Republicans, Dems Differ on Health Care Goals—Cost, Coverage, Quality—Which Is Your Priority?

It was interesting to note a comment made by Senator Kamala Harris (D-Calif.) during last week’s Democratic presidential debate. Regarding health care policy Harris said, “For a Democrat to be running for president with a plan that does not cover everyone, I think is without excuse.” Harris, obviously, places coverage as the top policy goal for health care.

Health care policy has three goals: cost, coverage and quality. Americans want the highest quality health care, at a reasonable price that covers as many Americans as possible. There is a specific priority for those goals.

Historically, the first goal was to provide the highest quality health care. In spite of the passage of the Affordable Care Act in 2010 which seemed to re-arrange the priorities, Americans continue to primarily demand the highest quality health care. In spite of what some studies conclude, the U.S. has probably achieved that goal.

The U.S. is usually ranked between the 10th and 15th best health care system in the world. The countries ahead of the U.S. all are countries with socialized medicine. The criteria for ranking usually includes something about coverage, mortality rates, patient rights, access, equity and spending as a percent of GDP.

However, if the criteria focused on availability of the latest techniques, achieving the best outcomes in the shortest time period and quick access to the latest technology, the rankings would likely change. Personally, based on what I have seen, if I was severely injured or had a serious illness, I would much rather be in the U.S. than any other country.

After quality, the next priority was to control cost and the third priority was to have as many people as possible covered with health insurance.

The Republicans want to keep the priority of the goals the same. That means quality should be the primary goal followed by providing the service at the most reasonable price. The third priority is to cover as many people as possible.

The Dems' position seems to reverse that order. They want the top goal to be 100% coverage of the population. Then they want to contain the cost. And finally, they want the highest quality.

It will be up to the voters to decide which priority ranking is best for the country.

In theory, ours is a system that benefits the majority, without infringing on the basic rights of anyone. But is health care a basic right? Candidate for president Bernie Sanders (I-Vt.) says that healthcare is a basic human right and therefore coverage should be the top priority. His Medicare for all plan emphasizes this point.

According to the Declaration of Independence, all Americans have the right to “Life, liberty and the pursuit of happiness.” Health care is not mentioned as a basic right. Neither is food, shelter or clothing mentioned. And while one of the health care goals is to cover as many people as possible, health care is not a basic human right.

Voters will help make the health care policy decision during the next presidential election. The GOP had a plan to implement new health care policy that fell one vote short of passage in the Senate. While that plan would have increased the number of insured Americans, it did not cover all Americans.

The GOP will continue to push for health care reform that is based more on market principles than government control. The Dems will push for a plan that covers all Americans, most likely by removing the private sector and placing health care under complete government control. The Dems say not only will this increase coverage to 100% of Americans, but this will eliminate the $72 billion that companies in the health care industry earn as profit annually. That alone, they claim, will reduce the cost.

Harris said, “Let's talk about the fact that the pharmaceutical companies and the insurance companies last year alone profited $72 billion, and that is on the backs of American families.”

The Dems will argue that the GOP plan will not cover all Americans. The GOP will argue that removing the private sector will eliminate the efficiencies of competition and increase overall cost not decrease it. That’s because the government has no incentive to reduce cost. Government is not motivated by profit and government will control 100% of the market.

What should the health care priorities be? The Dems want the order to be coverage, cost and quality. The GOP wants quality, cost and coverage. Which do you want?