Conservative Health Policy

Dan Miller laments that “the right has basically abdicated its role in the conversation” on health care reform.

Health care has been THE liberal project for literally decades; entire careers (not to mention presidencies) have been built around it.  There’s a vast policy apparatus on the progressive side of the aisle built around health care, with industrious wonks digging into every nook and cranny.  Meanwhile, the right has…nothing.  To the best of my knowledge, the right has never instituted any major policy shift in health care (with the exception of Medicare Part D, although even that came about substantially because of pressure from the left and with the help of liberal Senators).  The right, speaking broadly, doesn’t see a problem with the current state of affairs in the health care system; it’s just not a subject that excites them.  If there was a way they could continue the status quo while solving the problems of cost growth, I think most conservatives would gladly take it.

Well . . . yeah.

There’s not a large conservative apparatus around health care policy because conservatives, fundamentally, don’t think providing health care is a legitimate function of government.  Defending the status quo simply doesn’t require a lot of infrastructure.

Kevin Drum does a very sound job of explaining why even “status quo, give or take” doesn’t have a significant conservative wonk base.  His post defies excerpting but, suffice it to say, once you get beyond subsidizing defined groups (the poor, the elderly, veterans) there’s no tinkering to be done — massive government regulation is inevitable.  You know what conservatives hate?  If you guessed “massive government regulation,” you get a gold star.

The upshot, then, is that conservatives tend to approach the debate from first principles whereas liberals are pushing their favored implementation plan.  The latter requires far more detailed knowledge.

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James Joyner
About James Joyner
James Joyner is a Security Studies professor at Marine Corps University's Command and Staff College and a nonresident senior fellow at the Scowcroft Center for Strategy and Security at the Atlantic Council. He's a former Army officer and Desert Storm vet. Views expressed here are his own. Follow James on Twitter @DrJJoyner.

Comments

  1. Dave Schuler says:

    What it looks like from where I sit is too many conservatives trying to fight the battles they wish they had rather than the battles they actually have.

  2. CBetley says:

    “Right of the people to petition the government for redress of grievances”. Surely conservatives recognize that right. If conservatives can’t respond to problems in health care costs, access, and distribution without saying something more substantive than “Government will just make it worse”, get out of the way.

  3. Zelsdorf Ragshaft III says:

    There was a time, long ago, when doctors visited the sick and infirmed at their homes. This all before a group of people far more interested in increasing their pay rather than advancing any cause began litigating what they called malpractice. This caused doctors to need expensive insurance, which of course they passed the cost on to people needing their services. Soon, on the circular railroad, the cost of medical care became so high one needed insurance against the need of medical help. The answer is simple and direct. Tort reform. The other thing that would fix this was advised by none other than William Shakespeare. Some thing about the first thing we have to do.

  4. Zelsdorf Ragshaft III says:

    CBetley: I guess by what you wrote you feel the will of the majority should be able to overturn the rights of the minority. If you can take my money to pay for someone else’s health care, what next. You think you can take my money to buy their cars? You already think I have to educate their children. If you want socialism go live in a socialist country. We fought government tyranny in WWII, why would you now invite that here. The old adage, that which governs best governs least still holds true.

  5. odograph says:

    Interesting, James says:

    There’s not a large conservative apparatus around health care policy because conservatives, fundamentally, don’t think providing health care is a legitimate function of government. Defending the status quo simply doesn’t require a lot of infrastructure.

    CNN says:

    A national poll indicates that most Americans are receptive to having more government influence over their health care in return for lower costs and more coverage.

    Sixty-three percent of people questioned in a CNN/Opinion Research Corp. survey released Friday said they would favor an increase in the federal government’s influence over their own health care plans in an attempt to lower costs and provide coverage to more Americans; 36 percent were opposed.

    I guess it comes down to “conservatives” positioning themselves as “the 36 percent.”

  6. just me says:

    I have had government healthcare and my husband currently experiences the VA system. Thanks but no thanks, if this is what is thought of as making my healthcare better.

