By Shiam Kannan
Recently, support for a plan which used to be a fringe idea espoused only by the leftward-most members of Congress has been gaining traction within the mainstream Democratic party. Its name? “Medicare for All.” At first glance, the idea certainly sounds compelling. After all, who wouldn’t like free, universal healthcare? However, this program, just like any other form of centralization, would be devastating to the economy (the healthcare industry in particular), and would certainly cause the national debt to skyrocket. America’s healthcare system is definitely flawed, but more government is not the answer.
To analyze the effects of the Medicare for All legislation, it is important to look at what the plan actually entails. Under this single-payer plan, tax revenue collected by the federal government would be used to pay for everyone’s healthcare. The plan would have very low, if any, copays and deductibles, and would ensure that Americans’ healthcare status is not dependent on employment. All current government-sponsored healthcare programs, such as Medicare, Medicare Advantage, Medicaid, and CHIP, would be eliminated and replaced with a single Medicare for All system. The proposed single-payer legislation would outlaw private and employee-sponsored healthcare plans which provide any of the same services the government provides. These are certainly ambitious ideas, and a lot of them are very appealing, so it is no surprise to see how quickly the Democratic Party has jumped onto the Medicare for All bandwagon. But a closer look at the effects of the plan show that it is most definitely not the right path for America to take.
Perhaps the biggest concern involving Medicare for All is its effect on federal spending. According to a study done by the Mercatus Center at George Mason University, the single-payer plan would cost a whopping $32.6 trillion over the first 10 years following its enactment. The same study projects that federal healthcare spending, as a result of this plan, would total over 10 percent of the American GDP by 2022. The costliness of single-payer stems from several factors. The plan makes the federal government responsible for basically all of the healthcare spending in the United States. In addition, the plan greatly expands the number of services that federal insurance covers. Of course, this massive hike in spending leaves us to wonder how we are going to pay for Medicare for All. In short, we aren’t. Because we legitimately can’t. Even if the corporate tax rate and every personal income tax bracket were doubled, the cost for this program would still not be covered. Therefore, if enacted, Medicare for All would end up as just another monstrosity of a federal entitlement program, eating up more and more of the budget every year while driving up the debt.
However, this program would not only be harmful from a governmental perspective, but also an economic one. If we are going to conjecture the effectiveness of Medicare for All, it would do us good to look at an existing example of socialized medicine in America: the Veterans Affairs system (VA). The VA scandal in 2014 revealed the inefficiency of government healthcare for our veterans, as many were placed on waiting lists for months on end (the average wait time for all veterans was an appalling 115 days for initial care), with some of them committing suicide while waiting for healthcare. If the government cannot even properly administer healthcare to our veterans, it doesn’t take much imagination to envision how terrible government healthcare for 315 million Americans would be.
Defenders of socialized medicine frequently point to single-payer systems in Canada, the United Kingdom, and other European countries, claiming that if it works there, it should work here. But is it really working in Europe? Let’s take a closer look. Earlier this year, the NHS, Britain’s government healthcare system, cancelled over 50,000 non-urgent operations due to an overload on the system, following claims from British physicians that their patients had to endure “third world” conditions. The overload was due to a spike in winter flu, and left many patients with the disease waiting for over 12 hours to receive treatment. This scenario illustrates one of the worst aspects of government healthcare: rationing. When the government controls all the healthcare, if the system is overloaded, the government gets to decide who receives treatment and who doesn’t. If the condition of a patient is bad enough, government rationing could very easily be a matter of life or death for him or her. And even worse? Rationing is inevitable if healthcare is socialized. It’s basic economics: all resources are finite. The market will always allocate these resources more efficiently than a centralized authority. If a centralized authority is in charge of allocating healthcare resources, then it has the power, essentially, to determine who lives and who dies. I don’t know about you, but that’s not exactly a power I would feel comfortable with the government having. If I had a serious injury, I wouldn’t want to be hauled off to a hospital, only to be denied service because the government determined that someone else’s condition was more severe.
