Why We Have To Get Healthcare Right: Part II

A few weeks ago, I outlined how the policy areas of Immigration, Fiscal Policy and Poverty Assistance are integrally bound up in the larger healthcare debate. Today, we’ll examine three more. There are two indisputable facts on which everyone can agree: first, everybody will need medical care at some point. Second, the cost of medical treatment is astronomically high. A couple days of uninsured hospital care could easily saddle someone with a lifetime of debt. What many don’t realize however, is just how deeply entwined healthcare is with nearly every arena of public policy. Today, we’ll examine its impact on Agriculture, Education, and Federalism…
Agriculture Policy
One of the major areas healthcare needs reform is rural medicine in agricultural areas. These areas face challenges including high aging populations, high dependence on government insurance, larger concentrations of high risk patients who are more likely to need medical attention, sharp shortages of medical personnel, and providing service to greater geographic areas.[1] Furthermore, it’s not difficult to grasp how food production itself and healthcare are intertwined: clearly, what we eat affects our health. A look at the numbers though illustrate this reality. The US spends a hefty $246 billion on agriculture subsidies per year for commodity crops. Here a surprising conflict begins to emerge. The vast majority of these subsidies go to crops like wheat and soy instead of fresh fruits and vegetables. This in turn contributes to obesity and undermines public health. [2]
Education Policy
There is clear evidence that your level of educational attainment impacts your earning potential, and consequently both your access to healthcare and your overall health[3], and education policy has suddenly become public health policy as well. In addition however, the new Obamacare regulations are rewriting the way medical higher education is done.[4] Consider: as 30 million new patients flood the medical system, and Obamacare imposes 190 million additional man hours of paperwork, there are expected to be significant staffing shortfalls across the medical profession. The problem with this is that even if med schools become less competitive as enrollment caps are raised and more students attend, the number of federally funded residencies available to new M.D.s has not increased.[5] Since all doctors must complete a residence prior to practicing medicine in the US, the increasing residency shortage could cause many medical graduates unable to find a residency to look overseas for employment, or simply pursue other career options. All in all, the current healthcare education situation is unacceptable and demands immediate reform.
Personal Liberties and Federalism
As the costs of healthcare continues to rise, and the government continues to foot more and more of the bill, both state and federal governments pass an increasing number of “public health” laws. Consider the controversial soda tax in New York, or the “sugar tax” proposals gaining traction in New England. These kinds of impositions on personal liberty are passed in the name of “public health” and could even be justified if we allow the federal government to take more and more control of healthcare. This should give us pause. How much of our diet or lifestyle should the government be allowed to control in the name of public health? Healthcare policy hits close to home the more we realize its individual liberties implications. Does an individual have the right to eat what they want, even if it results in obesity or diabetes? Do individuals have the right to engage in “risky” behaviors such as adrenaline sports, outdoor adventure, or smoking if it could result in higher healthcare costs overall? In the end, we cannot discuss massive federal healthcare policies without federalist and individual liberties concerns arising.
Conclusion
The point of this analysis has been to demonstrate how important healthcare policy is by examining how far reaching the impacts of healthcare reform are. Whether we look at education, poverty assistance, agriculture, immigration, debt, or federalism, we find healthcare policy deeply entwined with the most pressing issues in each of these fields of policy. No matter where one falls on the geopolitical spectrum, there can be no question that healthcare reform is possibly the most pressing arena of public policy that demands reform. In future posts I will begin to examine what this might look like.

[1] http://files.cfra.org/pdf/Ten-Rural-Issues-for-Health-Care-Reform.pdf
[2] http://www.pcrm.org/health/reports/agriculture-and-health-policies-unhealthful-foods
[3] http://www.nber.org/digest/mar07/w12352.html
[4] http://www.modernhealthcare.com/article/20130204/INFO/302049986
[5] http://www.heritage.org/research/reports/2014/03/the-impact-of-the-affordable-care-act-on-the-health-care-workforce
[6] http://www.marketplace.org/topics/health-care/ers-are-still-busy-affordable-care-act-and-all