  7. Conservatives argue from first principles? I thought they were just greedy racist bastards that hated poor people. Meanwhile odograph remains true to form with his intellectual integrity by quoting CNN polls as an authoritative, dispositive source. Perhaps odograph is unfamiliar with Benjamin Franklin’s aphorism concerning the sacrifice of liberty for temporary security, or maybe he just likes to see the world burn. Hey, this casual impugning of motives is easy peasy. But then I get to watch a master at work.

  8. Our Paul says:

    Said it before, but it is worth saying again. When the French cops find a dead body, they say: “Cherche la femme”, while the American fuzz bark out “Follow the money trail”… thus, I have to wonder about this:

    The upshot, then, is that conservatives tend to approach the debate from first principles whereas liberals are pushing their favored implementation plan. My bold, OP

    Since the days of St. Ronnie, Conservatives have held as their first principle that citizens of the Shinning City on the Hill have the absolute right to make as much money as possible while paying the least amount of taxes. And, let’s face it, there is lots of money in health care to be made. It rattles around the halls of Congress and fills the bathtubs of Insurance executives and canny investors. It is said that there are more then one thousand companies providing some form of health insurance, and that does not count “private investors” dipping into the money pot.

    The unwashed who carry the water up the hill? No need to keep them healthy, they can always be replaced. A certain number have to be kept in good shape for National Defense, and in reserve. That is why we have Tri-Care, full government sponsored health care on the cheap for the ready reserves. The City on the Shinning Hill has to be defended, even at the cost of caving into a small bit of socialism.

    The Hisss you here is not ZR(III), but my spleen venting. Dave Shuller is almost there, but he keeps stumbling over the Mexican and Canadian hoard expected to cross our boarders and the expected increase in health care visits without our ability to increase health care professionals (docs, nurses, etc). James Joyner has reached the point where he recognizes that the system is not sustainable. What is missing for conservatives is what judges should never, under any circumstances have (seven letter word, starts with a E and ends in a y).

    Fight on, St. Ronnie’s first principle must be preserved…. His thoughts can be found here.

  9. Our Paul says:

    James spam eater will gobble up posts with more than 3 or 4 links, thus a slow thinker and writer such as myself who relies on others to make one’s argument is at a distinct disadvantage. But this from our host is quite correct:

    There’s not a large conservative apparatus around health care policy because conservatives, fundamentally, don’t think providing health care is a legitimate function of government. Defending the status quo simply doesn’t require a lot of infrastructure. (My italics, OP)

    From Next Right, examining five “non socialist” options to decrease costs, we get this:

    On No 5, the Left has consciously been using these kinds of regulations to drive up costs. This limits people’s “access.” They don’t care. They want medical socialism no matter the cost. The plan is, and always has been, either to hasten the destruction of the insurance market and/or to drive up costs so we’ll cry uncle. Once we cry uncle, they’ll usher in the age of bureaucare. Functionaries will make our healthcare decisions. Bureaucrats will decide if and when you need a drug. You will wait in medical bread-lines for care. Innovation will dry up. Just go to a Cleveland hospital. Find Canadians getting MRIs because Canada has made them wait.

    Standard Center Right scare tactics defending the status quo, for this paragraph color code it red. With the usual false hoods presented as fact. The issue has been studied more than once, there are no Canadian hoards invading our health care system. It is a myth, a Health Care Zombie.

    The real problem the Center Right can be seen in the exchange between odograph and Charles Austin. Brother Charles, an expert in fine print, is living in the days of Ben Franklin, when blood letting was a cure. Friend odograph is pointing to today’s playing field, scare tactics are not working, solutions have to be presented

  10. anjin-san says:

    Now would be a good time for the “world is flat” crowd to jump in and tell us that the Canadian, French, & British health care systems are on the brink of collapse. Funny that, as they have been “on the brink” for over 25 years now…

  11. Stan says:

    Following up on anin-san’s remark, why is it that the Canadian, French, British, Israeli, Dutch, German, Finnish, Swedish, Danish, Swiss, Japanese, etc. electorates don’t dump their health care systems in favor of our model?

  12. brainy435 says:

    http://www.rasmussenreports.com/public_content/business/healthcare/july_2009/50_oppose_government_health_insurance_company

    I guess odo is positioning him as “the 35 percent.” Either that or he doesn’t get the difference between a) people ok with government implementing a theoretical program that lowers costs and increases care and b) reality.

