Humanities › Issues Conservative Perspectives on Health Care Reform Share Flipboard Email Print John Moore/Getty Images Issues U.S. Conservative Politics The U. S. Government U.S. Foreign Policy U.S. Liberal Politics Women's Issues Civil Liberties The Middle East Terrorism Race Relations Immigration Crime & Punishment Animal Rights Canadian Government View More By Marcus Hawkins Political Journalist B.A., Political Science, Florida Atlantic University Marcus Hawkins is a journalist and writer who focuses on conservative politics, issues, and perspectives. our editorial process Marcus Hawkins Updated August 28, 2019 Many on the left may not believe it, but conservatives do indeed believe there is a need for health care reform. Republicans, Democrats, liberals, and conservatives can agree that the health care system in America is broken. What to Fix The issue, then, is what exactly is broken about it. Liberals generally believe the only way to fix the system is for the government to operate it, the way Canada and the United Kingdom run their systems—via "universal health care." Conservatives disagree with this notion and contend that the American government is wholly unequipped to take on such a huge endeavor, and even if it were, the resulting bureaucracy would be terribly inefficient, like most government programs. Conservatives aren't just naysayers, however. Their plan is more optimistic because they believe the current system can be fixed with reform measures such as: Promoting competition between health insurance and pharmaceutical companiesReforming the Medicare payment systemEstablishing clear standards of careEnding the "lottery" court system by capping damage awards ordered by activist judges Democratic Arguments Democrats on Capitol Hill want a single-payer health care system similar to the ones currently in practice in Canada and the United Kingdom. Conservatives staunchly oppose this idea on the grounds government-run health care systems are notoriously slow, inefficient and costly. Before he was elected in 2008, President Barack Obama promised to save the "typical American family" $2,500 annually by reforming the insurance market and creating a "National Health Insurance Exchange." In his press releases, Obama claimed the Obama/Biden plan would "Make Health Insurance Work for People and Businesses—Not Just Insurance and Drug Companies." The National Health Insurance Exchange was ostensibly modeled after the Congressional health benefits plan. The plan would allow employers to reduce their premiums by switching most of their employees over to the government program (of course non-unionized workers would have no say in the matter at all.) The new nationalized health care plan would then absorb these new individual health care costs, bloating an already overburdened federal government even further. Background Costs surrounding the health care industry are inflated by three very particular elements, two of which involve the insurance industry. Because of (in many cases) preposterous court settlements that create a veritable lottery for plaintiffs seeking damages, liability insurance for health care providers is out of control. If doctors and other medical professionals want to continue to operate and generate a profit, they often have no choice but to charge exorbitant fees for their services, which are then passed along to the consumer's insurance company. Insurance companies, in turn, raise premiums on the consumers. Physician and consumer insurance plans constitute two of the culprits in the high cost of health care, but both are related directly what is happening in American courtrooms. When consumer insurance companies receive the bills for these high-cost services, it is in their best interest to find reasons not to pay or reimburse the insured. In many cases, these companies are unable to successfully avoid payment (because in most cases the services are medically necessary), so not only the consumer but the insured consumer's employer experiences a rise in health care insurance premiums, as well. Bottom line: Activist judges, seeking to drive home a point or make an example of a particular physician, combine to drive up the costs of liability insurance, which in turn drives up the costs of health care insurance. Unfortunately, these problems with the health care system are compounded by an out-of-control pharmaceutical industry. When a pharmaceutical manufacturer makes an important discovery and successfully introduces a new medication into the health care market, the immediate demand for that medication creates a disproportionate rise in cost. It's not enough for these manufacturers to make a profit, these manufacturers must make a killing (literally, when certain consumers are unable to afford the medication they need.) Some pills cost upwards of $100 each in the retail market, yet cost less than $10 per pill to manufacture. When the insurance companies receive the bill for these very expensive medications, it is in their nature to attempt to find a way to avoid absorbing those costs. Between exorbitant physician fees, exorbitant pharmaceutical fees and exorbitant health insurance fees, consumers often cannot afford the health care they need. The Need for Tort Reform The main culprit in the battle over health care costs is the extensive damage awards doled out by activist judges every day across the country. Thanks to these inflated awards, defendants hoping to avoid a court appearance are left with no other option than inflated settlements. Conservatives