Why do some conservatives seem to favor increasing both health care costs and taxes?

I do not mean this to be a rhetorical question. It seems to me that conservatives who are opposed to allowing Medicare to negotiate, as a whole, for discounted prices on pharmaceuticals is a deliberate attempt to increase the cost of the program. Similarly, the opposition to expanding Medicaid to cover the homeless, or other folks without health insurance is a deliberate attempt to increase health care costs.

It is well known that people without insurance tend to wait longer to get care, and when they do get care, it is in the most expensive fashion: the emergency room. Since ERs can not turn anyone away, and they must keep on providing health care until the person is healthy enough to be discharged, we can say that all health care is provided for all people living in this country.

What results when people can not pay for health services is called “uncompensated care.” Hospitals get paid for uncompensated care in two ways. First, they charge those who are privately insured more. The insurance companies then raise insurance premiums to cover the higher rates they pay for hospital services. Second, hospitals receive what are called “disproportionate share” payments from the government. These are additional funds under the Medicaid program for hospitals that have a higher burden of uncompensated care.

Yet many conservatives are opposed to programs that expand health insurance coverage to those who can not pay. In essence, this position favors increased taxes and increased private health insurance rates.

Now the politicians can’t all be in the pockets of the health insurance industry, although many of them are. A lot of this opposition to expanded coverage is ideological in nature. It is an article of faith about the value of “competition,” even when there is and can be no free market.

However, most conservatives say they are against higher taxes, and for increased efficiency. Yet opposition to expanded coverage results increased taxes and lower efficiency.

What gives? These are well-known facts. Certainly, the link is indirect and understanding cause and effect requires a complex understanding. However, in general our Congress critters are well-educated, and can understand complex issues if they wish to. I honestly can’t understand how conservatives are thinking about this. It must give them an extraordinary feeling of cognitive dissonance. How can they reconcile their positions when these positions violate their basic principles so strongly?