Posted on 07/28/2017 6:25:40 AM PDT by Colonel Kangaroo
Don’t tell anyone, but American conservatives will soon be embracing single-payer healthcare, or some other form of socialized healthcare.
Yes, that’s a bold claim given that a GOP-controlled Congress and President are poised to un-socialize a great deal of healthcare, and may even pull it off. But within five years, plenty of Republicans will be loudly supporting or quietly assenting to universal Medicare.
And that’s a good thing, because socializing healthcare is the only demonstrably effective way to control costs and cover everyone. It results in a healthier country and it saves a ton of money.
That may seem offensively counterintuitive. It’s generally assumed that universal healthcare will by definition cost more.
In fact, in every first-world nation that has socialized medicine–whether it be a heavily regulated multi-insurer system like Germany, single-payer like Canada, or a purely socialized system like the United Kingdom–-it costs less. A lot, lot less, in fact: While healthcare eats up nearly 18 percent of U.S. GDP, for other nations, from Australia and Canada to Germany and Japan, the figure hovers around 11 percent. (It’s no wonder that smarter capitalists like Charlie Munger of Berkshire Hathaway are bemoaning the drag on U.S. firm competitiveness from high healthcare costs.) Nor are healthcare results in America anything to brag about: lower life expectancy, higher infant mortality and poor scores on a wide range of important public health indicators.
Why does socialized healthcare cost less? Getting rid of private insurers, which suck up a lot money without adding any value, would result in a huge savings, as much as 15 percent by one academic estimate published in the American Journal of Public Health. When the government flexing its monopsony muscle as the overwhelmingly largest buyer of medical services, drugs and technology, it would also lower prices-–that’s what happens in nearly every other country.
So while it’s a commonly progressive meme to contrast the national expenditure of one F-35 with our inability to “afford” single-payer healthcare–and I hesitate to say this lest word get out to our neocon friends–there is no need for a tradeoff. If we switched to single payer or another form of socialized medicine, we would actually have more money to spend on even more useless military hardware.
The barrier to universal healthcare is not economic but political. Is profligate spending on health care really a conservative value? And what kind of market incentives are working anyway–it’s an odd kind of market transaction in which the buyer is stopped from negotiating the price, but that is exactly what Medicare Part D statutorily requires: The government is not allowed to haggle the prices of prescription drugs with major pharmaceutical companies, unlike in nearly every other rich country. (Both Hillary Clinton and Donald Trump pledged to end this masochism, but the 45th president has so far done nothing, and U.S. prescription drug prices remain the highest in the world.) Does anyone seriously think “medical savings accounts” with their obnoxious complexity and added paperwork are the right answer, and not some neoliberal joke?
The objections to socialized healthcare crumble upon impact with the reality. One beloved piece of folklore is that once people are given free healthcare they’ll abuse it by going on weird medical joyrides, just because they can, or simply let themselves go because they’ll have free doctor visits. I hate to ruin this gloating fantasy of lumpenproletariat irresponsibility, but people need take an honest look at the various health crises in the United States compared to other OECD (Organisation for Economic Cooperation and Development) countries. If readily available healthcare turns people hedonistic yahoos, why does Germany have less lethal drug overdoses than the U.S. Why does Canada have less obesity and type II diabetes? Why does the Netherlands have less teen pregnancy and less HIV? The evidence is appallingly clear: Among first-world countries, the U.S. is a public health disaster zone. We have reached the point where the rationalist santería of economistic incentives in our healthcare policies have nothing to do with people as they actually are.
If socialized medicine could be in conformity with conservative principles, what about Republican principles? This may seem a nonstarter given the pious market Calvinism of Paul Ryan and Congressmen like Reps. Scott Perry (R-Pa.) and Mo Brooks (R-Ala.), who seem opposed to the very idea of health insurance of any kind at all. But their fanaticism is surprisingly unpopular in the U.S. According to recent polling, less than 25 percent of Americans approve of the recent GOP healthcare bills. Other polls show even lower numbers. These Republicans are also profoundly out of step with conservative parties in the rest of the world.
Strange as it may seem to American Right, $600 EpiPens are not the sought-after goal of conservatives in other countries. In Canada, the single-payer healthcare system is such a part of national identity that even hard-right insurgents like Stockwell Day have enthusiastically pledged to maintain it. None of these systems are perfect, and all are subject to constant adjustment, but they do offer a better set of problems–the most any mature nation can ask for–than what we have in the U.S.
