RSS Feed MenuWhat’s the future of healthcare after the Dems pass their bill? More regulation, more taxation, more redistribution – or so the liberals are promising themselves.
It might be helpful to compare this bill to the Social Security Act of 1935, which, when passed, had some really bad elements. Most significantly, the bill excluded domestic and agricultural workers, which meant a large number of poor workers, especially African Americans, were not eligible for retirement or disability benefits. (The provisions were, of course, inserted to get the votes of southern senators who controlled key committees.) It also required people to pay into the bill for several years before seeing benefits.
But subsequent legislation in the 1950s and 1960s expanded those covered to the point that it became a fairly universal component of the American welfare state. Indeed, even Barry Goldwater consistently voted on Social Security expansion in the 1950s Senate. Now today is certainly different in the Senate but Social Security shows that adjustments that broaden existing systems are far easier to pass than the creation of new components of a welfare state.
If this is the end of health care legislation, I too would be dissatisfied. But logically, it can be seen as the second step after medicare/medicaid toward the creation of a broadly universal health care system.
The question for conservatives and free-marketeers, now more than ever, is to agree among ourselves on a positive vision of a healthcare future – and then see if we can beat the libs at their own game, steering the system in the direction in which we’d like it to go. Things are moving, and if we don’t develop a better strategy than we have had for guiding that movement, the movement will proceed in directions we won’t like.
balconesfault // Dec 22, 2009 at 10:13 am
Let’s see – regulation, taxation, redistribution.
Well, it is impossible to move a system towards universal coverage without what some will call redistribution. Medicare incorporates redistribution. Medicaid IS redistribution. CHIPS is redistribution. So you have that right.
And it is generally impossible to achieve that redistribution without taxation. Although if Republicans work with the Dems to achieve cost savings in Medicare, we may not have to increase taxes at this time to accomodate the subsidies in the new healthcare bill.
Regulation? Umm – yeah. Without regulation, insurance companies were not going to end the practices of denying preexisting conditions and recissions. Regulation is necessary to create the even playing floor for this to occur – it would be economically suicidal for any one actor in the marketplace to have ended those practices without all their competitors being forced to do so at the same time.
sinz54 // Dec 22, 2009 at 10:55 am
Frum: The question for conservatives and marketeers, now more than ever, is to agree among ourselves on a positive vision of a healthcare future – and then see if we can beat the libs at their own game, steering the system in the direction in which we’d like it to go.
Yugal Levin at National Review wants to steer the system in the diametrically opposite direction from the Dems: Break the link between insurance and employment, by providing portability of coverage from state to state; allow interstate competition among private insurance plans; and throw the problem of patients with pre-existing conditions back to the states, who should put such patients in state-run high-risk pools. (Where states get the money to pay for these high-risk pools, Levin doesn’t explain.)
So I don’t see a lot of room for compromise between this position and ObamaCare. So as long as the Dems have a filibuster-proof majority in the Senate, they will just ignore this proposal.
Nor do I think this proposal would find favor with the American public. All proposals to do away with group health insurance paid through employers, whether coming from the Left or the Right, end up frightening those Americans (better the devil you know than the devil you don’t, especially where life and death are concerned).
sinz54 // Dec 22, 2009 at 11:04 am
balconesfault: Regulation? Umm – yeah. Without regulation, insurance companies were not going to end the practices of denying preexisting conditions and recissions.
Pre-existing conditions represent a breakdown of free-market axioms, in that you don’t rationally choose to get sick. (You can be born with some, like hemophilia, childhood leukemia, genetic propensity to certain cancers, etc.) And correcting this market failure requires intervention by society (using the tools of government at some level).
Jonathan Chait made a great point in his most recent column: There is a common thread underlying the GOP’s failure on health care, global warming, and even the recent financial crisis: It’s that the hard Right has no response to market failures, except to deny that market failures ever occur or (even worse) to claim that we must live with market failures, because to do something about them would be “socialistic.”
And if any moderate Repubs propose government actions to fix market failures, they are deemed “RINOs” by the conservative base and drummed out of the party as heretics.
Today’s conservative base is nearly indistinguishable from the libertarians and the Randian Objectivists on economic policy. And that wasn’t true 30 years ago, when I became a conservative.
So to answer Frum’s call, the conservative movement has to adopt a more rational approach to market failures. It has to acknowledge that they do occur; that the market isn’t always self-correcting; and that government intervention is needed to the extent that such intervention doesn’t produce a cure worse than the disease of market failure.
balconesfault // Dec 22, 2009 at 11:18 am
Sinz: And that wasn’t true 30 years ago, when I became a conservative.
