LIBERTY, EQUALITY, HEALTH CARE

 

Copyright © 2009 by Jim Hull

(Please cite the author if you quote from this work)

 

 

Recently, Roger Cohen wrote a thought piece in the New York Times about the puzzlement many Europeans feel about American hostility to government-run health care ("The Public Imperative", October 4, 2009). He points out that Americans clothe themselves in certain myths about individualism, myths that may run counter to notions of mutual cooperation and charity. Mr. Cohen came down strongly on the European side: "A public commitment to universal coverage is not character-sapping but character-affirming. Medicare did not make America less American. Individualism is more 'rugged' when housed in a healthy body."

The reason Europeans -- and, perhaps, Mr. Cohen -- don't understand American objections to government health care is that most European nations have political goals that are fundamentally different from ours. Cohen's article asserts that Europeans have fought devastating wars over money and class, and so they much prefer the calm of political and economic equality to the risks of, as he puts it, "unfettered individualism". America, on the other hand, was founded on the principle of individual liberty as a reaction to the overweening authority of the British Crown. Our Declaration of Independence and Constitution speak again and again about freedom. Equality -- political, not economic -- is seen as the chief means of obtaining that freedom. (We are all "created equal" before the law, not before the bank.) This is very different from European attitudes, where equality itself can be seen as the more important principle.

Over the decades, though, Americans have traded in their liberty, bit by bit, for bigger and bigger government entitlement programs, until today we are little more than a bad copy of a European state. All that's "left", it seems, is to finish off the unique ideal of American liberty by putting in place the last big unused section of European welfare states, government-run health care.

People protest that we can't let anyone among us suffer from lack of medical insurance. Let's assume, for the moment, that this is a valid point. How, then, can we best solve this problem? With government programs? Characteristically, these are badly managed, much more expensive than private alternatives, non-innovative, fraught with long waiting lists, and corrupted by special interests. On the other hand, how about removing the restrictions and rules that fetter medicine? And, while we're at it, let's disable the massive corporate cronyism between pharmaceutical companies and the AMA and Washington. We haven't even tried market reforms in medicine, but the populists argue that they've already failed to work.

What about charities? Can they handle the load? Most on the left say this would never work because people wouldn't donate nearly enough to provide for the poor. But that's like saying, "Now that we've already taken half your income in taxes, how come you're not making more donations? You must be selfish and venal, people, so we're going to tax even more of your dwindling income and distribute it as we see fit. Oops, we have to give it to the richest lobbying groups, not to the people who need it most. But that's politics."

Sometimes the health care debate is couched in terms of "caring people versus greedy people". That's not the problem at all. The problem is how to help the needy, not whether to do so. Market-based reforms and -- with the money we all could keep from reduced taxes and innovation in medicine -- greater participation in charitable giving will solve the problem vastly better than a bloated bureaucracy, one that becomes deaf to your problems but has exquisite hearing when the lobbyists speak.

Our century-long experiment with increasing entitlements has taught us to distrust our own charitable instincts and to be wary of any solution that isn't mandated, that isn't forced on everyone to make them "do the right thing". Our souls have shrunk as we've infantilized ourselves with our dependence on the Nanny State.

John Steinbeck wrote something appropriate to this discussion. Of course, he would spin in his grave if he knew I was quoting him on behalf of a fiscal conservative's arguments. Anyway, here is the quote: "A sad soul can kill you quicker, far quicker than a germ." Every time we run to the government to save us from our problems, including health care, we give away a little bit of our American spirit. We may yet decide to add health care to the lengthy list of obligations we force upon ourselves. But no doctor, federal or otherwise, can cure our souls if we've given them up.

Where were we? Oh yes. In America, in concept at least, liberty is fundamental, and equality before the law is the means to that end. In Europe, equality is fundamental, and liberty is a pleasant side-effect of democratic reforms. With government-run health care, then, America would cut out its own heart to save it.
 

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