To begin, allow me to quote myself:
Politics in America is about two coalitions trying to remove different things from the realm of politics.
— Elias Isquith (@eliasisquith) April 2, 2013
That was a pretty popular tweet, at least by my standards. And when I wrote it I was thinking primarily about same-sex marriage, which is rapidly — and through no small amount of effort on the part of activists and Father Time — becoming the kind of thing that many people don’t see as having to do with politics at all. That’s a win for supporters of LGBTQ equality, even those who don’t particularly thrill to see the further embrace of what they see as an inherently conservative institution.
I must admit, though, that I think of this concept most often when pondering the arguments of those on the Right. And a new long-read from National Review’s Yuval Levin and Ramesh Ponnuru is something of a case-in-point.
Both Matt Yglesias and Kevin Drum do a fine job of disassembling Levin and Ponnuru’s plan, but I honestly don’t think it’s worth the time getting into, unless you’ve simply got a jones for health care policy arcana (an affliction I do not have and never will). The plan isn’t that different from Paul Ryan or Mitt Romney’s vision of America’s health care future. Less federally provided coverage, less taxes on the wealthy to pay for it, and a decent amount of magical thinking about how competition will clothe the naked, feed the hungry, and heal the sick.
What the plan doesn’t do is treat universal coverage as the end-goal of reform. This isn’t made explicit, because it’s a politically untenable position (“Die quickly” caught on for a reason), but it’s true. The conservative approach to health care privileges reducing costs over providing coverage. And in a way that’s fine. Sure, a lot of the handwringing over health care costs is simply handwringing over the prospect of having to pay more taxes to support the Baby Boomers; but someone has gotta worry about costs and just so long as we’re not talking warfare or upper-class tax cuts, that someone is the GOP.
As you can tell, however, I don’t really care about cost control. I think it’s a way overhyped concern that acts as something of a trojan horse for the weakening of the welfare state. (But like Floyd Gondolli says, that’s just me.) What I care about is the moral imperative, as I see it, for a wealthy nation to provide all its citizens with health care. I want a future where injury or disease isn’t a financial death knell; I want a future where people don’t need to worry about their health any more than they want to; I want universal coverage that’s as cheap for the patient as possible. That’s it. That’s the goal.
You could say a lot of things about my ideal. One thing you couldn’t say is that it’s the same as Ponnuru’s or Levin’s. Everything I’d focus on, the bleeding heart stuff, they’d rather not consider political in nature. For example, just as we don’t have long political debates over solutions to strangers acting passive-aggressive, seeing it as a problem government could not even begin to address, conservatives tend to argue as if providing full health care — not just insurance in the case of catastrophe — should not be a political concern.
Here’s how Drum puts it:
…about a third of the country, maybe more, just flatly can’t afford decent healthcare for their families. No amount of smooth talk about HSAs and tax treatment and catastrophic care will change that. So you can either pay for this coverage via tax dollars or you can let them go without, and chalk it up to nature red in tooth and claw.
Taking health care out of politics and putting it back into nature. That, in a phrase, is the GOP position on the issue. It’s similar to lefty attempts to take same-sex marriage out of the realm of the political — to make it an unimpeachable reality of society, too sacred to be sullied with debate and legislation. You could probably find better ways to explain American politics. But you could definitely do worse.
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