Even if we were somehow able to magically make the laws of economics disappear and eliminate the rationing problem, socialized medicine still would have negative consequences on the people it should supposedly help. Let’s go back to the United Kingdom for a moment. It is a fact that the British spend far less than the United States on healthcare. But they also receive less. The United Kingdom has fewer doctors and nurses per capita than most other developed nations, and patients have less access to technologies such as MRIs and CT scanners than in the United States. It should come as no surprise that British doctors and nurses are also paid much less than healthcare professionals in the United States. Once again, the laws of economics prevail. Human beings are driven by the profit motive. When you turn physicians into government employees and pay them a public sector salary, less people want to become doctors. Therefore, the supply of healthcare decreases, which then feeds into the rationing problem discussed earlier.
However, the havoc that single-payer would wreak on the United States does not change the fact that our current healthcare system is flawed, and in dire need of reform. But real reform, which would help all Americans get quality, affordable healthcare, has to go the other way. Reform should be driven by decentralization and deregulation, not government ownership of an entire industry. Some policies we should implement include allowing insurers to sell healthcare plans across state lines, and allowing people to import prescription medications from foreign countries, such as Canada. Such legislation would increase competition, and drive down healthcare costs. Most importantly, we must repeal Obamacare and its onerous burdens on the healthcare industry. Such regulations as the 10 Essential Health Benefits (EHB) mandate do nothing more than make health insurance plans more expensive, by forcing people to buy coverage for services they may never need. For example, maternity/newborn care is included as one of the essential health benefits that all healthcare plans must cover. Obviously, this coverage is useless for demographics such as young, single men, who biologically cannot bear children; nonetheless, due to Obamacare’s EHB mandate, they cannot buy cheaper plans which don’t cover this service. Obamacare has also driven healthcare costs up at a faster rate than if the law were not implemented, which only goes to show that government intervention in the economy, however well-intentioned, only ends up harming the people it attempts to help.
Our healthcare system has many issues, not least of which are rising costs. But big government is not the solution. While the proponents of Medicare for All have good intentions, they are proposing an overly simplistic solution to a complex problem. The answer to America’s healthcare crisis is less government, not more, and the sooner members of Congress across the aisle come to realize this, the sooner we can fix this issue. But it is neither wise nor sensible to implement a $32 trillion behemoth of a government program which will only serve to accelerate our perpetual debt, while doing nothing to help, if not actively hurting, patients and consumers throughout the country.
By Erin Flaherty
Poverty, airstrikes, water insecurity, terrorism, blockades, and disease have all been components of what many have deemed “the forgotten war”. The conflict stems from the efforts of the Houthi group to overthrow the government. The Houthis, which are a group that stems from Zaidi Islam, had control of the Yemeni government until the 1962 revolutions, which led the country into the North Yemen Civil War. The war ended with the Yemen Arab Republic taking control of the nation, and since then, the level of animosity in the Houthi community towards their government has only risen.
In 2011, Many of the Houthis citizens were angry at their new leader, Saleh, for the rising unemployment and his abuse of the Yemen oil profit. Their protests continued, and in late 2011, Saleh stepped down. His Vice President, Abed Rabbo Mansour Hadi, took his place. Hadi’s want for more liberal and constitutional reform threatened the conservative values of the Houthis. In January of 2015, the Houthis captured the presidential palace in Yemen's capital, Sana'a, and continued to take control of the entire city.
Hadi and his government moved to the city of Eden in the South, but because of their successful capturing of Sanaa, the Houthis have been able to establish themselves in most of the country’s North. Since then, the war has been between pro-government forces from Saudi Arabia that have been supported by Riyadh’s new coalition, and the Houthis who have been partially supported by Iran. Both Saudi Arabia and Iran have gotten involved by aiding opposing sides, making Yemen essentially another proxy war in the struggle for power between Sunni and Shia Muslim sects, and those who support either side.
