The Government’s Role in Health Care: How Much Control is Too Much Control?

This post was authored by Dan Colacino, Vice President of Underwriting and Compliance at Rose and Kiernan, Inc.

We’ve now seen the Trump administration’s idea for the 2019/2020 budget year. I call it an idea rather than a proposal since the Constitution – which, by the way, is still in place – requires the budget to originate with the House of Representatives, not the White House. The House of Representatives may or may not even read the suggested budget proposal.

While there are several positive elements in the White House outline, the budget process itself raises questions about how comfortable we should be in trusting our government – state or federal, Democrat or Republican – with our health care.  Each year, there will be the struggle for government funding of various activities, some part of the discretionary budget and some part of the mandatory budget. Nearly the only thing that the government cannot struggle over is the 6% of our $4 trillion-dollar budget that is used to pay the debt on the Federal deficit.

It’s really not different from your household budget. In tight times, we need to economize, so we turn down the thermostat or go out to dinner less often. How many of us, though, will cut out that trip to the urgent care or emergency room to get health care for one of our loved ones?  It’s critical to someone’s long term health but it’s also under our control. We’ll find a way to pay for it.

Governments operate the same way. If they need money to build a bridge (or build a wall) they need to cut costs elsewhere. For example, the White House budget would cut Medicaid and Medicare spending for such proposals. The difference is, they’re cutting based on their priorities, not the priorities of the American people. So, before we run down the path of Medicare for All or Single Payer, we need to think seriously about who we’re handing our health care off to and whether it will be the best for our long-term interests.