The Conservative Logic of Obamacare

Today from Andrew Sullivan:

For conservatives, freedom is always coupled with personal responsibility. Your right to be free from government interference is also an implicit statement that you can take care of yourself – and won’t at some point suddenly change your mind. This is the core of conservative libertarianism: an assertion of radical independence, responsibility and self-sufficiency.

In many areas, this makes perfect sense – but healthcare isn’t one of them. Disease and accident make no distinctions among us. And since 1986, hospitals have been legally required to treat anyone seriously ill who presents himself at an emergency room, with clear medical needs. In the most fundamental way, that was the moment the US socialized medicine – and Ronald Reagan signed the bill. Alas, like so many Reagan domestic initiatives, there was no federal money provided to pay for this. And we all know what happened next: all those extra costs for the uninsured drove up premiums for everyone else, drove up hospital costs, giving them a reason to raise prices even further, and played a role in rendering healthcare unaffordable for many others.

What Obamacare does, like Romneycare before it, is end this free-loading.

The law is telling these young adults that if you want to go without insurance, you are not going to make everyone else pay for it if your risk-analysis ends up faulty. You have to exercise a minimum of personal responsibility to pay for your own potential healthcare. In other words, rights come with responsibilities in a liberal democracy. At least that is what I always understood the conservative position to be.

And that's why Obamacare was the product of conservative think tanks and was, during the Clinton years, a position advocated by Republicans.

Incidentally, I could care less about Obamacare. I'm happy to consider any other policy alternatives that extend quality (including preventative) health care to all Americas. We are the richest nation in the history of the world. It's a moral failure that we have yet to make this happen. Shame on us.