If healthcare reform passes, conservatives are planning to mount a constitutional challenge to the individual mandate on the grounds that the federal government doesn't have the right to force you to buy a product from a private corporation. This is doomed to failure, and Ezra Klein argues that that's a good thing for conservatives themselves:
Long-term, conservatism could suffer no greater disaster than the death of the individual mandate. This country will have a national health-care system, and sooner than later. The cost pressures make that inevitable. If you want that national system to be private, as most conservatives do, then your only hope is the individual mandate. That's been true in countries such as the Netherlands and Switzerland, and in Singapore, which is often upheld as a conservative model, contributions to health savings accounts are compulsory. Eliminate those options from the U.S. menu, and you're ensuring that Medicare, Medicaid or some sort of public option will eventually take over the market, as there's no constitutional issue with taxation in return for public services.
Exactly right. The Swiss model is basically about as conservative as you can get among national healthcare systems, and if that option were taken away we'd inevitably end up with something more like France or Sweden or Canada. Which would be fine with me, but not so great for conservatives. In fact, it might be even worse than Ezra says: if the individual mandate were killed but the rest of the current healthcare bill stayed intact, the private insurance industry wouldn't last out the decade. We'd have Medicare for All by the end of Obama's second term.1
Of course, movement conservatives don't believe any of this. They don't believe in things like "adverse selection" because language like that comes from pointy headed liberal healthcare professors. (Though they might want to ask a few insurance company executives whether they believe in it.) And they don't believe that national healthcare is inevitable because they're convinced that our current Rube Goldberg system really does provide the best healthcare in the world and can continue forever without bankrupting us. Or something. I'm not really sure what they believe. I'm not sure they do either. But they sure know what they're against.
1Hell, maybe we liberals should join in the challenge. Go ahead and pass healthcare reform with the individual mandate, get the mandate tossed out in court, and then wait for private health insurers to collapse. Sounds like a pretty good plan. Too bad the court challenge would never work.