The humanitarian crisis in the country only escalated after the start of the conflict. In response to Iran sending in weapons to aid the Houthi rebels, Saudi Arabia imposed a full-blown blockade around the entire county. In attempting to stop Iran’s efforts to aid the Houthis, they essentially cut off all access to food and medical supplies. Fuel-driven pumps transfer the majority of water in the country, especially near the cities where the conflict is occuring, so water insecurity became a massive issue for citizens of Yemen when the blockade took effect. Saudi Arabia lifted its blockade from the largest port in Yemen, Hodeidah port, but the effects of the water and food insecurity that Yemenis have faced will not be over anytime soon. The Red Cross reported that Yemen had over 1 million cases of cholera in 2017, and many of those infected still have not received medical attention due to the lack of medical centers and workers in the country.
Although this may seem like an issue that lacks connection to the US, the opposite couldn’t be more true. The US is Saudi Arabia’s top supplier of weapons, and has backed their coalition that started the blockade in the first place. Many in the United States political sphere have criticized US support for Saudi Arabia not only because of the Saudi-imposed blockade of Yemen, but also because of their inaccuracy with airstrikes intended to hit rebel groups. Several stories have come out over the course of the war about Saudi-led airstrikes hitting funerals, hospitals and schools– one of the most controversial being the Saudi airstrike that hit a Doctors Without Borders medical facility. The Trump administration has faced condemnation for continuing to supply Saudi Arabia with weapons when they recurrently hurt innocent citizens in an attempt to suppress the rebel groups.
US involvement escalated even more recently, when news came out that the Green Beret US soldiers were secretly deployed to Yemen in 2017. They were sent, supposedly, to train the Yemen troops and take down Houthi bases with them. This marked a huge step in US involvement, since beforehand the US was only involved in 'refuelling and logistics', as the Pentagon said.
Until recently, not much had been done regarding US involvement in Yemen, but on November 28th, the Senate voted to stop all US support of the Saudi-led coalition. Vermont senator Bernie Sanders, a heavy advocate for this bipartisan action, said on the 18th that “the time is now to tell Saudi Arabia that we are not committing to partner with them in this horrific crisis.”
But this bill did not pass all of a sudden; it precipitated from the death of Saudi Arabian journalist Jamal Khashoggi. Khashoggi died at the hands of Saudi government agents who tortured him at the Saudi consulate in Istanbul, Turkey. Despite this assassination, Trump continued to support the Saudi Arabian government, angering many lawmakers. The 63-37 vote in the Senate was quite bipartisan, since many Republicans have turned against their original stance on the issue which aligned with Trump’s view. U.S. intelligence officials have confirmed that the Saudi crown prince, Mohammed bin Salman, was at least aware of the plan for the murder of Khashoggi. This news has been denied by several members of Trump's cabinet, but has ultimately confirmed for many that Khashoggi’s death at the Saudi consulate was no coincidence or accident.
United States Secretary of State, Mike Pompeo, has condemned the Senate’s decision, saying that “degrading U.S.-Saudi ties would be a grave mistake for the national security of the U.S. and its allies.” Trump has also continued to reinforce the importance of the United State’s alliance with Saudi Arabia, even advocating for a new proposed arms deal that would supply Saudi Arabia with more weapons from the United States, saying that it would provide citizens of the United States with new jobs. Though Trump has touted that Saudi arms deals provide 500,000 additional jobs, Reuters estimates between 84,000 and 168,000.
This decision brought up a huge question that could set precedent for many issues in the future; Who has the right to pull our country out of war? Well, Senators cite the War Powers Resolution of 1973, which says that if US troops are involved in any hostile conflict abroad “without a declaration of war or specific statutory authorization, such forces shall be removed by the President if the Congress so directs by concurrent resolution.”
This means that the House would need to pass the bill, which does not seem as unlikely as it has before, since Democrats will be taking the majority in the next House due to their midterm victory. House Democrats have been advocating for an end to US involvement in Yemen for a while and would most definitely vote in accordance with the Senate. Then, only Trump would need to approve ending American assistance in the war. If he tried to reject their decision through a veto, it would still go back to Congress, which logically would still end in a vote to end United States involvement.
The Senate’s decision speaks volume about the increasing concerns among lawmakers in regards to the United State’s relationship with Saudi Arabia. The vote on the 28th may not ultimately end our questionable role in the war in Yemen, but it signifies an important step in possibly changing our country’s current role in said foreign affair.