  13. An Interested Party says:

    Perhaps odograph is unfamiliar with Benjamin Franklin’s aphorism concerning the sacrifice of liberty for temporary security…

    Not to change the subject, but it is a pity that more people weren’t familiar with this aphorism in the wake of 9/11…

    re: brainy435 | July 17, 2009 | 02:02 pm

    Rasmussen, huh? Why not just go straight to the elephant’s mouth and cite a poll from the RNC…

  14. brainy435 says:

    Rasmussen, huh? Why not just go straight to the elephant’s mouth and cite a poll from the RNC…

    Really? From the guy who cites CNN? Hilarious.

  15. brainy435 says:

    And you still didn’t address the wording, which as I pointed out CNN words it as a hypothetical bill while Rasmussen uses the actual bill in its poll.

  16. James Joyner says:

    why is it that the Canadian, French, British, Israeli, Dutch, German, Finnish, Swedish, Danish, Swiss, Japanese, etc. electorates don’t dump their health care systems in favor of our model?

    They’re social democracies with a collectivist mindset. Traditionally, that’s not who we are as Americans.

  17. just me says:

    And hey, my husband has a totally screwed up knee because the doctor in the US military system didn’t think his complaints of continued pain were worthy of an MRI. When his knee locked while on a ship and he fell down ladders twice they ordered the MRI-about 6 years too late. The scar tissue was so bad it couldn’t be repaired without a knee replacement.

    And I have lots more stories-really, I understand that some people want something done, but in reality I don’t. I don’t want the government anymore involved in my healthcare than it already is. The military was not a very confidence building system, and the VA has been even less so.

    I will say from this conservative’s standpoint-I think the vast majority of the problem with the US healthcare system is that affordable healthcare is linked too closely with employment. I don’t think the answer is government funding or providing insurance, but the government encouraging the industry to be creative in pooling together those who need insurance individually.

    But the government regulating or making any decisions about my healthcare-no thanks i will take a pass.

  18. Our Paul says:

    James, in the interest accuracy may I re-arrange two words, drop a word and change the tense of this:

    They’re social democracies with a collectivist mindset. Traditionally, that’s not who we are as Americans.

    To this:

    They’re collectivist democracies with a social mindset. Traditionally, that’s who we were as Americans.

    Now the foreign governments reflect the collective will of the people, who have a social mindset, i.e. high quality health care for everybody is a social benefit from which everybody benefits. The change in tense is necessary because if the braking point is not now, it sure is in the immediate future.

    just me (July 17, 2009 | 03:21 pm), anecdotal stories are great at dinner parties, but add little to policy discussions. Give this one a try, probably more of an urban legend than a true story, but I think the way it starts out at a hair dresser indicates that the writer is a bit more skilled than what my rum sodden brain can produce…

    Off to the summer cabin, and its enforced silence with the nearest wire 20 minutes away…

  19. James Joyner says:

    Paul,

    The problem with your rewriting is that it’s inaccurate.

    Europeans see themselves as collectivist subjects, whereas we’re individualist citizens. The United States has never been a socialist state that believed in collective provision of health care to everyone paid for by a few. We’ve gradually taken it on ourselves to help certain groups — crippled war veterans, the very elderly, and the truly indigent — but that’s a far different thing.

  20. Stan says:

    In answer to my question about why we’re the only industrial democracy without a mechanism for guaranteeing universal medical insurance, our genial host says “Because they’re social democracies with a collectivist mindset. Traditionally, that’s not who we are as Americans.”

    With all due respect, Dr. Joyner, Switzerland is not a social democracy. Neither is Japan. And no country on earth is more capitalist than Singapore, which also has a system for insuring universal medical coverage. You seem to be saying that we shouldn’t do something because we haven’t done it in the past. Can’t you come up with a better argument?

  21. James Joyner says:

    Switzerland is not a social democracy. Neither is Japan.

