Single-payer healthcare is back on the radar after the collapse of Trump’s attempt to “repeal and replace” the ACA. Senator Bernie Sanders announced that he would be introducing a “Medicare for All” bill soon. While pollsters have known for years that a majority of Americans support single-payer, universal heath care, including many Republicans, the conservative case for it hasn’t received much attention.
Conservative pundit David Frum writes:
“Whatever else the 2016 election has done, it has emancipated Republicans from one of their own worst self-inflicted blind spots. Health care may not be a human right, but the lack of universal health coverage in a wealthy democracy is a severe, unjustifiable, and unnecessary human wrong. As Americans lift this worry from their fellow citizens, they’ll discover that they have addressed some other important problems too.” (http://pnhp.org/blog/2017/03/28/can-more-republicans-support-single-payer/)
The problems Frum lists range from hindered entrepreneurship, the struggles of the white working class, and a lack of racial equity. While not all of these problems weigh equally on the minds of conservatives, the understanding that universal health care coverage will make other goals easier to achieve.
Avik Roy of National Review argues that Republicans must “come to agree that it’s a legitimate goal of public policy to ensure that all Americans have access to quality health care” and that it is a mistake to “cede this moral ground to the Left”. He continues: “To credibly advance this approach, conservatives must make one change to their stance: They have to agree that universal coverage is a morally worthy goal…Ensuring that every American has access to quality health coverage is a legitimate goal of public policy, and it can be done in a way that expands freedom and reduces the burden on American taxpayers.” (http://www.nationalreview.com/corner/368772/conservative-case-universal-coverage-avik-roy)
Many past arguments against universal healthcare have revolved around a dislike of larger government, and the burden on taxpayers Roy mentions. In his article in IVM, Craig Burlin argues that neither of these have to be a reality in order to accomplish something along the lines of “Medicare for All”. He points out that:
“Unless someone is very poor or disabled and likely receiving disability or Medicaid benefits already, the tax base can be broad. This could be via a transaction tax, meaning everyone would pay including the underground economy and those who are at an age where they might forego coverage. The insurance pool would therefore be 100%, an actuarial benefit.” (https://ivn.us/2016/03/04/conservative-solutions-to-universal-health-care/)
He also references Australia’s system in which nearly half of the population retains private health insurance despite being entitled to free treatment, saying “Those of greater means can always afford things others cannot”. Burlin also argues the moral stance, similar to Frum and Roy saying that “There is a compelling argument to be made that basing medical care entirely on the profit motive is likely going to produce the kinds of winners and losers that are hard to justify on an ethical basis.”
While such arguments from the right are unlikely to convert Republican Congress members any time soon, there’s evidence to suggest that movement is possible.