When I started this series, I wanted to systematically dismantle a myth that I’ve seen thrown in the faces of conservatives over and over. Specifically, I was inspired by a segment I caught on MSNBC, in which a panel of pundits were discussing the backlash to the Supreme Court’s ObamaCare ruling. The panel’s token conservative explained why conservatives aren’t just surrendering on ObamaCare. He highlighted a few of the policy issues with the health care reform law, pointed out its enormous cost and expansion of federal power, and began to explain why conservatives still think the law is unconstitutional.
It was at about this point that someone else on the panel cut him off with a smirking, “Please. The Affordable Care Act is a conservative law. You conservatives are just playing political games because you don’t like President Obama.” That’s not an exact quote, but that’s the gist of what he said. This is a myth that I’ve seen pop up repeatedly in debates between conservatives and leftists. One last time, here is the full myth:
“ObamaCare” is a conservative health care law whose main tenet (the individual mandate) was originally created by the conservative Heritage Foundation and proposed as a bill by conservatives in 1993. Now, a conservative-appointed Chief Justice leading a conservative Supreme Court has upheld that conservative law, and the only reason conservatives are so intent on attacking “ObamaCare” is partisanship/racism/political gamesmanship/fill in the blank.
In part one of the series, I explained that not all conservatives are Republicans, and that not all Republicans are conservatives, and that conflating the two is intellectually dishonest. So, while some of the accusations in the myth may be true of Republicans, they’re not true of conservatives. In parts two and three of the series, I looked at all eight of the myth’s individual claims and discussed whether or not they’re accurate. I determined that only one of the claims is clearly correct (that the individual mandate is the heart of ObamaCare), and acknowledged that one more claim (that the Supreme Court is predominantly conservative) could be arguably correct. I found that the other six claims are either flat-out wrong, or deeply misleading.
However, some liberals will argue that ObamaCare is still anintrinsically conservative law. This final defense of the myth relies on appealing to conservative support for personal responsibility and business.
Argument 1: ObamaCare promotes personal responsibility
The left loves to invoke this defense of the myth. Even President Obama himself often uses this defense:
“And the only people who may have a problem with this law are folks who can afford health care but aren’t buying it, waiting until they get sick and then going to the emergency room and expecting everybody else to pick up the tab. That’s not responsibility.”
Some leftist bloggers are a little more crude when explaining it:
“One thing that conservatives have been bitching about for decades is the unfairness of our society. …Why should people with medical benefits pay for people without medical benefits to get health care. Well, the liberals have solved this issue and the conservatives are still bitching about it.
…Under Obamacare EVERYONE pays for medical benefits. …The conservatives should be jumping for joy. Obama did the one thing that you guys have never been able to do and always bitched about… but you can’t stand the thought that a liberal did your work for you. So now you bitch about that too.”
Here’s one last liberal blogger. Sorry for the quotation overload, but this one gives a nice and full account of the argument, and I want to ensure that we understand the case being made in the myth’s defense:
“Personal responsibility is not only a conservative idea but a good idea. Those who can afford their own health care should because it shouldn’t be the taxpayers and those who do have health insurance to pay for everyone who doesn’t.
With the old system, when someone who doesn’t have health insurance shows up in an emergency room because of some unexpected health crisis, it means that everyone else paid for that person’s health care if that person can’t afford the out-of-pocket cost. With the new health care law, that individual will most likely have health insurance and if not, they’re at least paying a tax that will help cover the cost of their health care.”
To summarize, they’re arguing that the individual mandate forces everyone to be personally responsible to obtain health insurance. The idea is that people irresponsibly decide to forgo insurance coverage, and that when these people get sick, they just go to the emergency room and incur huge costs for hospitals and taxpayers alike. Therefore, the mandate is a means to force Americans to be responsible for themselves.
I’ll concede that personal responsibility is beloved by conservatives and that it can be referred to as a “conservative” idea. However, this whole conception of “the individual mandate promotes personal responsibility” is grounded in an enormous misunderstanding of our health care system.
