When it comes to health insurance in America, the GOP has plenty of criticism but is bereft of substantive solutions. While there are some good suggestions, such as tort and malpractice reform, we have failed to address the immediate and pressing issue of 28.9 million uninsured Americans. Every industrialized country except the U.S. ensures universal health insurance for its citizens while a recent poll has 63% of Americans in favor of universal healthcare. The oft-repeated cliche that “we are on the wrong side of history” regrettably applies to health insurance in America. Universal healthcare is an idea whose time has come, while many members of the GOP believe any government involvement in health insurance puts us on the “road to serfdom” (ignoring Hayek’s stance on the issue). A Republican-led healthcare reform bill could not only provide universal coverage but would also prevent the pitfalls of single-payer or NHS-style systems.
American health insurance is far from the free market ideal; instead, it is a patchwork of different systems that preserves the worst aspects of both free-market medical care and “socialized medicine.” We have a single-payer in Medicare and Medicaid, a Beveridge model NHS system in the VA and the Indian Health Service, and for the rest of the nation, they have to fend for themselves hoping their employer has a generous health insurance plan. The United States spends 16.9% more on healthcare than any other Organisation for Economic Co-operation and Development (OECD) country and has nothing to show for it. Yes, we have some of the best hospitals and medical research in the world. However, we also have the lowest life expectancy and the highest suicide rates amongst OECD countries and, most importantly, the highest number of preventable hospitalizations and the highest rates of avoidable deaths. The American healthcare system is also one of the most complex and bureaucratic systems in the world with vast amounts of money being used to sort out claims amongst the various health insurance providers. Bureaucratic nightmares and preventable deaths are not conservative principles and can be easily fixed by comprehensive reform that makes our system more free and effective.
Otto von Bismarck, the arch-conservative statesman who created modern Germany, recognized that providing health insurance to all not only fulfills the dictates of “practical Christianity” but helps to strip away the appeal of socialism to the working man. The Bismarckian system is largely in place today. Germany mandates that all of its citizens buy health insurance from over 400 regulated non-profit sickness funds. The federal government makes regulations and provides tax subsidies while states, employers, and individuals split the cost. The multitude of statutory health insurance (SHIs), which are similar to insurance companies but are non-profit, allows for competition with firms “offer[ing] a range of deductibles and no-claims bonuses.” Bismarck’s social reforms were the inspiration for most of our welfare state policies and it fits well with our existing system of employer contributions. Combined with overall better health outcomes and lower spending on healthcare, the German experience, along with most European healthcare policies, shows that we can have universal coverage with more regulation or less innovation than the United States already has while simultaneously spending less and providing healthcare to the entire policy.
Republican-led drive for universal healthcare would thwart the appeal of socialism and ease the burden of the disadvantaged in our society. A true conservative should not be reluctant to use the power of the state and the forces of the market to serve the interest of all classes in the nation. A healthy and electorally viable Republican Party will see universal healthcare as keeping in the best traditions of Bismarck, Disraeli, and Roosevelt, which seeks to use social policies to strengthen our country and the family.
