The Sovereign Mind

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The Next Best Thing for Health Care Reform

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As a supporter of the free market (although not a purist), I tend to prefer a solution to our country’s health care problems that enhances the advantages of the market, rather than places more government bureaucracy on top of it. But a bill that decreases government involvement in health care, rather than increases it, is about as likely to get passed as a white male was likely to have been nominated for Justice Souter’s seat on the bench. So that begs the question: if the conservative approach to health care reform is not viable politically, what is the next best thing we can hope for?

What about the much maligned status quo? Even critics of the reform proposals agree that our current system has problems, but would doing nothing be better than the current proposals? Even if some believe that to be the case, few politicians would admit it for fear of being labeled a defender of a broken system. But is the best option on the right to try to block reform and stall, in hopes of gaining political power in future elections, thus making a more conservative approach more viable? That might be tempting, but given the track record of Republicans on getting any major reform done in our health care system, I wouldn’t bet on that approach working out. A few of us are in the unfortunate circumstance of needing the liberals’ zeal to get something significant done and the conservative ideas to get the right thing done. It’s tough to have both at the same time.

What about a compromise approach? The Senate finance committee has recently come out with a bill that it believes to be more moderate than its counterparts. No public option. Less harsh mandates. Almost universal disapproval. Does compromise mean pulling in all of the best ideas from all sides, or the worst ones? In this case, we have none of the cost controls and all of the government bureaucracy. In an attempt to find common ground, it appears the finance committee has found no-man’s land. Worse still, if something along those lines passes, it is likely to give the impression that something has been done, when in reality nothing has been done except complicating the system even more. This impression is likely to cause real reform to be significantly delayed as we have an endless debate about whether the plan is really working or not (see the current debate about whether the stimulus is working).

How about this for the Next Best Thing for conservatives? Let the liberals’ plan pass. Yes, that’s what I said. Put in that strong public option and individual mandates. Punish those greedy private insurance companies and those evil employers that don’t provide insurance to their employees. Why might that be The Next Best Thing? Because when someone asks, “Why can’t I find a plan a low-premium catastrophic plan?” We can tell him that the government didn’t think that would be good for him. And when someone says, “I got laid off because my employer couldn’t afford the health insurance he’s mandated to pay for.” We can say, “Thanks for taking one for team.” Or when someone on Medicaid Advantage reports that their plan has been discontinued, and they are now forced to find another, we’ll just tell them they were part of the waste in the system that had to be jettisoned. Maybe then there would be more pressure to consider more conservative-minded approaches. (Or, maybe it would actually work. Either way, the American people win in the end.)

There was nothing like prohibition to solidify the idea that alcohol ought to be legal. Nothing like Vietnam to make the public wary of the casualties of war. Nothing like repealing Glass-Steagall to remind us of why it was there in the first place.

Does this idea sound good to me? No. I don’t want to see people in our country suffer. And it would likely take decades to undo the programs that would be put in place. I didn’t say it was The Best Thing. I suggested that maybe it is the Next Best Thing. If conservatives believe that liberal health care reform would be a harmful to our country, should they let the liberals prove it? Just a thought.


Written by Mike

October 23, 2009 at 10:03 pm