Mandates vs Single Payer

Let me ask fellow conservatives a question: Would you be in favor of replacing single-payer education with the individual mandate (aka, school vouchers)? Or reforming single-payer Social Security with an individual mandate to save (meaning, you *own* your retirement savings, can bequeath them to your children, can choose to move it to companies giving a higher yield, etc.) Because as a conservative I’m all for that.

The Republican party has done both its members and its mission a disservice by spending the past few years speaking out against the healthcare mandate as some form of liberal conspiracy, when in fact it is a conservative position invented by conservatives. The party has been putting the short-term interest of eliminating Obama over the long-term best interests of citizens. And I say that as someone who ran for public office as a Republican, so I’m not doing myself any favors by pointing it out, I’m just being honest.

Healthcare, education, and a few other fields simply do not obey the same laws of economics as oranges and iPods. Your lifetime earnings aren’t going to be seriously dented if you don’t get an XBox. You aren’t going to die if you don’t get a pair of Nike’s in time. This isn’t some kind of controversial position (except to politicians who find facts inconvenient). It’s been standard knowledge in freshman economics textbooks for decades.

Here’s reality: with healthcare costs projected to climb for decades, and with insurance companies increasingly booting people to avoid having to pay, *some* form of healthcare reform was inevitable. You can either go individual mandate, or single payer.  There is no 3rd option.  So if the individual mandate were struck down, we would have been ultimately left with single-payer healthcare, and you can see how good single-payer has been for education and retirement.

Education can primarily be judged by a) quality and b) cost. But measuring quality is hard and takes years, while measuring cost is much quicker and easier. Given that, in a single-payer system politicians often cut quality because the consequences won’t be evident until they’re out of office tomorrow, whereas raising taxes or cutting services gets voters riled up today. That’s one of the reasons why America’s education system has dropped to 25th in the world, behind such intellectual heavyweights as Latvia and the Slovak Republic.

An individual mandate preserves your freedom of choice. It only requires that you do something instead of nothing. We require kids get an education, whether public, private, or home school. You don’t have the right to *not* educate your kids because uneducated kids are a burden both on themselves and on others. Uninsured people impose similar costs.

And that is key to understanding why the pure free market solution doesn’t work.  If you don’t buy an XBox, it doesn’t affect me.  If you don’t educate your kids, or don’t buy insurance and end up sick, your failure *does* affect me, because my taxes have to pay for it when your kid goes to jail or you go to the hospital.

Having said all that, I prefer a mandate in the form of HSA’s and catastrophic insurance, but the anger conservatives have towards this is irrational, and seems to derive more from a dislike of Obama than a sober deliberation of the policy itself. It’s a “cut your nose off to spite your face” reaction.

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