Conservatives and health care Notes for November 13

Main points

This is a quick summary of the most basic arguments we talked about. Our actual discussion was much more rich than this.

Three values

Menzel and Light claim that there are three values conservatives share and that these values all support universal health insurance.

1. Individuals should be able to care for themselves.

Ben pointed out that this seems worded to lead to liberal conclusions. There is a lot that social policies can do to make people capable of caring for themselves, after all. He thought we could make this closer to what conservatives believe if we drop out the part in bold: be able to. But when it’s put that way, as “people should care for themselves,” this value doesn’t offer much support for socially guaranteed health insurance.

2. Free-riding is wrong.

That’s something that everyone accepts. But it isn’t clear that universal health insurance is going to be a significant improvement as far as reducing free-riding is concerned. Universal health insurance is going to require that some people subsidize others. Those others will, in that sense, free-ride on the ones paying the subsidy.

There are three differences. First, the subsidy will come fairly directly, through taxes, rather indirectly through hospital charges to insurance companies to higher insurance premiums. Second, a system of health insurance would produce more health than the present system, which relies on emergency room visits. That seems to me to be a significant advantage, though it isn’t one that is most naturally characterized as reducing free-riding.

The third difference is that a system of mandatory universal health insurance would block some kinds of free-riding.** Added November 17. What I have in mind is the sort of case that Emilio described in criticizing the Obama plan. Suppose someone who can afford health insurance decides not to buy it on the grounds that the emergency room is always available if necessary. That sort of person free rides on others and would not be subsidized under a system of universal health insurance.

3. Business and entrepreneurship are good.

As we discovered in the Blumenthal readings, businesses don’t seem to agree that universal health insurance is the answer to their problems. Perhaps this is because big, established businesses use the present system to gain an advantage on smaller, newer competitors, as Brittnee suggested. Perhaps it is because corporate human resources officers don’t want to give up their jobs, as Menzel and Light suggested, though Evan had his doubts.

Finally, perhaps it is because business doesn’t trust the government to run a more efficient system than the current one. If it doesn’t, they’ll pay more than they currently do while lacking control.

The reply to that point involves bringing in other countries. Countries like Germany have universal health insurance, profitable companies, and controlled costs. But can the German system work here or are there sociological barriers to its success? That’s the remaining question.

This page was written by Michael Green for The Election, ID-1, Fall 2008. It was posted November 14, 2008 and updated November 17, 2008.
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