As I see it now the only people who benefit from American health care are those directly in the health care industry, especially hospital administrators and health industry executives, and the people independently wealthy enough to never have to worry about cost. The other 90% of us, insured or uninsured, are getting the short end of the stick. Even if you like your insurance, it is an objective fact that if you live in the USA no matter how good your insurance may be you are paying the highest prices for the lowest return. American health care is not the worst in the world in terms of quality, however in terms of cost effectiveness it is undoubtedly the worst, even below Ethiopia in the sense that Ethiopians get what they pay for on a dollar a day salary, whereas the USA would charge a hundred dollars for Ethiopian quality care by comparison if we are measuring on cost effectiveness, like we charge tens of thousands for what other developed nations get for mere thousands, and hundreds for what they get for tens.
Here are ten key conservative reasons to support single payer.
1. First, it is simpler than Obamacare.
Under single payer health services are funded out of general revenues, it would probably mean higher taxes in the short run but in the end it would all go to the same place, there would not be a massive myriad of regulations and subsidies. You pay taxes, you get health care.
2. There is always going to be rationing and paperwork anyway.
Economics is all about scarcity. There will always be rationing in health care. Currently America rations by taking some people out of the line completely through the uninsured. Finally, paperwork is going to be an aspect of every health system, in fact single payer systems have less than the American system due to their simplicity.
3. Government is accountable to the people, big health insurance companies are accountable to their shareholders.
There is a lot to hate about the government, but like it or not at the end of the day we still have the right to vote and change things in Washington. When you are dealing with a government health system you can petition Congress to change something you do not like. At the end of the day big health insurance companies are bottom line accountable to their shareholders, not consumers. Unless you can go out and purchase a huge number of shares, you ultimately cannot hold your health company accountable.
4. Government regulation of health care already exists and is not going away.
Some people say that a totally free market in medicine would reduce costs. It probably would, but politics is the art of the possible. The reality is that if we could go out and purchase any health treatment we want over the counter without FDA oversight and make licensing voluntary it would end up costing us a lot less. Some lives would be lost due to unlicensed medical personnel and addiction resulting from easier access to controlled drugs, however I believe that the number of people saved due to lower costs and access to drugs would outweigh the risks many times. I believe medical innovation would speed up. In the end though people would only focus on the horror story of how some kid got hooked on Miracle Drug X and killed himself, instead of the 10,000 people who were saved by the fact that government did not stifle it. Regulation would return. Were it politically possible to have true free market medicine I would support it, but it is not.
5. By holding costs down, it will save you more than enough to make up for any tax increase.
It is undeniable we may have to pay slightly higher taxes to pay for single payer in the short run, however under single payer there is a single negotiator for prices of drugs and medical equipment. It is a monopsony, the opposite of a monopoly. A monopoly has one seller and many buyers, thus it can extract a high price for purchases. Current health care is an oligopoly, which has a similar effect, as there are so few sellers as to make holding down prices unrealistic. However in the mirror image case one payer can command a lower price. In reality competition among insurance is actually a bad thing, since sellers can continue to jack up price by denying some services covered to some companies, and charge them what they want. In the end you spend a good chunk of your income on health care premiums anyway, and will do more so in years to come Obamacare or no Obamacare. In the end the reduction in what you pay will more than make up for any tax increase.
