According to his campaign website, Cawthorn is positioning himself as a proponent of patient choice and the free market. He states, “We turn patients into shoppers and equip them with buying. Reform creates choices it doesn’t take them away.” Notwithstanding the errors in punctuation and grammar, the real problem with his position is its lack of policy prescription and substance. He rehashes tired vagaries reminiscent of former Rep. Mark Meadows’ time in office, when the opening salvo to any argument was an unabashed support of the free market. 

However, the free market does not always work in health care. It’s a problem that health care economists refer to as market failure. Basically, health care is not a normal commodity. It’s not a truck or a T-shirt or a pizza. You can buy a pizza — or not — it’s truly your choice. But if you’re having a heart attack, you don’t have a choice about health care. You go to the nearest hospital. If you want to live, there is no price you will not pay to live. 

And therein lies the trap. Our current health care system is based on the free market, on capitalism, and produces some of the most expensive and least valuable patient outcomes in the developed world, consuming over 20 percent of our GDP. 

Mr.Cawthorn writes that single-payer healthcare rations care without providing proof to support his assertion. In fact, the free market already rations care. If you don’t have health insurance, or the right amount of coverage, or the right network, then most doctors won’t see you. That’s why when you call a doctor’s office, the second question after your name is: do you have insurance? 

Many a politician through the years has answered concerned constituents’ questions about access to healthcare with the statement, “If you’re sick, you can go to the emergency department for treatment.” It’s a statement that lays bare their profound misunderstanding of how health care in America really works. 

Madison Cawthorn routinely brings up his paralysis in a car accident in high school as evidence of his knowledge about health care. Misfortune may be the father of success, but misfortune is not the same as success. Mr. Cawthorn’s experience as a patient does not make him a doctor, a nurse, or a pharmacist, and his time as a patient seems to have given him little insight into the struggles, be they health or financial, that plague most patients’ lives.    

Lastly, Mr. Cawthorn spends what little space he has allocated to health care on his website disparaging his opponent this fall, Col. Moe Davis, of desiring to replace our current health care system with a “Soviet-style socialist single-payer, government run plan.” Scare tactics aside, Mr. Cawthorn shows he fundamentally misunderstands what a single-payer system is. Single-payer is not socialist; it is an extension of Medicare to all in the population. It saves money by standardizing costs for hospitals and patients, allows Medicare to negotiate with pharmaceutical companies for the lowest price, and, in some models, cuts out insurance companies as unnecessary and obstructionist middlemen or co-opts them to be executors of Medicare, like in Medicare Advantage. Importantly, the hospital systems and local independent providers remain private, unaffiliated and unattached to government.

Health care reform is routinely listed as voters’ first or second most important election issue. Affordability and coverage are key concerns for voters. That Mr. Cawthorn expresses no deep, original thinking about the subject is consistent with Republican efforts at the national level over the last 3.5 years. When given an opportunity to replace the Affordable Care Act (ACA) with something else, Republicans waffled, and internecine fights play out among those who want limited government versus no government at all. 

Now is not the time for incendiary sound bites and full-throated protestations that lack any meaning whatsoever. What we need now are evidence-based policies that make sense and embrace what is best in our health care system while attacking the special interests that support the intolerably high cost of care that Americans experience. Mr. Cawthorn’s opponent, Col. Moe Davis, has shown through his detailed policy positions and interviews with the public that he understands and is committed to tackling the problems of the American health care system. Rarely has the right choice for Congress been any clearer.

William M. Hite BSN, RN-BC

Waynesville