Friday, March 26, 2010

Our Conservative Healthcare Reform

The fact that (nominally) serious conservatives are calling the healthcare reform bill “socialism” or “socialized medicine,” and that many people are still taking them seriously, shows that the U.S. is in dire need of a crash course in political ideologies.

Socialism in its orthodox form is summed up in Karl Marx’s dictum, “From each according to his abilities, to each according to his needs.” All means of production are owned by the people (read: the state), everyone works for the state, and the state provides for the needs of all the people. Socialism-lite, as practiced in many European countries, saddles its citizens with enormous tax rates, and provides them with everything they need for a “dignified” life – healthcare, college education, daycare, and so on and so forth – essentially restricting the free market to nonessentials.

What Obama’s bill does is require each American citizen to buy insurance from a private insurance company (except those on government plans like Medicaid and Medicare, and those who get insurance from their employers.) Those who can’t afford it receive money from the government to buy their private insurance plans. In turn, insurance companies are required to accept and cover all customers, regardless of preexisting medical conditions, and spend 80% of premium money on treatments for customers. Competition still exists. Choice still exists. Supply and demand still function. Doctors are still paid by customers, through insurance companies.

That is not socialism. That is a regulated and subsidized free market. Karl Marx is screaming from his grave right now. This bill is a huge victory for the bourgeoisie.

I long ago accepted the premise that in a country as rich as the United States, everyone should have access to education, food, shelter, and medicine. For me, access to healthcare, one of the most basic human needs, is a starting point for participation in a free society and a free market, not something you should be afraid of losing if you don’t perform. If you don’t agree, then I guess we’re just stuck. I don’t know what to say to someone who believes human life should be subject to the struggle of the fittest. Not to disparage your beliefs, of course, but the value of every human life is what we in the undergrad-philosophy business call a “presupposition” – you either accept it or you don’t.

But if you do believe that universal healthcare coverage is a good goal, there are two ways we can go about it: have the government take over healthcare and become everyone’s doctor (like in Canada and Britain), or have the government provide everyone the means to access the private healthcare market. President Obama and the Democrats have done the latter. American conservatives have reacted like he’s collectivizing our farms and relocating our peasants.

The only reasonable conclusion one can draw is that the conservatives and Republicans really are “the party of ‘No!’” Either they do not plan to do anything about the fact that tens of millions of Americans have no access to healthcare, or they are determined to bring down President Obama’s agenda, and damn the consequences.

David Frum, whom I consider to be one of the finest conservative writers, was fired from his job at the American Enterprise Institute, a conservative think tank, after writing a column about the healthcare bill’s passage. Here’s what he said:

At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama’s Waterloo – just as healthcare was Clinton’s in 1994.


This time, when we went for all the marbles, we ended with none.

Could a deal have been reached? Who knows? But we do know that the gap between this plan and traditional Republican ideas is not very big. The Obama plan has a broad family resemblance to Mitt Romney’s Massachusetts plan. It builds on ideas developed at the Heritage Foundation in the early 1990s that formed the basis for Republican counter-proposals to Clintoncare in 1993-1994.

Barack Obama badly wanted Republican votes for his plan. Could we have leveraged his desire to align the plan more closely with conservative views? To finance it without redistributive taxes on productive enterprise – without weighing so heavily on small business – without expanding Medicaid? Too late now. They are all the law.
(I urge you to read the whole column. It's excellent.)

After Frum was fired, another conservative exile, Bruce Bartlett, wrote this about him:

Since, he is no longer affiliated with AEI, I feel free to say publicly something he told me in private a few months ago. He asked if I had noticed any comments by AEI "scholars" on the subject of health care reform. I said no and he said that was because they had been ordered not to speak to the media because they agreed with too much of what Obama was trying to do.

Here’s the reality: the Democrats fought the Republicans tooth-and-nail to pass the most conservative universal healthcare program in the western world. Let us rejoice and be merry.


    All this points to the only certain thing about Obamacare: that this is just another episode in the long saga of health reform. Indeed, by adding tens of millions of people to an unreformed and unsustainably expensive health system, this reform makes it all the more urgent to tackle the question of cost."