Sullivan: Conservatism and Health Care

Andrew Sullivan of The Daily Dish offers his version of a true conservative proposal on health care reform.

But the deepest reason for reform is fiscal. No serious plan to reduce deficits without hugely increasing taxes excludes healthcare savings. There's no way to get from spiraling debt to stable public finances without tackling the exponentially rising costs of healthcare. So this is a fiscally conservative issue.

Instead of pulling a Palin, conservatives should propose real reforms: ending the tax exemption for businesses; medical malpractice reform; an independent body to provide some kind of data on the relative effectiveness of treatments; incentives to reward doctors less for any and all services provided than for health outcomes within clear budgets. This, actually, is not far from the Romney model, as the NYT notes today. Real conservatives should point out that the current proposals are not tough enough on costs - and criticize Obama for that, not for fantasies like a communist takeover or euthanasia program for special needs kids.

I've come to accept that the fiscal and economic costs of the current system, however wonderful it has been for a few decades, simply cannot be sustained much longer. I say that not because I have become a socialist, but because the US is on the brink of the kind of bankruptcy it will be very hard to recover from if we do not tackle its source now. Taking measures to avoid fiscal collapse even greater than today's is a conservative impulse. Letting one sector of the economy destroy the rest of it - and public finances too - is sheer recklessness. What do you want, GOP? A permanent populist culture-war? Or actual solutions to pressing problems? Let us know when you've matured enough to answer that question.

--Ballard Burgher