    Really? Both have very developed welfare states. The Social Democratic Party of Switzerland “was founded on October 21, 1888, and is currently the second largest of the four leading coalition political parties in Switzerland. It is the left-most party with representatives in the Swiss Federal Council. It is also the second largest political party in the Swiss parliament.” The Japanese Socialist Party has led the governing coalition in the recent past and remains powerful. The Liberal Democratic Party is center-right by European standards but there has always been a paternalism in Japanese politics.

    You seem to be saying that we shouldn’t do something because we haven’t done it in the past. Can’t you come up with a better argument?

    I’m arguing culture in response to a question about why others that have a socialized system haven’t moved in our direction.

  22. Stan says:

    Who’s right, William Graham Sumner or Werner Sombart? I think it’s Sombart, and I think that as our present system of employer provided health benefits collapses people will turn to the Federal Government for help, just as they did during the Great Depression.
    You may be right about culture being the primary determinant, but I’m betting against it.

  23. James Joyner says:

    as our present system of employer provided health benefits collapses people will turn to the Federal Government for help, just as they did during the Great Depression.

    The proposed plan is worst of both worlds: Mandating yet more employer coverage plus saddling taxpayer with others.

  24. An Interested Party says:

    Really? From the guy who cites CNN? Hilarious.

    The hilarity is only in your own mind, which appears to be confused…I haven’t cited CNN for anything…

  25. Stan says:

    “The proposed plan is worst of both worlds: Mandating yet more employer coverage plus saddling taxpayer with others.”

    Yet it’s the same plan used in the Netherlands, Germany, and Switzerland, three countries not noted for governmental inefficiency. And all three have better records than ours in terms of life expectancy and infant mortality and spend less per capita than we do.

  26. just me says:

    And all three have better records than ours in terms of life expectancy and infant mortality and spend less per capita than we do.

    Life expectancy and infant mortality rate comparisons as an indication of quality of care are poor, because definitions are inconsistent.

  27. I understand Cuba has higher literacy rates and free health care for everyone. Clearly we should abandon the US Constitution and ask Fidel to lead us too.

  28. JohnG says:

    Asking people if they favor universal coverage is like asking people if they favor owning their own mansion. Everyone says yes until you add the part about costs.

  29. Stan says:

    just me, do you have any sources showing that WHO statistics underestimate US longevity and overestimate our infant mortality rate?

    charles austin, Germany, the Netherlands, Switzerland, the UK, and many other countries have much better health statistics than the US at a much lower cost. Do you regard these countries as dictatorships?

    And finally, Dr. Joyner, are you really satisfied with our current health system? Is it a source of joy that so many people are underinsured? Are you happy that this number is increasing?
    Do you have any solution other than “conservative principles”?

  30. James Joyner says:

    And finally, Dr. Joyner, are you really satisfied with our current health system? Is it a source of joy that so many people are underinsured? Are you happy that this number is increasing?
    Do you have any solution other than “conservative principles”?

    Our system isn’t perfect but, for those of us with good insurance, I think it’s better than any currently operating alternative. I’d rather pay for the poor and otherwise uninsured out of hide rather than blow up the whole thing to accommodate a relative handful of people. Offhand, I’d just make it easier to get coverage by Medicaid.

  31. just me says:

    just me, do you have any sources showing that WHO statistics underestimate US longevity and overestimate our infant mortality rate?

    here are a couple of links-it isn’t that hard to find given that this has been a noted problem for a while and one even the WHO admits is an issue that skews comparisons.

    link #1

    link #2

  32. just me says:

    Our system isn’t perfect but, for those of us with good insurance, I think it’s better than any currently operating alternative. I’d rather pay for the poor and otherwise uninsured out of hide rather than blow up the whole thing to accommodate a relative handful of people. Offhand, I’d just make it easier to get coverage by Medicaid.

    I completely agree with this. i see no reason to break something most are happy with, because some don’t have it.

    i do think some problems with healthcare aren’t a problem of insurance but a problem of real accessability. If you live in rural BFE you may not have a lot of doctors available if there is a doctor close by at all. There also does appear to be a real shortage of primary care physicians. I think it would be wise to change how we train and certify qualified doctors. Either encourage more doctors be trained each year, or better yet provide incentives for doctors to go into primary care and to open practices in underserved areas.