Republicans are campaigning this year on a pledge to repeal Obamacare — and who can blame them? The Democrats are slathering another layer of bureaucracy onto the medical sector, an act that promises to both lower the quality of our health care and raise the price we pay for it. Happily for conservatives, the country mostly agrees with their anti-Obamacare critique: A Gallup poll taken in March shows that 65 percent of Americans believe that the new program has given Uncle Sam too much control over the health-care system.
But the same poll finds that Americans are skeptical of purely private-sector solutions. Fifty-two percent think the bill that Pres. Barack Obama signed into law should have included a “public option” for health insurance, and 51 percent think that the bill doesn’t go far enough in regulating health care. If the GOP makes big gains in November, there is a danger that repeal-minded Republicans in the 112th Congress will be seen as simply wishing to overturn Obama’s signature legislation in order to hand him a stinging political defeat, peeling away a bureaucratic layer but doing nothing to address the fundamental flaws of our health-care system. This danger is compounded by the fact that just at the moment a new Republican congressional majority would be pushing to eviscerate Obamacare, many on the right would no doubt be arguing that Republicans must take the lead in cutting federal spending — including, inevitably, spending on Medicare. Unelected would-be budget-balancers, secure in their ivory towers, don’t have to worry about town halls or voters, but members of Congress do.
Health-care spending is a problem, but it is important to remember that spending is a secondary issue. The primary issue is health itself — how to achieve it, how to maintain it, and how to regain it in the case of sickness or injury. Health-care finance is hotly contested political ground, yet Washington has had precious little to say on the subject of health in recent years.
That is perplexing — and a huge missed opportunity. After all, people don’t go to the doctor because they have insurance plans or health-savings accounts. They go to the doctor to get well and to stay well. Americans’ eyes may glaze over at the wonky debates that are catnip to Washingtonians, but, beyond the Beltway, they can’t seem to get enough information about their bones, bladders, and blood pressure.
And they can’t get enough care for them, either. According to the Kaiser Family Foundation, 67 percent of Americans say that they are not getting the tests and treatments they need. By contrast, just 16 percent say that they have received unnecessary care. In other words, Americans want more health-care services than they currently are consuming. This is the political chasm that separates average Americans from the elites who dominate the health-care policy debate: Reformers in both parties argue that Americans spend too much on health care, but most Americans believe we should be consuming more.