RSS Feed MenuTens of millions of Americans lack health insurance. Extending coverage to them has been a core goal of health reform proposals since the 1960s. President Richard Nixon offered a universal health plan in his first administration, but since then Republicans have hesitated to commit the nation to so costly an undertaking. Is it time to rethink? Should Republicans accept universal coverage as a goal? We posed this question to NewMajority’s contributors.
I do not think that Republicans should adopt a policy of universal health insurance. It is obvious, I hope, that health insurance is an important product and that the current markets for health insurance leave a lot to be desired. Republicans should be foursquare in favor of major reforms.
But there are two very large problems with the idea of universal coverage. The first is conceptual – what does “universal” mean? But the second is more important. However defined, universal coverage is an outcome. The only way to guarantee an outcome is to be willing to utilize the coercive power of the government to achieve it. Republicans should not endorse this way of thinking.
Conservatives have correctly focused on creating opportunity, and have been guided by the notion that fairness is a concept richer than equality. Those principles should guide the health insurance debate as well. Republicans should favor reforms that eliminate unfair and preferential treatment of some (those who get insurance from their employer) over others (the rest). They should be in favor of market reforms that engender competition regardless of health status. But they should stay out of the business of coercion and excessive government guarantees.
To read other contributions to this symposium, click here.
NM Symposium Part 2: Universal Coverage: Right Goal, Wrong Principle? // Aug 25, 2009 at 7:27 am
[...] Holtz-Eakin, Universal Coverage: Focus on Reforms that Increase Competition Republicans should be in favor of market reforms that engender competition regardless of health [...]
debs // Aug 25, 2009 at 11:06 am
Mr. Holtz Eakins stands forthrightly against government “coercion,” by which he apparently means a democratic polity reaching a decision to provide health care to all of its citizenry (why he uses the word “coercive” to describe such decisions reached thru legislative means and freely advocated and argued in an uncensored media is baffling and misleading). This sounds vaguely ennobling, and incontrovertible, as a ringing attack against “coercion” must, but I doubt that he believes that the government should leave itself out of business of national defense. Ah, the exception you say. But, somehow, basic protection against the ravages of disease and the economic catastrophe that can come in their wake is not such an exception–even in the name of the “fairness” that Mr. Holtz Eakins claims to champion.
As stated, this is neither a coherent nor humane world view. Nor is one that any of peer nations agree with, whether they rely mostly upon private insurance, like the Netherlands, a single payer system like Taiwan, or government provided health care, like the UK. This is American exceptionalism of the kind we can do without.
NM Symposium Part 2, Universal Coverage: Right Goal, Wrong Principle? // Aug 25, 2009 at 3:23 pm
[...] Holtz-Eakin, Universal Coverage: Focus on Reforms that Increase Competition Republicans should be in favor of market reforms that engender competition regardless of health [...]
ProfNickD // Aug 25, 2009 at 7:33 pm
debs said,
“why he uses the word “coercive” to describe such decisions reached thru legislative means and freely advocated and argued in an uncensored media is baffling and misleading”
Holtz-Eakin usues the term coercive because democratic legislatures can be every bit as coercive as a dictatorship. It’s why, for example, we have a First Amendment– to prevent democratic bodies from using the coercive power of the state (the courts, the police, the penal system) to suppress speech.
The various health care plans before Congress require, among other things, a person to purchase insurance or else he faces a 2.5% surtax on his income tax and forbid insurance companies from issuing any new health care policies after the enactment of the bill into law.
This is the coercive route that Holtz-Eakin is speaking of.
Why is it so hard for so-called progressives to grasp this when it comes to matters of property and commerce?
debs // Aug 25, 2009 at 8:21 pm
These seemingly rational libertarian arguments always leave me cold. Yes, as it happens, democratically elected legislatures require people to do all kinds of things they may not want to do on behalf of a engendering a better society for all of us. To the extent that those decisions are controversial or misguided, they can be revised or corrected by subsequent democratic legislators.
We’re required to stop at red lights–both pedestrians and drivers, even though it might be our wish to keep driving whenever we thought we had a clear path. Yet, it’s true, laws have been passed that “coerce” us into stopping whenever the light turns red. Or you call that coercion–I call it representative government in action, as opposed to anarchy.
If you want to make an argument against universal health insurance, make one. Coercion is not that argument unless you want to argue, also, as I put it on another thread, against taxes, purchasing dog licenses, obeying red lights, and a thousand other things that we lawfully do every day. And that companies lawfully do every day, too, since you seem also to be concerned that the insurance company’s perogatives are also being proscribed. Indeed–we also don’t let companies (anymore) dump toxic chemicals into rivers. Sorry, what’s “coercion” to you (or General Electric) is clean water for me (and even you, whether you like it or not).