And virtually no one looks at our expensive American mess as a model.
I recently spoke with one German policy intellectual, Nico Lange, who runs the New York outpost of the German Christian Democrats’ main think tank, the Konrad Adenauer Stiftung, to get his thoughts on both American and German healthcare. Is socialized medicine the entering wedge of fascism and/or Stalinism? Are Germans less free than Americans because they all have healthcare (through a heavily regulated multi-payer system), and pay a hell of a lot less (11.3 percent of GDP) for it?
Mr. Lange paused, and took an audible breath; I felt like I had put him in the awkward spot of inviting him over and asking for his honest opinion of the drapes and upholstery. “Yes,” he said, “we are less free but security versus freedom is a classic balance! National healthcare makes for a more stable society, it’s a basic service that needs to be provided to secure an equal chance for living standards all over the country.” Even as Mr. Lange delineated the conservative pedigree of socialized medicine in Germany–“You can certainly argue that Bismarck was a conservative in founding this system”–I had a hard time imagining many Democrats, let alone any Republican, making such arguments.
Indeed, the official GOP stance is perhaps best described as Shkrelism than conservatism, after the weasel-faced pharma entrepreneur Martin Shkreli, who infamously jacked up the price of one lifesaving drug and is now being prosecuted for fraud. (Though in fairness, this type of bloodsucking awfulness is quite bipartisan: Heather Bresch, CEO of Mylan corporation, which jacked up the price of EpiPens from $100 to $600, is the daughter of Senator Joe Manchin (D-WV), who defended his daughter’s choice.)
But GOP healthcare politics are at the moment spectacularly incoherent. Many GOP voters have told opinion polls that they hate Obamacare, but like the Affordable Care Act. And as the GOP healthcare bill continues to be massively unpopular, Donald Trump has lavished praise on Australia’s healthcare system (socialized, and eating up only 9.4 percent of the GDP there). Even in the GOP, this is where the votes are: Trump’s move to the center on questions of social insurance–Medicare, Medicaid, Social Security–was a big part of his appeal in the primaries. The rising alt-Right, not to hold them up as any moral authority, don’t seem to have any problem with universal Medicare either.
It will fall on “reform conservatives” to convince themselves and others that single-payer or some kind of universal care is perfectly keeping with conservative principles, and, for the reasons outlined above, it’s really not much of a stretch. Lest this sound outlandish, consider how fully liberals have convinced themselves that the Affordable Care Act–a plan hatched at the Heritage Foundation for heaven’s sake, and first implemented by a Republican governor–is the every essence of liberal progressivism.
Trump’s candidly favorable view of Australian-style socialized healthcare is less likely a blip than the future of the GOP. Republican governors who actually have to govern, like Brian Sandoval and John Kasich, and media personalities like Joe Scarborough, and the Rock, will be soon talking up single-payer out of both fiscal probity, communitarian decency, and the in-your-face evidence that, ideology aside, this is what works. Even the Harvard Business Review is now giving single-payer favorable coverage. Sean Hannity and his angry brigade may be foaming at the mouth this week about the GOP failure to disembowel Obamacare, but Sean’s a sufficiently prehensile fellow to grasp at single-payer if it seems opportune–just look at his about-face on WikiLeaks. And though that opportunity has not arisen yet, check again in two years.
The real obstacle may be the Democrats. As Max Fine, last surviving member of John F. Kennedy’s Medicare task force, recently told the Intercept, “Single payer is the only real answer and some day I believe the Republicans will leap ahead of the Democrats and lead in its enactment,” he speculated, “just as did Bismarck in Germany and David Lloyd George and Churchill in the UK.” For now, an invigorating civil war is raging within the Democrats with the National Nurses Union, the savvy practitioner-wonks of the Physicians for a National Health Program, and thousands of everyday Americans shouting at their congressional reps at town hall meetings are clamoring for single-payer against the party’s donor base of horrified Big Pharma executives and affluent doctors. In a few years there might even be a left-right pincers movement against the neolib/neocon middle, whose unlovable professional-class technocrats are the main source of resistance to single payer.
I don’t want to oversell the friction-free smoothness of the GOP’s conversion to socialized healthcare. Our funny country will always have a cohort of InfoWars ooga-boogas, embittered anesthesiologists and Hayekian fundies for whom universal healthcare is a totalitarian jackboot. (But, and not to be a jerk, it’s worth remembering that Hayek himself supported the socialized healthcare of Western Europe in one of his most reasonable passages from the Road to Serfdom.)
