I consider myself a politically conservative guy. Yes, I’m rather upset at the conservative movement right now. But that’s because it seems more about inner loyalty than any kind of expansion of the movement. That is people preach to the choir and look for dissent rather than making compelling arguments that will bring more people into the movement. The level of argument is often pretty frightening in its superficiality at the moment.
Case in point: medical insurance.
I think everyone recognizes that the medical system in America is a mess. It seems to me that there are several reasons for this.
1. bureaucratic messes. From the very odd way hospitals and insurance bill each other to the ridiculous paper overhead to the non-standardized forms. There’s a lot of unnecessary overhead.
2. expensive treatments with little payback. A lot of recent technology does improve things, but at a high cost with only slight improvements. Yet people don’t want to get into cost/benefit analysis. So you end up with some very odd, and perhaps counterproductive ways of insurance companies limiting coverage.
3. subsidizing the rest of the world. Yes the rest of the world has cheaper medicine. That’s partially because most of the R&D is done by the US and even European drug companies count on making their profits in the US. This means that (as with a lot else) Canada, Europe and other nations get cheaper care on the back of American consumers.
4. the uninsured. Have a pre-existing condition? You’re screwed. Don’t belong to a large group? You’re screwed. Change jobs? Yeah. You know it.
I could go on enumerating the problems. I won’t bother.
What I don’t understand is the conservative (and religious) reaction to all this. Beyond silly talk about “socialism” (are interstate highways socialist?) there is a sense in which medical care is an individual responsibility. But I’ve never seen people really make the case for this. Why is medical care taboo for government but not police, fire departments, roads, garbage collection, and so forth. All of which are handled on a community basis. Could someone make a coherent argument here?
The problem is that by denying the medical debate on real grounds, by throwing out silly and misleading arguments, conservatives allow Democrats to frame and ultimately control the issue. When conservatives do tend to do something (say Bush’s prescription drug program) it’s handled poorly and ends up being expensive.
One hope I had to Mitch Romney was his approach to health care. Even if his state didn’t turn out as well as was hoped, it seems to be the most successful attempt in the country.
Anyway, this may be the one place I as a conservative break with many Republicans. (Well, global warming too) I think that the government needs to
a. start doing cost/benefit rationing on medicare in line with what most European countries do.
b. expand medicare to the uninsured children
c. standardize insurance forms and billing for the country
d. make rejection for pre-existing conditions illegal
e. allow the upper lower class and lower middle class to buy into medicare with tiered premiums and deductions
f. get rid of hidden taxes on hospitals that medicare imposes by paying less than cost