Center-right parties in Australia, Canada, New Zealand, and the United Kingdom have all made peace with government guarantees of healthcare for all. These conservatives do not abjectly defend the healthcare status quo; they attempt to open more space for competition and private initiative within the health sector. But they accept that universal health coverage in some form has joined old-age pensions and unemployment insurance in the armature of an advanced modern economy. In this, their American counterparts are the true outliers. Before 2010, the United States provided the industrial world’s most lavish single-payer health system for citizens over 65—a hugely expensive and hugely inefficient system of tax subsidies for private insurance—at a total cost per U.S. taxpayer that was more than Canada spent on healthcare per Canadian taxpayer. And that system still left tens of millions uncovered and tens of millions covered but still exposed to large healthcare costs that they could not possibly afford. The pre-Obamacare American healthcare system was indefensible, and non-American conservatives are stronger for not having to try and defend such a thing.
These parties have updated for the 21st century their core message of respect for family, work, and community. None seek to police women’s sexual behavior or to impose restrictions on women’s reproductive choices. All have accepted gay equality, with Australia on the verge of a parliamentary vote to permit same-sex marriage. They are parties comfortable with racial inclusion and competitive with ethnic-minority voters—the Canadian Conservatives particularly so; people of Chinese origin are Canada’s second-largest non-white ethnic group, and in the country’s 2011 election, Canadian Conservatives won two-thirds of the vote among Canadians who speak Cantonese at home.