I’m not sure that I like this line of thinking, but I’m starting to think that it’s true, so I’ll put it out there and see what people make of it in debate.
It’s starting to look fairly certain that while a bill called “health care reform” will pass the congress and be signed some time before the 2010 elections (because the administration needs to sign something, even if it’s a fig leaf that does little and doesn’t go into effect until after 2012) what passes will not in any sense be a “comprehensive” health care reform package. Given the people who would be in charge of designing it if it made it through right now, I think that’s probably a pretty good thing.
However, conservatives would be foolish to rest on their laurels for the following reasons:
– Regardless of what we may think about subsidiarity and the importance of non governmental solutions, it has become fairly clear that the majority of the voting population is willing to consider it a major political issue if some people cannot get or cannot afford health care coverage.
– Just providing a tax credit to buy insurance (without requiring guaranteed issue and/or community rating in some form) will not satisfy this need in the minds of most voters, in part because:
– Many people are not very educated or diligent in seeking out all possible means of coverage that might be available to them (difficult and impossible become elided) and we as a society do not have the will (rightly or wrongly) to tell people: Sorry, you didn’t get yourself good coverage with the money you were given (or had) and so now you’re going to have to be crippled by medical bills.
– This doesn’t mean that something like ObamaCare or single payer health care needs to be adopted, but it does mean that some fairly simple system needs to be put in place that will ensure that everyone has some minimum level of coverage. Otherwise health care will remain a political live wire issue.
– If people with a reasonable understanding of markets and economics don’t put together a plan that meets these basic requirements while keeping in place incentives towards innovation and cost savings — eventually someone on the left will succeed in getting a single payer or otherwise economically disadvantageous program created. It’s only a matter of time.
I don’t really like all this, as I don’t accept that these things need to be solved at a national level. But given that it seems I’m outside the political center of gravity on this, I’m not sure that matters. The niche will eventually be filled, and it’s only a matter of who gets to pick the way it will be filled.