...In Which I Try to be Fair to Conservatives on Health Care

I was thinking about the health care debate this week, in light of this article someone sent me about the failures of ObamaCare and the private sector improvements that are coming about (in spite of health care reform presumably) to make insurance more affordable.

I'm certainly ready to agree that ObamaCare is imperfect in a lot of ways, but I'd frame it in the sense that the problem is that it doesn't solve enough of the current problems our system has, rather than that it creates new problems.

But here's what it boils down to: liberals have a goal of universal coverage for health care. To reach that goal (or get close to it- ObamaCare gets close), it is necessary to make some sort of major change involving increased government involvement. ObamaCare changes the health care system as minimally as possible within the frame of reaching its goal.

Conservatives are aghast at the increased role of government- which is fair enough. But of course Conservatives also don't share the goal of universal, affordable health care for everyone. They feel that the downside of increased government isn't worth the upside of insuring everyone.

So there's a stalemate, but it's not really an argument about the technocratic outcomes or unintended consequences of legislation. It's not about a secret Democratic party plan to turn the whole country into a socialist dystopia. It's not about a secret Republican plan to ensure poor people die off faster. It's just about priorities. I care about all Americans having access to health insurance more than I care about government control of my life.  It seems that Conservatives feel the opposite.

 

Yet when I suggest such a formulation, in which I think I'm being fair to Conservatives and their sincere urge to keep government as small as possible, I get pushback- "what do you mean, we don't want universal coverage? Of course we do!"

 

But that's ridiculous- many of the ideas that Conservatives throw out there to improve the health care system in America are fine, good thoughts, which really might improve things- increased competition, less opaque payment systems, making sure consumers see prices, malpractice reform, etc.  These proposals are just fine, and would probably lead to more efficiency and lower prices for many of us.  But none of these ideas would do anything to ensure universal coverage.  People who work in low paying jobs for companies that don't offer health insurance would still be out in the cold.  People with pre-existing conditions would still have nowhere to turn for affordable coverage.  Remember there are 50 million uninsured people in the US.  Go with these Conservative ideas and maybe some small percentage of them would be able to afford it, but the vast majority still wouldn't.

 

We should at least have honest debates.  There's no way to make health insurance accessible to everyone without lots of government action.  It's still perfectly legitimate to oppose universal health care- government doesn't provide universal automobiles for everyone, for example, so maybe health care shouldn't be provided either- but let's dispense with the pretension that Conservative plans would produce health care for all.