Even with all the major aspects of the Affordable Care Act now in effect, conservative criticism of the law is still here. Thirty-one million Americans are still uninsured. Many who signed up on the exchanges still haven’t paid their first premiums. All this is bolstered by the resignation of Kathy Sibelius, who oversaw the rough website rollout, which confirms for many how flawed the law has been.

But I have one huge piece of advice for conservatives: stop criticizing the law without a better way to reform healthcare. Criticism without an alternative will push the U.S. closer to a single-payer system, where the government owns and pays for everyone’s health insurance.

Despite some good the ACA has done, people will look for ways to fix its flaws when they’re constantly pointed out. If people on the right can’t give a solution, people on the left will propose a single-payer system. People will soon be able to point to Vermont, the state working to pass a universal coverage law by 2017, as a national model. The same way Romney’s Massachusetts healthcare law inspired the ACA, Vermont’s could do the same if it succeeds.

The answer to this dilemma is simple: The biggest issue in healthcare today that the ACA doesn’t address is the high costs compared to other countries. For example, angiograms on average cost $914 in the US, but only $35 each in Canada. This is the biggest factor driving up prices and premiums, making it harder for millions of Americans to get treatment.

The ACA tries to bring more people in the insurance market so their payments will better cover high costs. This is dancing around the issue of directly bringing down costs, though. If conservatives can fix this, the odds of single-payer reaching the U.S. are much lower.

The huge roadblock, however, is that there isn’t a real conservative answer to this yet.

The most common one I’ve heard is a free-market solution. But as much as I love the free-market, it doesn’t work on healthcare. Consumer options are limited by location, due to medical emergencies or the person not being healthy enough to travel, letting providers hold local monopolies on prices. Plus, when people see a service that’s expensive, they can’t just decide not buy it and wait for something cheaper like in a good free market — they need that service to stay alive.

If the choice is between emptying their savings and dying, people will choose the former. A desire for profits doesn’t drive down prices in America’s healthcare; it drives up prices for customers.

The liberal answer to the issue is single-payer, but conservatives are against it for many reasons. There are often much higher waiting times due to fewer companies chosen by the government providing services for many more people. The government also has total control on what healthcare it provides and which stays in the private sector. Plus, obviously, this system isn’t cheap. Vermont needs to raise $2 billion for its own system, while its highest tax only covers $624 million a year, so they’ll likely be getting a big tax increase, according to a April 9 Vox article. All this adds up to conservatives wanting a better alternative that keeps taxes lower and government smaller.

So the ultimate question is, what’s the conservative answer to lower healthcare costs? Some starting ideas are making physicians’ pay based on a salary instead of services they give, or setting maximum price limits based on the costs of services, just to start.

The only clear fact is that none will be totally free-market friendly. But if conservatives aren’t willing to make a compromise on free-market ideas in healthcare, in a few years there’ll likely be actual socialized medicine spreading from Vermont to the U.S.

Decide which choice is worse.

Max Antonucci is a junior newspaper and online journalism major. His column appears weekly. You can find him on Twitter @DigitalMaxToday or email him at meantonu@syr.edu.

Published on April 14, 2014 at 1:00 am