Health Care

If you look at any nationwide poll, health care always ranks at or near the top of the “biggest issues” facing the United States. What exactly is the political issue (or issues), though, when the subject is health care? Affordability of health care—is that something for the government to solve, or will economics and competition control prices? Citizens with personal health problems—how can the government do anything about that? Curing cancer? As with all policy topics, the first step for health care is to define the problem we want our government to solve. Then, we apply principles to the issue.

Using this principled approach, we will focus the issue on which aspects of health care the federal government should and should not prioritize for budgeting and attention.

The principles that help us find the proper federal role in health care are protecting the vulnerable, limited government, and the related concepts of freedom and free enterprise. Clearly, some of the most vulnerable among us are those with actual or potential health care needs. Equally clearly, the government cannot pay for all of the health care desires of everyone in the country, and our principle of limited government requires strong justification for federal involvement. Freedom and free enterprise act as another counterweight against federal control and funding of all things related to health care.  

All three of the applicable principles must be balanced against one another in analyzing each specific public need. The government should jump in when (and only when) it is the single entity capable of providing an essential service. By this standard, some of the strongest cases for federal funding and action are as follows:

• Disease prevention and control. The Covid-19 outbreak, if nothing else, taught us that America must have someone preparing for plagues and pandemics. The Centers for Disease Control and Prevention can do that, assuming it is run competently and is not political. 

• Research. Grants to universities and others who perform medical research also fill an important need that often struggles for private funding. Cancer, mental health, heart disease, obesity, and similar health concerns fall into this category, as well as rare diseases that never will generate a large enough “market” to be filled by private enterprise.

• Safety net for the poor. Medicaid combines the resources of the federal and state governments to pay for the health care of those without the means to do so themselves. The Children’s Health Insurance Program and the Affordable Care Act also help additional people by making health insurance more available, including to people with pre-existing conditions. A “safety net” is necessary; the only question is who should be eligible. Those living in poverty, especially children, are the vulnerable “least of these” who most deserve protection. The federal government should continue as the funder of last resort for those needing health care.

• Mental health. So many of our nation’s problems stem from poor mental health. Drug addiction (including opioids), suicide, obesity, gun violence, and other evils come to mind. Mental health is too significant for the federal government not to be involved, thus great federal resources should be devoted to funding and coordinating research, treatment, education, and prevention efforts. 

In most other areas, the federal government should defer to private businesses, individual choice, charities, and the states to do what is necessary to care for the health of our country. For example, we do not need our federal government (and us as taxpayers) to pay for the health insurance of everyone in America.