Monday, May 8, 2017

A conservative argument for universal healthcare

I am naturally conservative in many ways. I value in-group loyalty and moral purity. I respect hard work and independence.

Therefore, I believe we need universal healthcare.

Think about it. Entrepreneurs, job creators, are one of the great archetypes of conservative ideology. But the single greatest obstacle to entrepreneurship may be dependence on health insurance: why would I give up my stable job, with my access to health insurance, to try something that may or may not pay enough to let my kids go to the doctor? I wouldn't.

Barack Obama's progressive compassion is commendable, but the Affordable Care Act didn't solve this problem. Instead, it increased the burden on job creators, by putting much of the burden of paying for health care on employers' backs. Everyone needs health care, but should it really be employers' responsibility to cover that?

My libertarian and Constitutionalist readers will be quick to note that it shouldn't be the government's job, either. The Constitution does not give the federal government power to administer universal healthcare. The Affordable Care Act tried to get around that, awkwardly.

But what if the state governments were responsible for healthcare?

State and local governments' involvement in education and healthcare is not new. They have been since America's founding. The Founders reserved that power for the states and the people, and did not give it to the federal government. On the state and local level, I believe that a conservative system for universal healthcare would focus on conservative principles: family, entrepreneurship, competition.

First, universal healthcare should focus on families. Providing generous prenatal and postnatal care would likely reduce the number of abortions nationwide. Work requirements for government aid should recognize that parenting young children is hard work, and providing healthcare for parents and young children can make one of the most challenging phases of life a little less stressful. Likewise, we should continue to provide aid for the elderly.

Entrepreneurship is another core value of conservativism: what if we started by extending Medicaid to entrepreneurs and their families? How many more people would experiment with creating jobs and services? What would happen to our economic growth? I'd also like to note that good health is a prerequisite to hard work: if we provide universal mental health services, in particular, we can increase the proportion of the population that is capable of self-reliance.

As a conservative, I believe that single-payer healthcare is unnecessary for universal healthcare (one of Hillary Clinton's criticisms of Bernie Sanders), and removes the power of competition. Instead, we simply need minimal legislation to oversee fair competition: price transparency, anti-monopoly measures, and so on. Our current system allows for monopolistic health insurance companies, and it hides the prices for medical procedures. We have a strange for-profit bureaucracy, not a capitalist or socialist system. By making the health insurance system truly capitalist--transparent and competitive--we could promote efficiency and entrepreneurship in that field.

Bernie Sanders means well, but we don't need to jump to single-payer in order to have universal healthcare. Switzerland and Hong Kong provide universal healthcare in ways that, I believe, would greatly appeal to American conservatives.

America is tied for the best healthcare in the world--but among the world's top countries, our healthcare is the most expensive and least efficient. We use Canada as an excuse for avoiding universal healthcare, but among developed countries, Canada is unusual in having such long waiting times. We can build our own system, using the best of the world's wisdom as an inspiration, just as James Madison did when he draft our Constitution.