I value the private healthcare system in the US, that, for all its faults, has innovated medicines that have saved my life.
And in response?
Almost everything Sullivan turns his attention to is filtered through the lens of “what is best for Andrew Sullivan?” More often than not, especially in the case of his writing on conservatism, that makes for some fairly interesting reading. With regards to policy though, this approach is terrible. The measure of a health care system isn’t whether or not it generates innovations which benefit Andrew Sullivan, it is whether or not it adequately serves the majority of health care consumers. And at this point, it’s virtually incontestable that that’s the case. Sullivan might understand this on an intellectual level but it has yet to pierce through his elitism, which at times makes for very frustrating reading.
It's not that this is technically wrong, but I think it loses a lot of its potency when it's directed against Sullivan's belief that he owes his life to current health care policies. I think you'd be hard pressed to find anyone who would say "I'd be dead if X policy wasn't in place, nonetheless, we should abandon X." That's asking a lot out of people.
"Gated community conservatism" is not always or even largely limited to cases like these. Mostly, "what's best for me" isn't "what keeps me alive" but rather is "what makes me marginally more comfortable while foisting huge costs on everyone else." PB's citation to the Ross Douthat/Ta-Nehisi Coates debate over whether our draconian crackdown on crime has been "vindicated by events" is a far better example: the persons behind the gates feel a little safer and a little more secure, and that's enough to justify massive intrusions on the safety, security, and liberty of poor and dark American citizens. But just as we might step more lightly when the speaker is someone who had been a crime victim themselves, I think we also might put on soft shoes when dealing with someone for whom the health care system status quo is not just mildly more convenient but literally life-saving.