost control would inevitably mean reduced payments to physicians.  So since most hospitals and physicians do not want this kind of reform and so many people in this country are adamantly opposed to the return of a military draft, how can anyone favor the conscription of the healthcare industry—as if it would be that simple?

Reform takes time.   Most would advise to keep it simple and do it fast, but healthcare reform and simplicity are as close to antonyms as two words can possibly be.  Recall earlier that a medical education takes nearly a decade and the first thing that must be fixed is the shortage of providers.  Could you imagine adding millions of people to an already breaking system?  And even though this is not going to be simple and the language is often clouded, as Republicans we must remember that we do have a place in reforming the system and we must not settle, content with the way things are.  Because the way things are is messed up.