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A New Health Safety Net

by David Goldhill

National catastrophic coverage should complement markets

Are conservatives ready to think about health care independently of Obamacare? Because even if the Affordable Care Act achieves its goals, American health care will remain extraordinarily expensive, incomprehensibly complex, and inaccessible to millions. The Left is largely unified around the idea of eventually implementing a single-payer system — a type of “Medicare for all.” This approach is at least superficially attractive: Single-payer countries seem to adequately meet the basic health-care needs of all their people with much less complexity and at lower cost. On the right, the widespread assumption is that the ACA mess should be replaced by — what, exactly?

What most conservative ideas have in common is a preference that the private sector take on responsibilities increasingly assumed by government. In theory, there is also much that is attractive in this approach. Unfortunately, though, the idea that private is preferable runs contrary to most Americans’ experiences with health care.

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