Sunday, August 9, 2009

Real Health Care Reform Is Conservative

Andrew Sullivan, as usual, puts it well:

I find myself again in agreement with David
. It was one thing to oppose greater government involvement in
healthcare in 1993. It is another to do so in 2009. There are several reasons
for this and it is hard to improve on David's summary of them. The status
quo means:
(1) flat-lining wages, (2) exploding Medicaid and Medicare costs
and thus immense pressure for future tax increases, (3) small businesses and
self-employed individuals priced out of the insurance market, and (4) a lot of
uninsured or underinsured people imposing costs on hospitals and local
governments. We’ll have entrenched and perpetuated some of the most irrational
features of a hugely costly and under-performing system, at the expense of
entrepreneurs and risk-takers, exactly the people the Republican party exists to

I'd add the crippling health costs for the private sector - costs that
are slowly killing their global competitiveness. But the deepest reason for
reform is fiscal. No serious plan to reduce deficits without hugely increasing
taxes excludes healthcare savings. There's no way to get from spiraling debt to
stable public finances without tackling the exponentially rising costs of
healthcare. So this is a fiscally conservative issue.

Instead of pulling a Palin, conservatives should propose real reforms:
ending the tax exemption for businesses; medical malpractice reform; an
independent body to provide some kind of data on the relative effectiveness of
treatments; incentives to reward doctors less for any and all services provided
than for health outcomes within clear budgets. This, actually, is not far from
the Romney model, as the NYT notes today. Real conservatives should point out
that the current proposals are not tough enough on costs - and criticize Obama
for that, not for fantasies like a communist takeover or euthanasia program for
special needs kids.

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