Monday, September 14, 2009

What Burke Has To Teach Liberals

Edmund Burke was an influential conservative thinker, but his lessons are particularly useful for Democrats trying to push healthcare reform. There is value in bringing about a universal scheme gradually. Actually, that’s probably the only way it can happen.

Universal coverage with a strong public option will be hard to achieve at one time, particularly now. Americans believe that a “government take-over” will take away their choices and worsen their care. People will not stand for such a swift change.

So what reformers can probably accomplish is to expand coverage and reforms of the private insurance market. Reforms which prevent companies from discriminating against people with preexisting conditions and allow consumers to buy across state lines for example will be popular. Democrats can also probably achieve subsidies for poor and working class families to buy insurance.

But then costs will still be a huge problem for businesses, families, and the government. So maybe in ten years when families are facing the prospect of losing their private insurance because it’s become prohibitively expensive, the government will have an easier time selling a public option as a way to keep costs under control for families. Reformers are trying to do that now, but the vast majority of Americans still have health insurance, and are satisfied with their coverage. I have a hunch they won’t be in ten years though.

So the struggle for universal healthcare will be a long one. Medicare and Medicaid were the first efforts in the 1960s. That was followed by programs like SCHIP in the 1990s. And sometime in the next decade or so, I think we’ll have universal healthcare with a government option. That just might not happen today. Burke would counsel patience.

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