Well, this week's "Health Care Summit" again helped clarify where we're at politically with respect to health care reform, and I can only dream that it will move us away from dreary platitudes about how we need bipartisan reform. We shouldn't have bipartisan reform because liberals and conservatives have different goals. President Obama ran for president arguing for Universal Health Care, in which all Americans would be able to get health insurance no matter what. That's what Democratic leaders are trying to deliver.
Republicans clearly don't share this goal. They might support some form of cost controls, plans to cut the growth of health care costs, and certainly want to increase free market influence on health care. They want malpractice reform. All of that is fine; it just doesn't accomplish the goal of universal health care.
Now some conservatives feel this way because they don't think that poor people deserve to get health coverage if they can't afford it- I guess the argument is that we're a capitalist country and it's every man for himself- only the strong can survive. Other conservatives would like to make health care universal, as they see the injustice for those with pre-existing conditions out of their control who can't get coverage, but they just don't want to raise any tax revenue to pay for it. Low taxes are just seen as more important.
So the answer is for Democrats to finish health care and pass a bill. I wish I had more confidence in their ability to do it. As I've said before, I'm struck by the gutlessness of congressional Democrats, and wish they had half the courage displayed by Republicans when they were in power.
I'm trying to be fair to people on the Right, here. Did I miss something?
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Making healthcare universal would expand it to three groups of people who don’t currently have it: (1) those who want it but can’t get it due to preexisting conditions, (2) those who want it and qualify but can’t afford it, and (3) those who don’t want it.
ReplyDelete• Group #1: Regulations should require coverage for this group, but it will significantly drive up costs.
• Group #2: Some government program (Medicaid) should cover this group, but perhaps with a lower qualification threshold than liberals might like. The higher the threshold, the higher the costs.
• Group #3: Here’s the rub. It’s not at all clear that this group should be included. Universal healthcare would need to include them to keep overall costs under control, but requiring it reeks of government intrusion into personal lives. Damned if you do, damned if you don’t.
Given that any movement towards universal healthcare will raise costs, a reasonable conservative might argue we should wait until we can better afford it. This is a terrible time for the government to incur even more debt, however noble the goal. Instead, as a first step, control costs with tort reforms, provisions to control cost increases, and allowing free market influences. When the economy is in better shape and the government balance sheet more favorable, take more meaningful steps.
It's true that a government mandate is an intrusion and lessens freedom for those who want to go without health care. But I would point out that some of those people in Group #3 get a sudden serious illness (say a car accident, or a diagnosis of cancer), and then they're a huge burden to society. They can't get health insurance, but they're going to use emergency rooms and they're not going to pay the bill. So I'll settle for the "damned if you do".
ReplyDeleteA reasonable conservative critique is that we can't afford this bill at this time, but could afford it later when the recession is over. But that's not what I'm hearing from Republicans- they clearly will never agree to these costs, so it has to be done while there's a large Democratic majority or it will never happen.
The fiscal responsibility thing has resulted in liberals being played for suckers in recent years. We get Clinton reining in liberal programs to balance the budget (e.g. Welfare reform), and then the Republicans get in power and wipe the whole thing out with enormous tax cuts, causing a huge deficit that they now expect liberals to fix.