I missed this post by Andrew Sullivan from a while back.
One reason I’m a conservative is the British National Health Service. Until you have lived under socialism, it sounds like a great idea. It isn’t misery – although watching my parents go through the system lately has been nerve-wracking – but there is a basic assumption. The government collective decides everything. You, the individual patient, and you, the individual doctor, are the least of their concerns. I prefer freedom and the market to rationalism and the collective. That’s why I live here.
Andrew, of course, is a British citizen, who was born and raised there but has been living in the US for a long time now, so his perspective is certainly worthwhile.
Now I’ll be the first to admit that this is mere anecdotal evidence which does not prove anything. Andrew Sullivan’s healthcare experience has been better in the US; there are obviously British citizens who prefer their system. However as long as we keep the anecdotal nature of this statistic in mind, there is nothing to lose by considering it. Indeed, I get the idea that a lot of dyed-in-the-wool liberals who have lived in the US all their life automatically assume that everyone who has lived in single payer prefers it. Quotes like these may at least help them open their minds to the truth.
For the truth is much deeper than that little quote by a popular blogger. Yes, the US healthcare system sucks in many ways. However any system of government mandated healthcare has fundamental drawbacks. Excessive regulation adversely affects medical research and the quality of healthcare provided. It encourages the passage of nanny-state laws designed to compel people to stay healthy. Even the claimed reduction in costs does not necessarily happen in all cases; see this article on the Massachusetts mandate. Above all there is a moral issue — a government mandate involves coercive takings and elimination of choice.
My personal preference leans towards “freedom and the market”, as Sullivan puts it. If the government has to be involved it should do so in the following ways:
1) Change the nature of regulation to light, smart ones designed to reduce costs (those associated with litigation, inefficient record keeping, bureaucratization, compliance with unnecessary rules), increase transparency/information disclosure and foster competition.
2) Replace Medicare etc. with a system of vouchers that can be spent on any health provider.
3) Retain one catastrophic government run health insurance system with a high deductible that would cover everyone in case of emergencies and other catastrophes and deal with the free-rider problem in those situations; eliminate all other government insurance schemes.
These measures are influenced by Milton Friedman’s views, espoused among other places in this article.