Let me put a question to you: Why is it that people know that they can skip buying health insurance, and that if they get sick, they can just go to the emergency room at the last minute for life-saving treatment? It hasn’t always been that way. Isn’t that a little strange, isn’t it a perverse system of incentives in our health care system? Who made it that way? The answer is the federal government.
In 1986, Congress passed the Consolidated Omnibus Budget Reconciliation Act (COBRA). As part of this law, Congress also passed the Emergency Medical Treatment and Active Labor Act (EMTALA). Simply put, EMTALA is the cause of the problem. I’ve written on this subject before, so allow me to quote myself in explaining the EMTALA mandate:
EMTALA mandates that hospitals provide emergency screening and stabilization care to those who present themselves at the emergency room, regardless of citizenship, immigrant status, or ability to pay. This mandate applies to every hospital that accepts federal payments on behalf of Medicare beneficiaries. In effect, this means that virtually all hospitals fall under this mandate.
Yes, the federal government created the “free rider” problem that leftists are now clamoring for the federal government to solve by increasing the power and influence of the federal government. Makes sense, right? The EMTALA mandate destroyed personal responsibility, and now the left wants to use another mandate to force Americans into buying health insurance in order to fix the problem that government mandates themselves caused in the first place.
By the way, the EMTALA mandate was also an unfunded mandate, which caused the cost-shifting that the left is complaining about. If you’re curious and you want to learn more about EMTALA, I would recommend this excellent article by health care policy expert Avik Roy.
Here’s a novel idea: Let’s get rid of these onerous government mandates and promote personal responsibility in a free society with a patient-centered health care system.
Argument 2: ObamaCare is good for business
This argument relies on another misunderstanding of conservatives. It goes all the way back to the early days of progressivism, and the demonization of “robber baron” capitalists and corporations. If you’re interested in the subject (and why the progressives got it wrong), I’d advise you to look into a book by Dr. Burt Folsom of Hillsdale College titled, “The Myth of the Robber Barons: A New Look at the Rise of Big Business in America.”
Anyway, the argument goes like this: “Conservatives are pro-business. (More pejorative versions of the argument will claim that conservatives love greedy corporations or something like that.) ObamaCare’s individual mandate will give private insurance companies tens of millions of new customers. If ObamaCare were a liberal or progressive health care law, then it would have created a single-payer system or at least a public option. Instead, it’s a boon for private business, which gets all of these new customers (who will mostly be young and healthy) in exchange for a few piddling regulations that they really should’ve been following anyway.”
I won’t get into the wisdom of those regulations right now (primarily guaranteed issue and community rating, I think they’re a bad idea), but I will take umbrage at the rest of the argument. Here’s the misunderstanding: Conservatives aren’t blindly pro-business.
Conservatives support free markets. While a lot of businessmen will pay lip service to maintaining a free market, few would resist the temptation to take a subsidy from the federal government, or to use federal regulations to create heavy barriers to entry in their market, thereby restricting competition. Indeed, many businessmen whose industries receive plentiful support from the federal government are terrified of free markets.
In reality, conservatives are pro-entrepreneurship, not pro-business. We want there to be as few barriers to entry to markets as possible. Take heed once more of the difference between Republicans and conservatives. Many Republicans do cozy up much too closely with corporations and use the power of the federal government to help their friends, but these are not conservatives.
Think of the conservative Tea Party. The Tea Party began as an outpouring of conservative anger over the Bush bank bailouts, and then the Obama bailouts, and not to mention the various stimulus packages. If conservatives love it when the government forcibly transfers wealth to corporations, either through bailouts or the individual mandate, then why would the Tea Party have even begun? It doesn’t make sense. Conservatives don’t want the federal government to give insurance companies a massive handout, so this defense of the myth also falls flat.
I believe that I have discredited the myth that “ObamaCare is a conservative” law. If you disagree, feel free to comment below, I always welcome debate on this blog. In reality, ObamaCare is a law that appeals to few people in its entirety. Its violations of individual liberty horrify conservatives, and its gigantic handouts to business anger liberals and progressives. Perhaps that’s why a majority of Americans continue to oppose the president’s health care reform law. Conservatives must continue to fight for full repeal of ObamaCare, and we must replace it with affordable, patient-centered care.