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Musicmystery -> A Thoughtful Conservative Take On Health-Care Moving Forward (3/25/2017 7:09:24 AM)
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There's an interesting piece in today's Atlantic by conservative author David Frum. It's thoughtful. Here's the end -- especially look at the second to last paragraph.
Paul Ryan still upholds the right of Americans to ‘choose’ to go uninsured. His country no longer agrees.
In that third week in March in 2010, America committed itself for the first time to the principle of universal (or near universal) health-care coverage. That principle has had seven years to work its way into American life and into the public sense of right and wrong. It’s not yet unanimously accepted. But it’s accepted by enough voters—and especially by enough Republican voters—to render impossible the seven-year Republican vision of removing that coverage from those who have gained it under the Affordable Care Act. Paul Ryan still upholds the right of Americans to “choose” to go uninsured if they cannot afford to pay the cost of their insurance on their own. His country no longer agrees.
What happens now? What happens now is that—a few bitter-enders aside—Republican politicians, especially in the states, begin the slow and belated process of entering the next era of health-care politics. Contrary to Paul Ryan’s bleak vision of a political “tipping point” after which the nation declines into “dependency and passivity,” Americans will continue to find plenty to argue about—and possibly more than ever.
How generous should health coverage be? What should be done to control costs? Who should pay, and on what terms? To what extent should citizens be free to impose the cost of their unhealthy choices upon others? Conservative-minded people will converge on one set of intuitions; progressives on another. It’s possible to imagine a Republican health-care politics that rejects the ultra-redistributionary approach of the ACA and instead argues that since all benefit from health coverage, all must contribute to its costs via some kind of broad-based tax. It’s possible to imagine a Republican health-care politics that emphasizes cost control over benefit provision. It’s possible to imagine a Republican health-care politics that incentivizes providers and insurers to achieve better outcomes at lower prices. It’s possible to imagine a Republican health-care politics that resists socializing the burden of addiction, obesity, and other unhealthy behaviors. It’s possible to imagine a Republican Party that cares about the details of health policy and is not satisfied with poorly informed hand waves toward outworn party shibboleths. It won’t happen soon, perhaps—but the sooner the better.
Conservatives have a crucial role to play in shaping the future American health-care system to enhance and support enterprise, innovation, individual responsibility—to resist open-ended spending, state planning, and the risk that social insurance will penalize effort and success. It’s past time to accept reality, quit promising the impossible, and do the work that a democracy that seeks both equity and efficiency should expect from its more conservative-minded thinkers and politicians.
Whatever else the 2016 election has done, it has emancipated Republicans from one of their own worst self-inflicted blind spots. Health care may not be a human right, but the lack of universal health coverage in a wealthy democracy is a severe, unjustifiable, and unnecessary human wrong. As Americans lift this worry from their fellow citizens, they’ll discover that they have addressed some other important problems too. They’ll find that they have removed one of the most important barriers to entrepreneurship, because people with bright ideas will fear less to quit the jobs through which they get their health care. They’ll find they have improved the troubled lives of the white working class succumbing at earlier ages from preventable deaths of despair. They’ll find that they have equalized the life chances of Americans of different races. They’ll find that they have discouraged workplace discrimination against women, older Americans, the disabled, and other employees with higher expected health-care costs. They’ll find that their people become less alienated from a country that has overcome at last one of the least attractive manifestations of American exceptionalism—and joined the rest of the civilized world in ameliorating and alleviating our common human vulnerability to illness and pain.
We’ve all been wrong about enough things to teach us humility about our rare bursts of foresight. What I would urge is that those conservatives and Republicans who were wrong about the evolution of this debate please consider why they were wrong: Consider the destructive effect of ideological conformity, of ignorance of the experience of comparable countries, and of a conservative political culture that incentivizes intransigence, radicalism, and anger over prudence, moderation, and compassion.
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