Monday, February 7, 2011

ObamaCare and the Bigger Question

Why do liberals believe that the only way to improve the delivery of health care is by more compulsion? That is, after all, the assumption behind ObamaCare.

There are millions of people without proper health insurance, say liberals, the millions of the uninsured. We propose to correct this with a system of subsidies paid out of taxes and mandates and administrative regulation. In other words, faced with the problem that many people lack the means to acquire the middle-class approach to health care, government should force the nation to supply health insurance to them.

The liberals get to this position through a political narrative of inequality and oppression. They observe that many people cannot afford the social goods of health care and education. They conclude that the reason is injustice. It may be that a minority--racial or ethnic--has been historically marginalized. It may be that employers exploit their workers with low pay and limited benefits. It may be privilege, that certain groups have access to desirable social goods because of their parents' social and economic position. It may justs be that skilled people can afford more than unskilled people. Or there is the poverty-line argument. It takes a certain amount of money for a family to afford the basics of food and shelter, and society should assist those people that fall below that standard.

But in all cases, our liberal friends make the same leap. If there is a deficiency, it should be made up by a government program. Our liberal friends do not seem to understand what they are saying when they do this. They are saying that there is no way of providing social goods except through a lot of force and compulsion.

Oh really?

Many of the arguments that liberals make, of course, begin by assuming that force is needed. If you make the inequality argument, you are saying that only a certain degree of inequality is just, and that inequality in excess of that standard requires government intervention. The marginalization argument and the employer exploitation argument imply that discrimination, a veiled form of force, is abroad and probably can only be corrected by countervailing force.

The conservative argument is that, while exploitation and privilege certainly abound in the United States, they are not absolute barriers to a decent life. Uneducated immigrants and kids from single-parent families have a hard row to hoe. But they can and do get ahead. Indeed, they mostly do. In fact, we add, if you look at the numbers you learn that it is very difficult to be poor in America if you finish high school, get married, and don't have a child in your teens. That expresses the notion that even with a basic education, you can earn a decent wage in America to get food, shelter, and modest luxuries.

The question we wish to open is this. Why do we assume that "social goods" should be delivered through government? "There is such a thing as society, it's just not the same thing as the state," says Prime Minister David Cameron. In fact, as social animals, humans derive much of their feeling of self-worth and meaning from contributing to social enterprises, whether in a work team, a family, a church, or a benevolent association. Conservatives believe that it is part of everyone's duty to be aware of the needs of people they know, and to work to help them when they need help. These services are best delivered person to person, face to face. Failing that, it is best to deliver them through small, local organizations rather than big bureaucratic administrations. Failing that, it is better to deliver services through big non-profit associations than big government departments.

Why is that? Why is it better to help the helpless and the less fortunate face to face rather than through a big organization? It is partly because each person is an individual, and has specific and personal needs that are not easily accommodated to the rules and procedures of a large bureaucracy. It is also because people feel a larger obligation, both in giving and receiving in a personal face-to-face relationship. People feel more obligated to do the right thing around people they know. With a bureaucracy, they find ways to game the system, because nobody will know, and nobody will care.

There are some social goods, perhaps many social goods, that can only be delivered using force. But conservatives believe that, for the headline social goods of pensions, health care, education, and welfare, a sharply reduced government share would be beneficial to all: to those that must step up their help for their fellow citizens to those receiving help from their fellow citizens. It's the social thing to do.

Conservatives believe that ObamaCare will either get repealed or it will lead to a meltdown in health care. We believe that there has to be a better way than force.

1 comment:

  1. Lest you forget, Mitt Romney created compulsory health insurance in MA, too & he's a conservative. Plus I know someone with a bachelor's degree who has been married 30 years with 3 children whose wife also works. He was a draftsman at a large hospital. Did great work, including real estate transactions for them with his license. Got regular calls from the President of the hospital. They laid him off nonetheless seven years ago and they still struggle. He takes every odd job he can find, but no permanent, full-time available. They are good Catholics & as frugal as the come. Hard NOT to get ahead in America? Come on, what dream world are you living in?