realize, of course, that in many cases there are reasonable complaints against providers who misdiagnose, mismanage or neglect a consumer's proper treatment. We've all heard the horror stories about doctors who confuse patients, leave utensils inside surgery patients, or make an egregious misdiagnosis. One way to ensure plaintiffs receive justice while keeping health care costs from becoming artificially inflated is to develop clear standards of care to which all physicians must abide, and assign clear penalties—in the form of reasonable financial damages—for breaches of those standards and other transgressions. This may sound eerily like the concept of mandatory minimum sentencing, but it is not. Instead, it sets maximum civil penalties, which judges may impose, with the maximum penalties being awarded for circumstances resulting in wrongful-deaths. For more than one transgression, more than one penalty would apply. Such guidelines could also urge jurists to be creative; requiring providers to perform specific community service or, in the case of physicians, pro-bono work for a specific segment of society. Currently, legal lobbyists have made imposing caps on damages virtually impossible. Lawyers have a vested interest in procuring the maximum penalty possible since their fees are often a percentage of the settlement or award. Reasonable legal fees should also be built into any system placing caps on penalties to ensure settlements or awards actually go to intended parties. Extravagant lawyer fees and frivolous lawsuits do as much to drive up the high costs of health care as the scandalous damages awarded by activist judges. The Need for Competition Many conservatives believe families, individuals and businesses should be able to purchase health insurance nationwide to heighten competition for their business and provide a variety of choices. Further, individuals should be permitted to obtain insurance privately or through organizations of their choice: employers, churches, professional associations or others. Such policies would automatically bridge the gap between retirement and Medicare eligibility and cover multiple years. More choices in coverage is just one aspect of a free-market health care system. Another is allowing consumers to shop for treatment options. This would promote competition between conventional and alternative providers and make patients the center of care. Permitting providers to practice nationwide also would build genuine national markets and give consumers greater responsibility in their own health care decisions. Competition ensures the public is better educated about preventive health care and treatment options. It forces providers to be more transparent regarding medical outcomes, quality of care and the costs of treatment. It also means more competitive pricing. Lesser quality providers get weeded out, because—like elsewhere in the free-market economy—they get priced out of malpractice insurance and have no way to raise their prices. Developing national standards of care to measure and record treatments and outcomes ensures only top-quality providers remain in business. Dramatic reforms in Medicare would have to supplement a free-market health care system. Under this scenario, the Medicare payment system, which compensates providers for prevention, diagnosis and care, would have to be overhauled into a tiered system, with providers not being paid for preventable medical errors or mismanagement. Competition in the pharmaceutical market would force down drug prices and expand cheaper generic drug alternatives. Safety protocols permitting the re-importation of drugs would keep competition in the drug industry vigorous, as well. In all cases of health care competition, the consumer would be protected through enforcement of federal protections against collusion, unfair business actions, and deceptive consumer practices. Where It Stands The Patient Protection and Affordable Care Act (ACA), popularly known as Obamacare, passed Congress and was signed into law by President Obama in 2010. It largely went into effect in 2014. The law forces all Americans to buy health insurance, with penalties imposed if they do not comply. Those who cannot afford it are given subsidies by the government. It also mandates employers with at least 50 employees to provide insurance for at least 95% of their employees and their dependents. Republicans have fought since then to "repeal and replace" Obamacare with varying degrees of success. President Donald Trump signed an executive order preventing the IRS from enforcing the individual mandate on individuals who do not buy insurance, though the Republicans in Congress failed to outright reverse the mandate. The 2015 King v. Burwell decision also weakened the ACA by allowing states to opt out of expanding Medicaid. Republican attempts to completely overturn the ACA have failed. Trump was elected in 2016, campaigning partly on the issue of overturning Obamacare. He inherited House and Senate with Republican majorities. But conservative bickering over competing plans and fears over public reaction that Republicans were taking away their health care stopped any legislation from being passed. Democrats ended up taking over the House of Representatives in 2018, ending any hope in the near term of "repeal and replace." In the meantime, premiums have risen and choices have gone down. According to The Heritage Foundation, in 2018 80 percent of counties had only one or two choices of health insurance providers on the ACA exchanges.