Former President Donald Trump is calling for the government or insurance companies to pay for in vitro fertilization treatments, making them free.
Perhaps this stance is a political move intended to thwart accusations of pro-life extremism and win over moderate female voters. But it’s still a bad policy proposal — one that will empower insurance companies and ultimately make it harder for conservatives to articulate a better vision for healthcare. Trump should pivot and focus on taking down the administrative leviathan that is our insurance-centric healthcare system. This would appeal to many women, as both patients and caregivers.
While the government heavily influences our healthcare system — more than 40% of the country depends on government programs for healthcare — we do not have a totally government-run healthcare system as some of our peer countries in Europe do. Instead, we have an insurance-run healthcare system in the United States.
The headaches of insurance-run healthcare do not discriminate by age, sex, race, or political affiliation. It would be hard to find someone who has not spent hours on the phone with a hospital billing department, only to be told to call their insurer, only to be told by their insurer to call the hospital back. Sadly, this is a common part of the U.S. healthcare experience.
This makes for a great opportunity for Trump. He can define this problem and, even better, offer solutions.
Some see our current healthcare system as the product of capitalism. But this explanation doesn’t make sense. Other industries, while they have all experienced inflation in recent years, do not have the same dysfunction we see in healthcare and insurance.
The real culprit? Obamacare.
Indeed, our insurance-centric system is Obamacare’s defining legacy. The program mandates that all Americans carry government-approved health insurance. Can you imagine anything better for the insurance business?
Furthermore, the law (and the regulations that flowed from it) spell out particular services and treatments that must be included in that insurance coverage, including, for example, birth control.
Conservatives were right to fight the so-called birth-control mandate. The Obama administration was wrong to force Catholic nuns to pay for coverage that they found objectionable on moral and religious grounds (and that they’d never need). The same could be said of a potential IVF mandate.
But culture wars aside, there’s another reason we should not pay for all healthcare through health “insurance.” In the case of birth control, preventive care, or other routine healthcare, such coverage no longer serves as true insurance.
Insurance is meant to be a backstop against unexpected costs, not a third party to every transaction. When we move from a true insurance model to nonsensical third-party payment, we simply add an unnecessary layer of costs and bureaucracy, and we invite the “group lunch” problem: We essentially tell patients never to care about healthcare prices, even for non-urgent care.
Worse, we make healthcare providers accountable to insurance companies instead of patients because they will always answer first to whoever is paying the bill. As P.J. O’Rourke once quipped: “If you think healthcare is expensive now, just wait ‘til it’s free.”
Indeed, we pay dearly for “free” coverage. We pay with higher insurance premiums, and we pay in a deeper sense as we lose control of our own care. Our options reduce to only what is in network, on the formulary, or preauthorized by the health insurance gods.
But if anyone can tackle this problem, it’s Trump. He has the largest platform, and he can simplify complex topics in a way most Republican policy wonks cannot. But he must avoid mimicking the Left’s approach to healthcare, which will lead us to socialized care.
The political Right cannot compete with the Left when it comes to government giveaways, nor should we try. But we can offer a competing vision. Rather than adding to the long list of what should be “free” in our healthcare system, Trump should focus on making only one thing free: patients. Let us choose how to pay for healthcare, allowing for more direct-pay options. Restore insurance to its rightful, limited role. This will lead to lower prices, more options, a better experience for patients, and better healthcare for all.
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Hadley Heath Manning is the executive vice president of the Steamboat Institute.