Universal Coverage: Not a Right, Nor a Conservative Obligation
Tens of millions of Americans lack health insurance. Extending coverage to them has been a core goal of health reform proposals since the 1960s. President Richard Nixon offered a universal health plan in his first administration, but since then Republicans have hesitated to commit the nation to so costly an undertaking. Is it time to rethink? Should Republicans accept universal coverage as a goal? We posed this question to NewMajority’s contributors.
Should the Republican Party endorse the concept of universal coverage in health insurance? No, of course not.
To insist upon guaranteed universal healthcare for every living person in America is to insist that healthcare is a universal right, which it is certainly not. If it were, then all Americans (especially conservatives) would be moved by the Declaration of Independence—which reminds us that government was instituted to “secure these rights”—to demand nothing less than socialized medicine. But, once again, it’s not.
Begging the main question also invites a brief reflection on (among other items already covered in this symposium) the difference between the Republican and Democratic parties, and American conservatism and liberalism. It will help to explain why the right should not champion—or necessarily deride—the concept of universal care.
In general, the GOP is the party of liberty; the Democrats are, more or less, the party of equality. Freedom is our alpha value, fairness is theirs. It is the conservative movement’s deep commitment to human freedom and the conditions that preserve it that animates and binds Republicans. Thus, we wholeheartedly endorse the idea of equality of opportunity as strongly as we oppose forced equality of outcome.
But when conservatives frequently and proudly brandish the GOP as the party of small government, they are actually a bit mistaken. After all, the United States government is very, very large and is (rightfully) not challenged by conservatives with the animus of say, libertarians or anarchists. It would be far more accurate for the right to describe themselves as defenders of limited government.
This truth requires Republicans to fulfill two roles. First, the right must be a firewall, standing athwart the flames of liberalism yelling, “Too big,” “Too expensive,” “Too intrusive,” or simply, “No!” The second role is that of superior manager, commanding restraint and demonstrating expertise where the left would otherwise parade excess and clumsiness. Either function can be achieved even while out of power or in the minority ranks. In the current healthcare debate, the right can and must serve both.
Conservatives are right to totally oppose the public option, which even the left admits is an inevitable road to a single payer system, which itself is an outright affront to free enterprise, the Constitution, and much more. David Frum recently called it our “line in the sand” which, now judging from the chatter here in Washington, appears unlikely to be crossed. Thus, now on the brink of the collapse of President Obama’s health care hopes, Republicans must responsibly rise to the occasion.
We on the right can still win the healthcare debate, and we can do so without retreating from all that we stand for. Getting behind a co-ops plan is one such way to do this. The left’s attack on the free market (via the public option) would be averted, and our values would indeed be the major foundation of a plan that exhibits conservative openness toward powerful but principled government aid.
Whether a health insurance co-ops plan ala Romneycare in Massachusetts materializes and is able to pass through Congress remains to be seen. But if it does, it will be because conservatives chose to be proactive in defense of the free market, a primary obligation, of which scratching for universal coverage is not.
To read other contributions to this symposium, click here.