Actually, you left out the market failure that cause me to first break with the Republican Party, which was in fact around 30 years ago – environmentalism as a whole.
Climate change is simply one aspect of this. I actually welcomed the election of Reagan in 1980 (I remember a particularly strong discussion with a college prof friend of mine at the time) even though I had been an Anderson supporter during the election. But the Burford EPA and the Watt Interior Department both represented such drastic change not only from the Carter Administration but even from the Nixon Administration (Russell Trane has always been a favorite of mine) that it led me, a young fairly conservative Chemical Engineer at the time, to question all of the “free market” rhetoric that was being circulated.
I know from my career that strong regulations are absolutely necessary if we want to protect the environment and human health and safety. I have had clients tell me flat out – they want to be in compliance with the law, but they can’t afford to spend one penny more on compliance than is necessary. Thus, Bushian ideals of “optional compliance” generally led to non-compliance.
FWIW, in general GHW Bush got it on environmental issues. But does anyone believe that a GHW Bush could get any traction in today’s Republican Party?
sinz54 // Dec 22, 2009 at 11:40 am
balconesfault:
To Reagan’s credit, he did sign the Montreal Protocol which phased out halocarbons that scientists had found were causing the hole in the ozone layer over the Antarctic.
But to get back to health care, here’s a fascinating assertion from today’s NRO Online:
“Pregnancy is not a disease. Hence abortion, in the vast majority of cases, is not health care. Contemporary liberalism is ideologically committed to denying this truth.”
http://tinyurl.com/y8w62p8
It should not be hard to find the logical flaws in this argument.
DFL // Dec 22, 2009 at 12:14 pm
Better yet, let the budget and economy implode into some sort of revolutionary cataclysm similar to that of 476, 1066, 1453, 1789 or 1917. The whole system is terminally sick and reform is impossible.
Kevin B // Dec 22, 2009 at 12:43 pm
End Game? Health care reform is just beginning. And it will be bipartisan. It will just take decades for it to become that way. That’s how we’ll get a truly American health care system.
In 2030 or so, Republicans will take credit for it. Whenever people point out their behavior this year, they’ll shrug and say, “Yes, but Republicans made it work.” It might even be true.
balconesfault // Dec 22, 2009 at 12:48 pm
To Reagan’s credit, he did sign the Montreal Protocol which phased out halocarbons that scientists had found were causing the hole in the ozone layer over the Antarctic.
Yes – but we were lucky that the ozone hole was reversible – because scientists for a decade had been noting the problem, but one of Burford’s first actions as EPA chief was to squelch any EPA movement on ozone limits, declaring the ozone issue “a non-problem”. It wasn’t until there were measurements that showed the ozone hole was already becoming a serious threat to human health that the Reagan State Department took it seriously.
That kind of strategy doesn’t work as well with effects that aren’t readily reversible.
I’m really not sure why you bother reading the NRO. They don’t even try to apply any intellectual rigor these days – and after their editor directly offered to help the Bush Administration provide spin on the US Attorneys scandal, there isn’t much credibility there either.
sunroof // Dec 22, 2009 at 1:15 pm
So what do Republicans do? Hope for the success of the new healthcare system when its enacted or pray for it to be a failure.
Right now, this Globe and Mail cartoon pretty well summarizes how the Republicans, and their free-markets-without-regulation philosophy is seen by many.
http://www.theglobeandmail.com/news/opinions/
PracticalGirl // Dec 22, 2009 at 3:11 pm
David says
“The question for conservatives and free-marketeers, now more than ever, is to agree among ourselves on a positive vision of a healthcare future – and then see if we can beat the libs at their own game, steering the system in the direction in which we’d like it to go”
I think both the conservatives and free marketeers have answered this question, year in and year out, with their refusal to see the current system as an issue. That’s the problem with a “status quo” action plan: Conservatives never act to improve issues until somebody else acts first.
mthen // Dec 22, 2009 at 6:45 pm
Listen to Frum pretend hes not overjoyed. “More regulation, more taxation, more redistribution” has been the extent of your advice for the Republican party. Dont worry Frum, its only a matter of time now before youll get your VAT.
DFL // Dec 23, 2009 at 9:38 am
Considering the property tax Mr. Frum pays to live in the Palisades area of DC, a VAT is small change.
mthen // Dec 23, 2009 at 5:03 pm
Frum dreams of being the “conservative” steward of a european style welfare state.