The health care reform bill signed into law this week by President Obama is significant and historic, but I’m having a hard time explaining to some of my more conservative friends why I’m not loudly denouncing it for its infringements on the market.

Conservatives are up in arms … livid. This is Tyranny and Socialism, they say, and Unconstitutional, to the point where some conservative state Attorneys General are filing lawsuits against the federal government on that basis. They may be right about its unconstitutionality. Liberals, on the other hand, say health care is a basic right and this is the US government’s acknowledgment of it.

I have to tell you, this one’s tough for me. I’m a libertarian, which means technically I don’t want the government involved in health care (and that’s also a tacit rejection of the claim that health care is a ‘right’). But the big problem with the conservative argument is this: government is already involved in a huge way! Furthermore, given that fact, this reform bill actually improves things somewhat. Let me explain what I mean.

In a libertarian society, all health care would be private, which means that most people would pay on their own or have insurance. Because it would be a true free market, it would be vastly more competitive than it is in America today. Prices would be much lower, and care would therefore be much more affordable. For the relative few who still really couldn’t pay, friends, family, health care loans, unemployment insurance, churches and charities, nonprofit pools and other things could bridge the gap. Doctors’ organizations would likely step in to make it easier to gain access to such care. It wouldn’t be a perfect system, and in that respect it would be like every other system that exists.

Health care in the United States, even before this bill, is very different. The biggest insurer in the nation is already the US government. Medicare and Medicaid constitutes government insurance for seniors and those with low income. Many factors push up the cost of care: frivolous lawsuits, government underpaying, regulations, complicated approval processes, lack of doctors, and – perhaps the most significant with regard to this discussion – people with no coverage at all get care from providers who know they won’t get paid, and who then pass on the cost to the rest of us.

In other words, our existing system already forces everyone else to share the costs of caring for those who can’t afford it. Insurance premiums are higher, hospital and doctor fees are higher. To every conservative who somehow feels that the new health care reform bill will be making them responsible for the first time for paying for the health care of others, you are failing to acknowledge that that’s the way the existing system works. This just formalizes it, and perhaps makes it more equitable.

We’ll now have a more even spread of risk and cost, and we’ll have some cost-controlling measures, and more people covered, and a system which actually intends to reduce the federal budget deficit, and a healthcare exchange for purchasing plans (which should boost competition), and much else.

Strictly, I have an ideological opposition to the government’s involvement in health care, but – in reality – it already was involved. And if we’re going to see the government involved, I don’t think the new bill can get my panties in a twist. In fact, it sounds like a vast improvement to me over the old system.

If you’re going to make health care a matter for the government, don’t do it half-assed; that’s the worst system conceivable. Give me an all-in system where health care is seen as a right, or an all-out system relying on pure market forces. The not-so-sureness we had before this bill was the worst system of all, and I certainly don’t want a system which leaves so many people behind.

So the reform bill will make things better. And that’s how a libertarian can (almost) welcome the health care reform bill.