Elitism, Conservatism, and Health Care

Most of you know that before Obamacare became the greatest threat to American freedom in a generation, it was a conservative idea, developed by conservative think tanks as an alternative to a single payer system. David Frum has found lots of conservatives heaping praise on the system in Singapore, which relies on a mandate to buy health insurance and required deposits to private medical savings accounts.

Frum: "The hard part isn't having principles. The hard part is remembering them."

Which brings me to the debate in the Supreme Court over Obamacare. All the conservative justices were expressing grave doubts about the constitutionality of any mandate to buy insurance, a concern that never seems to have surfaced during all the years that the mandate was a conservative idea. It remains to be seen how they will rule, but if they do strike down the law, they will undermine not just any plausible case for the Republican party, but also the case for elitism.

Parroting the current dogma of your party is what I expect from semi-educated primary voters or politicians involved in the thick of partisan combat. But Supreme Court justices are supposed to be better than that. I don't believe in a non-ideological approach to the law, and I expect that every judge will vote his principles. But I at least expect that the better sort of conservative will have a long-term view of what conservatism is. Fulminating against Obamacare may be good conservative politics, but as conservative philosophy it stinks. It amounts to saying that solving the problem of getting health care to all Americans is forbidden to our government. Nay, it is forbidden even to regulate the insurance market in a sensible way. Other governments across the world have managed to solve these problems while spending much less money than we do, but we must sit on our hands while our costs soar and more and more people lose their insurance. What kind of governing philosophy is that?

If Supreme Court justices can't see beyond the momentary partisan fray and vote the long view, what is the point of having a governing elite?