Wednesday, April 7, 2021


The great British playwright George Bernard Shaw once pointed out: “All professions are conspiracies against the laity.” Nowhere is this more true than in health care policy.

One of the longstanding concerns with the debate over health insurance is that those who work on the issue sometimes think of themselves as priests and priestesses of a religion that needs to have its deliberations and its orthodoxy protected from the unwashed and untutored.

For years, health policy experts of both parties in Washington have seemed to believe and, in some instances, acted as if they had more in common with each other than with their fellow Republicans or Democrats.

Partly as a consequence of that, Republicans are and have been afraid to talk about health care. It is, in large measure, why they lost Obamacare in 2009, why they have been unable to find their footing on the issue for years, and why they may further slip down the slope on the issue this year.

Lack of clarity combined with incomprehensibility guarantee failure in almost every form of human endeavor.

Fortunately, a number of groups in the health care arena — chief among them Dean Clancy at Americans for Prosperity — who are starting to understand that the way to win a policy or political contest is to draw sharp, clear and understandable differences between themselves and their competitors.

These efforts feature simple, direct, easy-to-follow ideas, including the crazy notion that voters are smart enough to make their own decisions about health care. These bold thinkers are clear-headed enough to point out that health care is a deeply personal matter. As such, everyone should have access to a personal option that best meets their needs at prices they can afford. 

Their approaches are built on straightforward, old-school American ideas. More competition is better than less competition, especially when it comes to the number and types of insurance plans. Giving individuals, rather than bureaucracies, power and choice (think health savings accounts) is essential. Citizens should be able to form themselves into pretty much whatever groups they want to leverage their purchasing power of health insurance.

“Certificate of need” laws — by which governments constrain the supply of health care — are unnecessary and get in the way of good health care. Do we have certificate of need laws for 7-Elevens? Bars? Home Depots? Why should we have them for health care facilities?

Hospitals — not lawyers or government employees — should decide which services they provide. Doctors and those who run hospitals should make those decisions, and then people can, in turn, make their own decisions about what they want to buy from hospitals.

These advocates have taken the first essential step to freedom, choice and common sense in health care. They are clear about the problem and equally clear about the solutions. They prefer clarity to jargon.

A world in which the government runs health care in league with the insurance companies is a world in which you and your family are nothing more than a cost center (in which case, don’t get sick) or a profit center (in which case you should keep paying your money).

We can do better. The coronavirus pandemic finished the conversation about ideas such as right-to-try lifesaving therapies and drugs or how fast the Food and Drug Administration can move when properly motivated.

We need to build on those experiences. 

The recrudescence of philosophical and practical differences could not have happened at a more propitious moment. Right now, the Biden administration is planning yet more “infrastructure” legislation, this time focused on “care infrastructure” (whatever that is).

That legislation will no doubt include attempts to increase subsidies for Obamacare, “Medicare for all,” lowering the age of Medicare eligibility, expanding Medicaid, and just generally create confusion, impose costs and further damage health care. Will the Republicans be ready this time to fight it out in the public arena?

Yes, if they understand that clear, easy-to-understand distinctions are the key to winning any contest. Yes, if they can avoid the priesthood of health care policy “experts” and talk to voters in a way they understand.

Yes, if they follow the lead of those who preach choice, personalization, individual empowerment, migrating power away from the government, and the wisdom of the crowd rather than the guesses of the experts.

All of the most powerful moments in life are expressed with simple, direct language. If you can’t express yourself directly, you probably aren’t thinking clearly. Thankfully, it looks like some on the right might finally be thinking clearly about health policy.

• Michael McKenna, a columnist for The Washington Times, is the president of MWR Strategies. He was most recently a deputy assistant to President Trump and deputy director of the Office of Legislative Affairs at the White House.

Copyright © 2021 The Washington Times, LLC.