6. Ideologues are the main thing holding us back, and true conservatives ignore ideology.
Conservatism is by its nature a rejection of ideology, instead it is an attitude that rests on empiricism and responses to changing conditions, and generally holds a view of the world driven by reason and logic. In a nutshell, conservatives were always the cooler heads in the room, whereas liberals where pie in the sky idealists. Today the right has been hijacked by libertarian extremism. Note this is not ten reasons libertarians should support single payer, they never will b definition. It is about how libertarianism is not conservatism and never will be, "conservative ideologue" though repeated ad nausea in the media should be an oxymoron. Libertarians who hate any and all government by definition are holding us back from ideological reasons, appealing to a vague notion of freedom. However a more staid conservative approach is to recognize not all freedoms are equal. Thus the libertarian sees no differentiation between the freedom to use and abuse whatever recreational drugs one wishes and the importance of freedom of speech. Whether drug legalization is good or bad, the conservative recognizes that freedom of speech is a far more consequential freedom to defend than freedom of drug use. It is thus that the libertarian views restrictions on major medical corporations with billions of dollars as no different than the Soviets shuttering the shops of the kulaks, however the true conservative recognizes a huge difference. The conservative believes freedom is important, but freedom toward the ends of a decent society, whereas the libertarian embraces a nihilistic vision of freedom for freedom's sake. To the libertarian there is no moral difference between the liberty of Aristotle and the liberty of a massive health care company CEO or a drug abuser.
7. We have a religious moral imperative to do something about the uninsured, and charity is not adequate.
This next piece reflects in true conservatives, not libertarians. Conservatives of a moralistic bent recognize the importance of collective moral values, and one of those is the value of charity. If we are to be a Christian society then our primary concern must be living up to Jesus' ethic. When we get to the gates of Heaven I suspect St. Peter will be asking us what we did for the least among us, not what we did to keep taxes low and government small. In the end the whole "private charity will take care of it" thing is a cop-out. We already have lots of charity but it is not nearly enough to keep up with the massive demand for medical services.
8. The rest of the world is doing fine, including nations often touted by conservatives.
Conservatives often tout Greece as a reason to fear government programs, however there are lots of nations doing fine. The Greek debacle is complex and single payer will not make or break us. Canadians are doing fine with single payer. The UK, for all its flaws, is not a North Korean gulag yet that is what some on the far right will have you believe single payer will make us. The Nordic states are booming, as is Germany. More importantly Hong Kong, often touted by the right as the freest economy on Earth, has a national health service. Is Hong Kong a socialist hell hole. Meanwhile we spend more than all the rest of them, in combined public and private expenditures.
9. Around the world, conservatives are at ease with national health care.
In Britain conservatives vow to fight for the NHS. Even Margaret Thatcher herself was an ardent supporter of the NHS. In every European country the parties of the conservative persuasion have accepted the role of government in provision of health care and are at peace with it. Only in the USA of major industrialized nations is there a holdout. Why is this? I suspect it has to do with the fact that America is a large country and often ignores the rest of the world as a cultural matter. Finally I think special interests are too ingrained and what is often touted as a principled conservative stance is really just defending the special interests of big corporations to keep things exactly as it were. For however much the current system hurts the rest of us, a lot of people are making a lot of money on it. However if even conservatives are at peace with it elsewhere, from Canada to Europe to Israel to Japan, it may not be so bad.
10. The number one reason; it is competitiveness, stupid.
Government bungled health care by making the tax code in such a way that health care became seen as the employer's responsibility. As I explained before, government involvement in health care at some level is currently an accepted matter of life in the USA and an advancement to a truly free system is unlikely. Thus health care has become an albatross around the necks of American business. Finally, high health care costs are what Warren Buffett correctly described as a tapeworm eating away at the economic competitiveness of America. Everywhere in the world the government has lifted any responsibility for health care off the private sector, making it easier for businesses to compete. We may have lower taxes on average than the rest of the world, but we make up for it in health care costs. In the end American business is being saddled with this albatross. They may not like paying higher taxes, but may be receptive if it could mean removing concern about health care from their agenda. In the end it won't matter as businesses in other industrialized nations are competing at a higher tax level. An increase in marginal tax rates to fund health care in the USA will not make us less competitive on tax rates, since the USA is already a (comparatively) low tax nation.
Obviously libertarians will reject all this, but this is not aimed at people who confuse conservatism and libertarianism. Even if single payer health care were proven scientifically correct, I believe libertarians would still oppose it since their core principle is the minimum of government involvement, but conservatism's core principle is pragmatism.