Four paradoxes of health care reform: Conservatives can take moral and political high ground

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Polls show that Americans trust Democrats more than Republicans on health care more than any other issue. However, they also show that consistent healthcare solutions, such as price transparency and increased choice and competition at lower prices, are popular.

This shift has led to common wisdom among the health care reform community – that Americans will become more loyal consumers if we talk more about our marketplace and state and local policies to make care and coverage more affordable.

We agree that Conservatives should not avoid discussing health care, but opinion polls conducted by our two organizations this summer suggest that a message that focuses too much on market support and savings will backfire.

What Americans want from health care is peace of mind.

What Americans want from health care is peace of mind.

First, while the American people support certain ideas of free market health care reform, it will alienate voters if we talk about health care as if it should be a normal commercial market. This is because health care is life or death – the stakes are too high for people to accept the power of the traditional market.


For example, in health care, there is little concept of “luxury.” When a new effective treatment comes along, it quickly becomes the standard of care. The idea that wealthy Americans can receive higher quality care than the middle class or the poor is anathema to what Americans want from the health care system.

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Second, Americans already believe that health insurance is too complicated, and the basic trade-off they are asked to make when choosing a plan, between paying higher premiums or risking more money, they feel compelled to gamble with their health and that of their families. .

Ultimately, what Americans want from health care is peace of mind. The concept of multiple options and customization of health insurance may be seen as adding to their stress and confusion and increasing health care inequity if it is defined solely by saving money rather than ensuring that everyone receives the care they need.

Third, this desire for peace of mind in health care helps explain why in our survey, the majority of Americans said they would prefer laws and regulations to be set at the national level to provide consistency and standards across the country. This is something we need to keep in mind while developing state and local health care solutions.

Fourth, although Americans give our health care system low marks on many measures (quality of care is different), they rate their individual care and coverage highly. Because of this, there is little support for immediate, large-scale health care reform.

President Barack Obama and Vice President Joe Biden during a health care credit event in the East Room of the White House, March 23, 2010.

President Barack Obama and Vice President Joe Biden during a health care credit event in the East Room of the White House, March 23, 2010.
(AP Photo/J. Scott Applewhite, File)

So, what should conservatives do? The answer is not to abandon our values ​​and embrace a big government socialist approach to health care. And it should not be shy and suggest only small tweaks to the system.

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Instead, conservatives should embrace the goal of ensuring that every American — regardless of income — receives high-quality health care at a price they can afford and use market forces to achieve it.

Fortunately, much of our agenda can be best described in those terms. For example, the ObamaCare and Medicaid programs are notorious for long wait times for appointments and small provider networks that often exclude the best doctors. The loosening of ObamaCare’s coverage rules will allow plans to specialize, partner with centers of excellence, and provide more Americans with the high-quality care they need. Providing a place for federal health plans, cost sharing, and direct contracting options will also empower more Americans to receive high-quality care at a price they can afford.


The same applies to the modification of the certificate of requirements rules that limit the number of health care providers in the area. We conservatives often talk about changing these laws to encourage competition to lower prices. We must also emphasize that it is the poorest Americans who suffer the most because of fewer providers, and reform will give more people access to care.

Conservatives would address the American people’s desire for consistency and standards in health care with clear national quality benchmarks but allow for regional and local interpretation and enforcement to avoid one-size-fits-all laws. The Section 1332 waivers and waivers the Trump administration has granted to states in response to COVID-19 provide possible models.

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Conservatives must also embrace the strategy that we at the America First Policy Institute have embraced, “radical incrementalism” – small but important changes that, over time, add up to big change.


Price transparency in healthcare is a perfect example. It’s a more than 90% acceptable problem that could dramatically change the integrated third-party payer system with all of its middlemen driving up costs and adding confusion. However, it will do so through the lives and time of patients and doctors making independent decisions, not through the designs of central planners in Washington.

The large government approach to health care is riddled with failures that increase health inequalities and cause more confusion and frustration. Conservative health care solutions that put patients and doctors back in control are the antidote to the chaos created by government. It is time for us ordinary people to take the moral and political high ground in health care by insisting that our solutions not only save money, but more importantly, save lives.



Bobby Jindal was the governor of Louisiana from 2008-2016 and a 2016 Republican presidential candidate. He is the chair of the Center for a Healthy America at the America First Policy Institute.


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