Conservatives are incensed over some of the latest medical research grants doled out by the National Institutes of Health (NIH). Libertarians are infuriated as well, but not for the same reasons.
Last year it was the $237,750 grant to George Washington University “to study whether the use of telemedicine can help overcome barriers to care for transgender women of color” and the $162,313 grant to the San Francisco Department of Public Health “to determine the HIV risk of female-to-male transgender persons (transmen).”
The former study “will develop and test a novel strategy to sample and recruit transmen for a survey of HIV prevalence and health risks, beginning with outreach to public places where transmen are found followed by referral of their peers.”
The latter study comprises two phases. First, “key informant interviews” will be conducted with providers of transgender women and “key informant interviews and focus groups” with transgender women to “evaluate the acceptability of the telemedicine approach.” Second, researchers will use “peer-referral” to recruit 25 out-of-care transgender women who will have a three-month comparison period followed by a three-month telemedicine/virtual medical home pilot study period.”
This year it is the $33,037 grant to the University of South Florida “to study factors that can increase vaccination among gay men for the Human Papillomavirus (HPV) to prevent them from developing anal cancer” and the $42,676 grant to the University of Pennsylvania “to teach yoga to drug-abusing convicts with HIV to help them once they are released from prison.”
The former study “will reinforce the applicants’ training plan in cancer epidemiology, the public health needs of Lesbian, gay, bisexual and transgender populations, and the use of qualitative methods in health education research.”
The latter study “will impact people with HIV and a substance use disorder who are re-entering the community from prison, a population with increased risk of high viral burden, and therefore an increased risk of infectiousness and drug resistance.”
If these grants by the NIH were for research into finding a cure for cancer, diabetes, Crohn’s Disease, Alzheimer’s, rheumatoid arthritis, or heart disease, then most conservatives would have no problem with them. Libertarians, however, would be just as opposed to them as they would be to NIH grants related to LGBT issues.
It is basically the same thing with conservative criticisms of Medicare, Medicaid, SCHIP, and Obamacare.
Medicare is government-funded health care for Americans 65 years old and older and those who are permanently disabled. Like Social Security, it is partially funded by payroll-tax deductions from both employers and employees. It covers 54 million Americans at a cost of about $590 billion a year. Medicare is the third-largest item in the federal budget, and accounts for 20 percent of total national health spending.
Medicaid is the government-funded health-insurance program for low-income persons. It is the largest source of health coverage in the country, covering more than 68 million Americans at a cost of about $440 billion a year. It accounts for 16 percent of total personal health spending in the United States. Although Medicaid is administered by the states, it is jointly financed by the federal government and the states, with the federal government matching state Medicaid spending at least dollar for dollar.
The State Children’s Health Insurance Program (SCHIP) provides government-funded health insurance to children in families with incomes too high to qualify for Medicaid. Like Medicaid, the program is administered by the states, with the federal government matching state spending up to an allotment. Across the country, about 6 million children are enrolled in SCHIP at a cost of about $10 billion a year.
The Patient Protection and Affordable Care Act, otherwise known as Obamacare, includes many “reforms” to the health-care and health-insurance systems: the creation of state health-insurance exchanges; federal subsidies for the purchase of health insurance; the employer mandate that all employers with 50 or more employees must offer health insurance or pay a penalty; the individual mandate that every American not covered by Medicaid, Medicare, or health insurance must purchase health insurance or pay a penalty; and the requirements that insurance companies must provide policies with minimum standards, cover all applicants without regard to their pre-existing medical conditions, eliminate annual and lifetime caps on benefits, eliminate co-payments and deductibles for selected health-insurance benefits, and allow children to remain on their parents’ insurance plan until their 26th birthday.
Conservatives’ opposition to elements of these government health-care programs is generally limited to criticism of the systemic waste and fraud inherent in the programs, their skyrocketing costs, the entrenched bureaucracies associated with them, and Democrats’ plans to expand them. Although Republicans in the U.S. House have voted to repeal Obamacare in its entirety numerous times, their statement on health care in their “Pledge to America” could have been made by House Democrats in defense of the need for Obamacare:
Health care should be accessible for all, regardless of pre-existing conditions or past illnesses. We will expand state high-risk pools, reinsurance programs and reduce the cost of coverage. We will make it illegal for an insurance company to deny coverage to someone with prior coverage on the basis of a pre-existing condition, eliminate annual and lifetime spending caps, and prevent insurers from dropping your coverage just because you get sick.
Libertarians would join with conservatives in their criticisms of certain elements of those health-care programs, but would also posit their own unique and more philosophical concerns.
Because conservatives miss the real issues when it comes to health care and its funding, there are a number of insurmountable differences between conservatives and libertarians when it comes to these subjects.
Conservatives believe it is the proper role of government to provide or pay for health care, make health care and health insurance more affordable, and institute a safety net to ensure that the poor have adequate health care; libertarians believe that it is an illegitimate function of government to do those things.
Conservatives believe government should fund “good” medical research by doling out grants; libertarians believe government should not fund any medical research because it should not dole out grants to any individual or any institution for any purpose.
Conservatives believe in forcing some Americans to pay for the health care or health insurance of other Americans; libertarians believe in voluntary payment of one’s own or another’s health care or health insurance.
Conservatives believe government should intervene in the health-care and health-insurance industries; libertarians believe in a free market in health care and health insurance.
Conservatives, who claim to revere and follow the Constitution, support federal grants for medical research, Medicare, Medicaid, SCHIP, and Republican/conservative versions of, and replacements for, Obamacare, none of which is authorized by the Constitution; libertarians, who are not as animated about the Constitution, oppose federal grants of any kind, Medicare, Medicaid, SCHIP, and Obamacare in all of its versions and replacements because they are all unconstitutional.
The alternative to NIH grants, Medicare, Medicaid, SCHIP, and Obamacare (in all of its forms) is medical freedom. That means that there should not only be no federal vaccination programs, federal funding of clinical trials, federal HIV/AIDS-prevention initiatives, federal laboratories, organ sale or donation restrictions, medical-licensing laws, medical-records mandates, drug laws, insurance mandates, or regulation of medical devices, medical schools, hospitals, nursing homes, or physicians, but also no NIH, Medicare, Medicaid, SCHIP, or Obamacare (in any form) in the first place.