A Conservative Argument for Single-Payer Health Care

Might a conservative argument exist in favor of a single-payer health insurance system? Yes, it’s a stretch, but our system is clearly failing many businesses and individuals, and taking such a sweeping reform off the table leaves us merely tweaking around the edges. The result is an ever more costly and complex problem that will only worsen as our population ages. A single-payer system might be the greatest boondoggle in the storied history of government boondoggle-ry, but the issue is too critical to too many not to consider every option.

So why might conservatives support a single payer system? For one, health costs are crippling our global competitiveness. Domestic automakers spend more on health insurance than they do for steel. Disputes over coverage have led to costly strikes and work stoppages in numerous industries. And finally, the cost of caring for the uninsured is built into healthcare prices, which are passed on to business in the form of higher premiums.

The problem is even worse for small business, the conservatives’ darling of economic growth. With limited ability to pool risk – and insurance companies cherry-picking low risk firms away from groups when small businesses do unite to form larger risk pools – a single unhealthy employee or family member can drive premiums up by tens of thousands of dollars (My premiums once increased $24,000/year thanks to the condition of one employee’s spouse). Furthermore, the fear of going without health insurance is one of the risks that prevent people from pursuing businesses of their own, driving yet another stake through America’s entrepreneurial heart.

One reason conservatives rightfully endorse free markets is that they are extremely adept at wringing out bureaucracy and inefficiency. But our current system does neither. Instead, it adds redundant sales and underwriting overhead, confusing billing practices that increase administrative costs for doctors and hospitals, and absorbs a not insignificant portion of our healthcare dollars in profits and executive salaries. Not that those are bad things, but when healthcare dollars are at a premium, we should be looking to maximize our bang for the buck – an elementary conservative tenet.

Philosophically, even limited government advocates such as yours truly would agree that some needs are so vital that a degree of government inefficiency is tolerable in exchange for universal availability. Highways, schools and mail service come to mind. Granted, none of these are perfect, but if left to free enterprise, we’d surely see large gaps in service, much like we see today with health insurance.

Finally, no one is safe from the expense of unforeseen medical bills. A 2005 Harvard University study showed that half of all bankruptcies were due to medical bills, though three of four filers had health insurance. We’re all at risk.

This is not a liberal or conservative issue, but a human one. I’d be the first to argue that healthcare is not a right, but I’m far less prepared to argue it’s not a responsibility – one that we owe to ourselves and each other. Let’s not dismiss any solution.