So even if there is some banshee GOP resistance at first, universal Medicare will swiftly become about as controversial as our government-run fire departments. Such, after all, was the trajectory of Medicare half a century ago. You read it here first, people: Within five years, the American Right will happily embrace socialized medicine.
Chase Madar is an attorney in New York and the author of The Passion of Bradley Manning: The Story Behind the Wikileaks Whistleblower.
When all else fails, change the definition of “conservative”.
How the hell is single payer “conservative?”
The author of this piece must be kidding himself.
Rationing, death panels, and everyone under the thumb of the fascist government.
Thumb up, you live, thumb down, you die.
Just like a Roman emperor.
Two words for the author of this piece (besides the obvious FU).....those words: Charlie Gard.
Well, duh, if you are denied care of course it's not going to cost you anything. Am I right, Charlie Gard? Up high!
What about a Conservative Case for HEALTHSHARE?
Yesterday,, listening to Rush talk about football injuries, I wondered whether the government would ban football once it takes over "healthcare" because of the financial burdens it places on everyone else. Certainly cigarettes would be out, and maybe skiing too? Everything except anal sex.
ML/NJ
Somehow, methinks the Juan McCainezes of the future will still receive better and more timely care than we mere peons.
That was my point. The author’s whole argument
is that we need to change what “conservative” means
to something it has never meant.
I will no longer be reading anything from “The American Conservative”. This is outright Communist Propaganda here...
Single payer would be a catastrophe. Why not regionalize health care into pseudo-autonomous ‘Fed’ like regions that provide Insurance. With no Federal money going to or from the general funds of the government.
The only way a state sponsored Insurance program would work is to keep politicians hands off it.
No. The left, no matter what party they inhabit, want to make it appear so. It’s after the pattern of Marx’s postulate, that mankind was “progressing” from feudalism through bourgeois capitalism into totalitarian socialism (and then his imaginary and undefined “communism”); so like the Shi’ite Twelver Mahometans who believe they must hasten the return of the Mahdi by instigating nuclear war, the left believes they must push headlong into socialism by any means at their disposal, particularly the most mendacious and violent means.
I can state for a fact that if I have no cost for healthcare other than the taxes that I already pay, then my wife and I will go to the doctor a LOT more than we do now. The torn cartilage in my knee? Fix it doc. That major dental work she’s been putting off? Get er done. And on and on.
A few questions. Throughout the campaign, the President repeated how terrible Obamacare was.
Did he ever actually mention a policy within the ACA that he believed needed to be fixed?
During the campaign he said he wouldn’t touch Medicaid, so he supported the expansion.
We know he supports providing insurance for those with pre-existing conditions.
Does be oppose the subsidies to help people buy insurance?
Does he oppose the minimum coverage requirements?
Does he oppose the individual mandate?
Does he oppose the business mandate?
Does he oppose the medical device tax?
Do you think the skinny repeal complies with his vision of repeal and replace?
Perhaps he could provide Congress with a better idea of what be thinks healthcare reform should look like.
If the Liberals in California who have been chomping at the bit to do Single Payer for decades can’t figure out a way to pay for it, my sense is that NOBODY will figure out a way to pay for it.
May sound good to them on paper, but won’t survive First Contact with reality in a country of 330 million.
Myth Romney paid the Heritage Foundation to write a pro-government health so he could pass it in Mass.
Most republicans are NWO SOCIALISTS. they don’t caveto Democrats they are Democrats.
Wow, so much stupidity crammed into one short article. The government’s interference with the free market results in “obnoxious complexity and added paperwork”, so the answer is more government involvement, in fact complete government control. Riiight.
The author also fails to compare the level and quality of medical care available in those enlightened countries that spend a smaller fraction of their GDP on healthcare with that available in the U.S.
My socialist father believes that healthcare cost should be dependent on your income level, rather than your risk level.
With single payer, he gets what he wants. Sure the out of pocket may be less as this author claims. But it is propped up by progressive taxes
Oh, there will be costs. One of them will be freedom.
These “conservative cases” for left-wing government control of all things are pure lies.
The NHS in the UK is the largest financial entity in Europe. It has more cash flow than Siemens, Fiat, Bayer or Daimler-Benz and it’s a government agency that takes money.
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