Distributism and Health Care Reform II

In Part I of this article, I discussed the process of how the Patient Protection and Affordable Care Act (Obamacare) was passed, the fallout that has occurred since its passage, the arguments being used by the current administration to defend it, and the greater implications of the law. In this part, I want to address the conservative and libertarian alternatives that opponents to the Democrat plan put forward. Rather than just focusing on what was proposed by the Republicans in Congress, I will also look at some other proposals that were, and still are being, advocated.There seems to be a general opinion that, while the Republicans did a lot of complaining about what was in the various versions of Obamacare leading up to its passage, they really didn't offer much in the way of alternatives. I know that in my own area, the conservative media hardly talked about any alternatives beyond allowing insurance companies to do business across state lines. Instead, they seemed more interested in scoffing at the administration's claims that Obamacare would be able to cover the currently uninsured (and “under-insured”) without raising taxes on the majority of Americans, increasing the public debt, or negatively impacting existing coverages. They took great delight in the use of inflammatory language like "death panels" when, in my opinion, that criticism should have been balanced by a detailed explanation of the alternatives they supported.It would certainly be wrong to say that those opposed to Obamacare offered no alternatives, or even that there was no coverage of them, it just didn't seem to get nearly as much emphasis as the attacks against Obamacare even in those media outlets that supported them. Even today, with the election coming up, the Republicans are running strongly on the idea of repealing Obamacare, as well as other things implemented by the administration, but there doesn't seem to be a lot of discussion of what alternatives they are offering. In fact, they are being criticized for this even by Republican-friendly media (This link will eventually require registration for viewing.). So what alternatives have been proposed? Some of these will be addressed below, and some will be addressed in the next part of this article.Among the proposals put forth by the Republican Party, the only alternative consistently offered by the “conservative” (monopolistic) capitalists was to allow insurance companies to compete across state lines. The real irony is that they were frequently denouncing the monopolies in the states as a reason for insurance costs being so high, but their solution was still based on the principles of monopolistic capitalism that would ultimately result in larger and more powerful monopolies.For those who criticize the Democrats for constantly expanding the role and power of the central federal government, the next few proposals will show that the Republicans are not as different as many on the conservative side like to claim. The Republicans proposed to crack down on waste, fraud and abuse in Medicaid and Medicare. While it is certainly a noble cause to cut down on fraud, waste, and abuse in government, it appears that the days of the conservative movement searching for responsible ways to bring these and other unconstitutional federal programs to an end are long gone. It seems they are now content with just “cleaning up” the system. It is very rare indeed to hear “mainstream” conservatives, Republican or not, calling for a way to end these programs. It leads one to question whether they will have the fortitude to really bring an end to Obamacare.If you are still in doubt about the expansion of federal power and authority by Republicans, the remaining proposals might clarify the issue. It may be true that the Republican proposals will not create nearly as large a bureaucratic structure as Obamacare, but a quick glance at what they proposed will make it obvious that they are not proposing something that will reduce government power from what is was before the passage of Obamacare. This is because more federal regulations and bureaucracies will be needed to manage things like new state high risk pools or reinsurance programs, enhancing Health Savings Accounts, incentives to encourage states to enact regulatory reforms that reduce premiums and expand coverage, and allowing dependents to remain covered through age 25. Additionally, Republicans show that they are not beyond using the federal taxing power to coerce states and private companies to get with the program. For what other “incentives” can the federal government really offer to encourage states to enact regulatory reforms that reduce premiums and expand coverage, or to encourage employers to sponsor “wellness programs,” which will guarantee lower insurance premiums for employees?While the Libertarian Party also proposed deregulating the health care industry and removing barriers to safe, affordable medicines, they also advocated establishing Medical Savings Accounts. It would seem to me that the regulations that govern such accounts would require a power many libertarians would find objectionable.You can see that the two main groups that stood in opposition to Obamacare offered proposals that would still have increased the size and power of the federal government. I say this, not because distributists necessary think that the federal government has no role in the issue, but because these groups are always accusing their liberal opposition of expanding the power of government. The reality seems to be that the “conservative” movement of today is not truly the movement of smaller government with the federal government strictly bound by the limitations of the United States Constitution. Instead, it appears to be the movement of those who don't mind bigger government, just not as big as the liberals. It is no wonder that the TEA Party movement is frequently as critical of the Republican Party as it is of the Democrats.