Recently, some articles here on Redstate and elsewhere on conservative sites have noted the inevitability of universal health care for all. Bernie Sanders is taking the lead in this area. Some of my comments in response to these articles somewhat recognizes the inevitability of such a plan born of political realism, especially in light of the collapse of the repeal and replacement of Obamacare.
My primary argument is that if it is to become a reality in the not-too-distant future, then the GOP should get ahead of the curve. Recent polls show that the Democrats are winning the propaganda war as a majority of Americans now report a favorable opinion towards a single payer health care system. Unfortunately, it is also an indisputable fact that when the government runs something, it usually results in a bloated bureaucracy where CBO estimates are grossly off the mark. The Veterans Administration run health care system is an example while Medicare spending is not sustainable.
But before anyone rushes onto the single payer bandwagon, it is important that three points be made. The first is the constant comparisons to foreign countries that have some form of a single payer system and life outcomes. We are constantly reminded of how these countries have higher life expectancy, lower infant mortality rates, lower rates of substance abuse, lower rates of obesity, etc. This is an exercise rife with pitfalls.
A decent comparison would be the United States, which lacks a universal single payer system, against Canada which adopted such a system in 1968. In 1970, life expectancy was 70.8 years in the US which was roughly life expectancy in Canada. Today, life expectancy in the US is 79.3 years, or a 12% increase in 45 years. In Canada, the life expectancy today is 81.2 years, or a 14% increase- not that great of a difference despite the presence of a single payer system.
Instead, the slight increase in Canada on this metric can probably be explained by the ethnic/racial diversity in the United States, not the health care system. The United States certainly has a larger black population than Canada and blacks have a lower life expectancy in the United States- about 4.5% lower than a white person. To illustrate the nonsensical nature of these international comparisons, in India which does not have a single payer system, life expectancy increased from 45 years to 68.5 years today- a greater than 50% increase WITHOUT a single payer system. So international comparisons mean very little.
The more important point to keep in mind is the underlying premise behind universal single payer health care- the belief that healthcare is a right. The Left will tell us that we treat healthcare in the United States as a privilege because only the well-to-do can afford it. Conservatives will argue that healthcare cannot be a right since it is nowhere to be found in any of our founding documents unless one adopts, as the Left seems to do, a broad expansive reading of “LIFE, liberty and the pursuit of happiness.”
The Left will further trot out declarations adopted by the United Nations that healthcare is a right. These declarations hold about as much water as the statistics cited to argue for a single payer system. In short, the metrics are nice numbers and UN declarations are nice words, but both basically mean squat.
The fact is that healthcare is neither a right nor a privilege. It is a commodity or service. One can argue that there is a greater right to “food” or “water” since they are certainly more essential to LIFE than healthcare insurance. But I doubt that anyone caught shoplifting food from a grocery store can successfully argue in court that they had a right to food. Try not paying a water bill for a few months and see how far that right to water extends.
When our founders wrote in the Preamble of the Constitution the words, “…to provide for the general welfare,” they did not mean “provide the general welfare.” They meant that the federal government’s role was to lay the groundwork for the general welfare of the populace.
A single payer system certainly plays to a sense of pity, compassion, helping one’s fellow man, and of mercy which are all honorable attributes. But, neither are they rights. To show the nonsensical nature of this argument, in Canada they have a private insurance market which many people take advantage of given its relatively lower costs and purchasers tailoring a policy to needs not covered by the single payer system. What that private insurance does is move one up in the “queue,” or up in line for rationed services like elective surgery or a private hospital room. If healthcare were a right, then there would be no “moving up in the queue.” If it were a right, everyone would be treated equally regardless of having private insurance or not.
The third point to make is that if there is to be this big push for a single payer system currently being led by Sanders and the Democrats, let us on the Right put them to a litmus test to determine their sincerity and rationale for such a system. Would they be willing to cease funding Planned Parenthood and instead divert that $500 million annual subsidy to community health centers that far exceed the number of Planned Parenthood clinics and perform the same services as Planned Parenthood (in fact, probably more since they offer mammograms) except for abortion? No one is saying Planned Parenthood has to cease providing abortions; they just wouldn’t get federal money. Would Cecile Richards and the harpies on the feminist Left agree to such a provision in the interest of getting all Americans insured for the greater good and “general welfare?” My guess is that the non-existent right to an abortion will run headlong into the non-existent right to healthcare. My guess is that the Left will want their cake and eat it too. Let them explain why universal single payer healthcare is being held hostage by a billion dollar abortion provider.
Until that day arrives, conservatives should insist on free market healthcare reform ideas. They are out there today just as they were seven ago and many years before that.