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The conservative case for single-payer health care

Guest post by Andrew Murphy

On the surface, the title of this article seems paradoxical. How can any conservative in the USA even contemplate the concept of the government creating a single-payer health insurance system covering all Americans and, in effect, ending private major medical health insurance?

In this post I hope to make the conservative case for a single payer incontrovertible for those occupying the centre-right politically.

Conservatives are supposed to be the defenders of business. Yet our current health care system works as an albatross around the neck of American business. Likewise, the piecemeal reforms of ObamaCare seem only to make some problems even worse. Hence it is only a matter of time before a single-payer becomes inevitable in this country. Therefore conservatives need to position themselves and come to terms with this eventual reality. And if history is a judge, many times it takes, say, a Nixon to go to China or a Clinton to do welfare reform. A Republican president may be the one who puts single-payer in place down the road.

The case for a single payer from a centre-right perspective is as follows:

The current burden on American corporations

According to the US Chamber of Commerce, group health insurance is the single most expensive benefit offered to employees. General Motors’ cost alone to offer health insurance yearly to employees is $5 billion dollars. To put it in perspective, health care insurance alone, adds $1,500-$2,000 to the price of each car that comes off the assembly line.

A RAND study from 2009 found that companies with higher levels of participation in employee health insurance benefits had much slower economic growth then those companies and industries which had lower health insurance costs or participation to deal with.

Let’s face it, health insurance is a drag on American competitiveness. Every major trading partner of the United States has some form of government-organized health care, so why do we continue to saddle American corporations like working donkeys with such expensive costs?

The burden to entrepreneurship

Americans pride ourselves on being the land of opportunity and of Horatio Alger. Yet the truth is social democratic Denmark now has higher levels of entrepreneurship than the USA. One primary difference between a Danish entrepreneur and his/her American counterpart is health care. Because of universal health care, a Danish worker with health problems can strike out on their own anytime and start up a business. Americans with health problems have to weigh the cost and benefit of leaving their jobs and decide if they can afford or even qualify for an individual health insurance policy.

Americans are more and more making working decisions based on health insurance. According to the Census Bureau, over 78 percent of all small business have no employees. Thus entrepreneurs in America are more likely to have to buy individual health insurance policies, which are usually more expensive and difficult to obtain than group health insurance.

The freest economy in the world has national health care

It is no secret conservatives and libertarians in the USA ♥ Hong Kong. After all HK has Ricardian free trade, low levels of regulations, no capital gains tax and an individual flat tax. Every year when the Heritage Foundation releases its Index of Economic Freedom, HK always tops the list.

However, HK has a dirty little secret. It has a very good national health care system. HK citizens have some of the highest life expectancies in the world but their government health care system only costs about three percent of their GDP to operate (a sharp contrast to the 20 percent of GDP that USA health care costs are expected to be in the next decade).

The point of the HK example is that this beacon of capitalism manages to operate the freest economy in the world while offering and providing a British-style national health service. if one listens to rightwing shock radio or the rhetoric of the Tea Party, it is impossible for that to happen. After all government health care would turn America into a giant Gulag Archipelago.

American conservatives are free to believe that a single-payer system in America will lead to a road to serfdom. Just don’t tell the citizens of Hong Kong, OK? You may embarrass yourself.

Happier workers for business owners

In many areas of America, words like “free trade” and “globalization” are fighting words. Blue collar America lives everyday with the worry that they will show up at work and find a sign saying, “Moved to China: See ya, Don’t want to be ya.”

Those workers are then left to scramble to find a job, usually for less pay and lesser benefits. In the meantime they go on unemployment insurance and hope they can pay their COBRA premiums with their unemployment pay and their spouse’s salary. (COBRA allows Americans to keep their former employer-offered health insurance if they pay the full cost once they leave the company. Typically, employers pay 50% of an employees health insurance premiums.)

Let’s contrast this to the Danish workforce again. When leftwing journalist Bob Kuttner traveled to Denmark, he discovered something very interesting (and probably fascinating since Kuttner is an advocate of managed trade). What he found was the Danish labor movement is completely at ease with free trade and globalization. Part of this is because of Denmark’s very proactive labor retraining policies; but some of it has to do with the fact that a Danish worker’s health care is not tied to their employment. So if a Danish worker’s job is outsourced to Poland, at least some of the pain is mitigated by not having to worry about losing health insurance.

If conservatives would like to take the teeth out of the American labor movement, what better way than to eliminated their fears about free trade and the free market by supporting a single-payer?

If it’s good enough for Margret Thatcher…

The name Margaret Thatcher is said with much reverence in the USA by conservatives, almost with the same love as for Ronald Reagan. Yet Lady Thatcher always supported Britain’s National Health Service(NHS). In 1983, for example, as she geared up for her re-election campaign, Thatcher said, “The NHS is safe in our hands.”

Rather ironic that if Lady Thatcher were to change citizenship, move to the USA and try and run for office as a Republican, she probably could not win a GOP primary. She would be denounced as a crypto-commie by Tea Party activists for having once supported “socialized health care.”

Thatcher– much like the other iconic conservative statesmen of the 20th century in Europe, from Winston Churchill to Konrad Adenauer to Ludwig Erhard to Charles DeGaulle– made peace with her country’s universal health care system. It is only in America where making peace with such an arrangement would be considered, “socialism” or “Marxism”.

The current system is unsustainable, a single-payer system is coming– it’s only a matter of time. Conservatives forget that health care is not an example of a perfect market. It is not the same as shopping for a car, choosing an airline or deciding which brand of cereal to buy. Health care is the quintessential example of information asymmetry (PDF).

If conservatives and Republicans can’t talk about these things, they will cede the issue to liberals and Democrats.