On Health Care, a Time for Choosing

Obamacare by from First Things, October 31, 2013

The well publicized problems of Obamacare are a sign of both opportunity and a danger for conservatives. The dysfunctions of Obamacare (the premium increases even more than the website problems) will give conservatives a wider hearing for their ideas on health care policy. But there is a danger: If conservatives fail to offer alternatives to the failures of Obamacare, the left will be able to offer single-payer as the only viable alternative to the problems caused by Obamacare. Whether or not conservatives can offer an alternative will determine if Obamacare is the high point of government control of medicine or just another step toward a complete public takeover.

It is understandable why conservatives haven’t wanted to talk about health care policy (aside from the importance of blocking liberal initiatives) in recent decades. Republican-leaning voters are more likely to have health insurance coverage so health care policy seemed less urgent. Health care policy plays little role in the conservative narrative of the last fifty years. Conservatives remember Reagan for cutting taxes and confronting the Soviet Union, not for his adoption of a centralized Medicare payment system that probably drove up health care costs. The closest thing to a heroic health care story among conservatives is how William Kristol and Phil Gramm helped sink Hillary Clinton’s health care plan.

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