Round 1
Peter Nouhan – The American Healthcare Act (aka Trumpcare) is a terrible deal for the American people, primarily because it will make coverage less affordable for the people who need it the most. Trumpcare subsidizes healthcare by providing tax credits based on age rather than income. Under Obamacare, an individual making less than $24,000/year or a family making less than $49,000/year (federal poverty line) will get subsidies so that a mid-level plan will cost no more than 6.4 percent of income. Under Trumpcare, however, subsidies are capped at $4000 for people over 60 and are capped at $2000 for people under 30. The average American spends more than $10,000 on healthcare per year so Trumpcare will screw over sicker and lower-income Americans (45 million Americans live below the poverty line). Meanwhile, the wealthiest 0.1 percent of Americans will gain more than $200,000 per year due to Trumpcare tax cuts.
Nick Cortes with the Young Americans for Liberty, Michigan Tech Chapter – It is true that any form of subsidization contradicts the conservative view of free-market capitalism and limited government. Obamacare gave individuals tax credits based on income, whereas the House Republican plan gives tax credits based on age. Both plans represent constant government interference. To understand why governmental controls negatively impact the economy, we can observe trends before such intervention took place. In 1958, before the era of Medicaid and Medicare, a worker would pay for all his or her medical expenses by working 118 hours. In 2012, that same worker would have to work 467 hours. It is true that the quality of care has improved, but so has the quality of other goods and services. Prices almost always fall over time. With the goal of making healthcare more accessible to those with lower incomes, the actual effects of the policies has been to make it more expensive. Republicans should work towards a much more conservative, free-market solution.
Round 2
Cortes – Republicans have won over the legislatures with the promise of full repeal and replacement of Obamacare in mind. However, the new legislation proposed by the Republican leadership falls short of that promise. For example, the most outrageous breach of free-enterprise in Obamacare: the individual mandate. Obamacare required American citizens to purchase health insurance or pay a penalty. It was argued by progressives that this would be a mechanism to incentivize young people to purchase health insurance. This was necessary as younger people had to pay in so that retired people could have medical expenses paid for. The new legislation does not get rid of this problem, but rather it requires continuous enrollment in order to avoid a 30 percent surcharge. Moreover, it leaves Obamacare intact. Instead of ending the government’s iron grip on the healthcare market, the proposed legislation attempts to quickly remedy the situation without offering any real steps in a conservative direction.
Nouhan – According to a 2016 Gallup poll, 41 percent of Republicans favor replacing Obamacare with a federally funded healthcare program that provides insurance. Republicans won over the state legislatures promising to repeal and replace Obamacare, but their constituents want it replaced by something bigger. Additionally, it turns out that Obamacare has primarily benefited people living in rural America, and its repeal would cause significant harm to people who voted for Trump. According to the Los Angeles Times, 90 percent of the counties backed by Trump would see people lose more than $6,000/year in federal insurance subsidies with Trumpcare. In an interview with the Washington Times in January, Trump promised that he would replace Obamacare with something that would insure everyone, force drug companies to negotiate prices of Medicare and Medicaid, and reduce deductibles and premiums. Trumpcare won’t fulfill any of these promises.
Round 3
Nouhan – Of the 25 wealthiest countries in the world, the United States is the only one that doesn’t offer universal basic health care coverage to its citizens. Furthermore, the American system is the most expensive per capita in the world and ranks as one of the least efficient. Japan has the best, most efficient healthcare system in the world because the government is heavily involved in the healthcare industry and sets strict prices on the provision of care. You argue that less government is better for increasing access to quality healthcare, but there is simply no empirical evidence to support that claim. If Americans want affordable, accessible, high quality care then they need to empower the federal government to set prices on the provision of care, negotiate drug prices with pharmaceutical companies, and make it compulsory for everyone to have insurance so the young and healthy can subsidize the old and sick.
Cortes – The problem with government price fixing is that it would waste resources as the market cannot respond to supply and demand, thereby diminishing the quality of U.S. healthcare. Liberal legislation has made healthcare less accessible. When the government subsidizes something, it makes it more expensive. According to the S&P Global Institute, Obamacare has led to individual healthcare premiums costs rising 38 percent between 2013 and 2014, and another 23 percent between 2014 and 2015 (69 percent in total). Employer-based health insurance has led to rising deductibles, according to the Kaiser Family Foundation. Comparing the United States to other nations is faulty. The United States is a much larger nation. If progressives want that style of health insurance, they should be arguing at the state level instead. Conservatives believe that the Republicans need to try something new in healthcare. Open up the markets. Let companies drive down rates in order to stay competitive.
One Response
Great debate. I am glad the Lode is taking on something of this magnitude. Keep up the good work!
I just want to ask about this point “In 1958, before the era of Medicaid and Medicare, a worker would pay for all his or her medical expenses by working 118 hours. In 2012, that same worker would have to work 467 hours.” Where did you get this information? Does this account of inflation? Does it account for wage disparity? In addition, the medical expenses available for purchase in 1958 were limited by the fact that there were fewer treatable (or identified) diseases. For example, as late as 1960 only one-third of all US doctors believed that the case against cigarettes had been established (www.ncbi.nlm.nih.gov). So, for many people with lung cancer in 1958, there was no need to purchase treatment; you just died. That is one way to keep costs down, right?
One other point. The debate over healthcare, I argue, is essentially rooted in whether or not you believe access to healthcare should be a for-profit enterprise or if you believe, it is a human right. Healthcare costs are high in the U.S. because consumers are willing to pay high prices and the government does little to nothing to regulate those costs. In addition, and this is what Republicans are trying to argue, the healthcare system is not open to free market competition and thus, there is no way for consumers to compare costs. This is not the governments fault completely, by the way; it is the result of millions of lobbying dollars by the pharmaceutical and insurance industries. It needs to be fixed and I think it is something that progressives and conservatives can agree on.
However, make no mistake; free market competition does not always lead to lower prices, so the argument that opening the market to competition is a little shallow. As long as someone is willing to pay high prices for a drug or treatment, means that the market will reflect that high price. Moreover, a for-profit open market healthcare system rations treatment according to your ability to pay. People with more resources or better jobs will get better coverage. Poor people will simply get sicker. Government regulation over prices is the only way, outside of a consumer boycott, to force for-profit firms to lower prices; however, you cannot really boycott a lifesaving treatment or service, can you?
The ACA (Obamacare) weakly attempts to control costs via the idea of defraying or spreading out costs by forcing people to buy coverage. As a young healthy (relatively in both cases), I don’t like being forced to buy health insurance at all, but it’s the sensible and responsible thing to do. The ACA has not worked as well as intended. It needs help, but not a big showy “repeal” which is just political nonsense.
Also, one other point: experimenting and trying “something new in healthcare” is fine for us young(ish), healthy people to argue, but what about older people? Or people with long-term disabilities? Can they afford to trust that for-profit companies will decide to lower costs? Maybe you are right and costs will get lower as a result of open insurance competition, but if you are wrong, then lots of people will suffer.