The Corner

Disrupting Health Care

Ross Douthat, after ruling out the tumbrels for me, concedes the case for gradualism in free-market health-care reform. But he also thinks that I underplay the political merits of making the case for disrupting current health-care arrangements. First, he points out, any reform is going to involve some acceleration of the shift away from employer-provided coverage and therefore we should not engage in a rhetoric that denies this fact or implicitly portrays it as terrible. Second, he thinks Republican politicians need to be jolted out of their attachment to the status quo. Once they embrace the case for free-market reform it will be time to explain that it should be pursued moderately.

I agree that conservative health-care reformers (and, I suppose, other kinds of reformers) should not deny that employer-provided insurance is eroding or portray that erosion as a calamity. Where we may differ is that I would not do a lot of celebrating of that fact, either. I think the right way to think about reform, given the way people get health insurance today and their reasonable concerns about change, is that employer-provided coverage is eroding, that this development presents some problems, but that there are ways of making sure that people will be able to pay for health insurance even as it happens. Since I think that’s the right way to think about reform, that’s also the way I’d recommend talking about it. I’d make the case, that is, in terms of conservative realism rather than libertarian utopianism. 

As for change-averse politicians, I think they are more likely to come on board if they see that free-market reform doesn’t have to take the form of a big bang, and if they can sell it to their constituents that way.

Ramesh Ponnuru — Ramesh Ponnuru is a senior editor for National Review, a columnist for Bloomberg View, a visiting fellow at the American Enterprise Institute, and a senior fellow at the National Review Institute.

Most Popular

Culture

Road Trip

EDITOR’S NOTE: The following is Jonah Goldberg’s weekly “news”letter, the G-File. Subscribe here to get the G-File delivered to your inbox on Fridays. Dear Reader (Especially future contributors to my GoFundMe page), I am currently in the passenger seat of our family fun mobile, passing mile marker ... Read More
Politics & Policy

Answering my Critics

My post on Elizabeth Warren’s cynical/bonkers proposal to effectively nationalize every American firm with revenue of $1 billion or more has met with predictable criticism. I will address two points here. One, some have complained about the use of the word “expropriation,” or more broadly about ... Read More
Books

The Maker of Middle-earth, in Gorgeous Detail

Oxford, England — After five months of ferocious and futile slaughter in “the Great War,” an Oxford undergraduate — knowing his deployment to the Western Front was inevitable — used his Christmas break in 1914 to cultivate his imagination. Twenty-two-year-old J. R. R. Tolkien began writing “The Story ... Read More