American healthcare has become ground zero for today's leading political debates. More than the question of whether healthcare should be federalized, subsidized, or deregulated, there are several key policy questions that put public health--and the relationship between the public, the government, and the system of care-delivery--front and center.
This is a good thing, because it means critical issues ranging from national security to the economy to the very role of government are getting refreshed by association--and for once, everyone has a stake in the outcome, because healthcare is a universal need. So here are five of the leading reasons why healthcare is--and belongs--in modern politics.
1 Global Health is a matter of national security
From the spring of 2014 to the beginning of 2015, the worst-ever outbreak of the deadly Ebola virus dominated headlines. The global health scare was politicized by anti-immigration sentiment, with calls to restrict travel and close the borders, under the pretense of national security.
Then the New Year saw a sudden surge in measles cases, traced back to Disneyland in California, where Patient Zero apparently infected more than a dozen others, who then returned to their respective home states to continue the spread.
Critics jumped on the opportunity to vilify anti-vaxxers, illegal immigrants, and other politically ripe targets. But in a globalized economy, the country of origin for highly communicable diseases ultimately matters less than ensuring the international response is coordinated and quick--and not nationalistically self-centered. Trade and technology has shrunk the world, which means health crisis from the third world or from 'the happiest place on earth' pose an equal threat to average citizens everywhere.
Obama recognized as much in his latest State of the Union, when he called on world leaders ""to use this lesson to build a more effective global effort to prevent the spread of future pandemics, invest in smart development, and eradicate extreme poverty."
First world problems officially include third world problems--at least when it comes to hygiene and access to healthcare services.
2 Doctor Compensation
The Affordable Care Act--Obamacare--ignited a lot of righteous fury by forcing Americans to purchase qualifying insurance plans, or face the threat of penalties (or taxes, according to the Supreme Court). While controversy centered on questions of insurance and free market principles, a few critical elements of the new law sparked debate among doctors and nurses.
In essence, the law attempted to emphasize preventive care--that is, stopping disease and illness from getting a foothold, rather than the comparatively expensive standard of treating symptoms and managing existing conditions.
To achieve this, it created incentives for primary care providers to operate practices--whether they be physicians, physician assistants, nurse practitioners, or a few other non-physician designations. The side-effect was that physicians, whose services generally cost more, were competing with nurses to provide the same primary care.
Physicians' groups predictably protest what they see as an unlawful redrawing of professional scopes of practice; patients, meanwhile, are just happy when they can find access to basic services. With legislation set to expand Medicare payments to pharmacists under similar set of prevention-oriented rules, this debate is only going to get more heated--and advocacy groups compete for influence among lawmakers.
3 Small Government/Big Government
Few partisan distinctions are as pithy and recognizable as the debate over the role of government: should it be big--using all of its strength and reach--or should it be small, leaving society and the free market to manage itself?
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