Saturday, January 9, 2010

ObamaCare - "Mandated to Fail"

With the Senate passage of its version of ObamaCare, the draconian enactment of the president’s dream of “meaningful healthcare reform” appears all but certain. The battle, then, will shift to the next level – building support for full repeal coupled with the presentation of a comprehensive and philosophically consistent alternative.

For supporters of the free market, there are two crucially important questions that must be asked and answered as we go forward. First, what is the nature and purpose of the Democrat’s plan? Second, how did we get to the precipice of socialized medicine despite overwhelming American public opposition to socialism?

NJ Star-Ledger columnist Paul Mulshine does a pretty good job of answering the first question. ObamaCare is designed to fail. It is a fascist bill. The government will gain almost total control over American medicine, even though ownership of insurance companies, hospitals, the medical providers, product manufacturers, etc., will remain in private hands. This will give the illusion of a private, market-based system. When the government-controlled system, which is riddled with perverse incentives, fails, the free market will be blamed. Mr. Mulshine writes:

“The Democrats’ biggest accomplishment of this decade was getting a package through both houses of Congress mandating that every American have health insurance.

“Their biggest accomplishment of the next decade will be watching it fail. Then they can get what they really want, a government takeover of health care.

“That’s my prediction. It’s based on what I call the Frito-Lay theory of health reform: Mandates are like potato chips; you can’t have just one.”

Mr. Mulshine gives a brief description of how government controls (in this case in the form of mandates) lead to more and more government controls, citing New Jersey’s experience with auto insurance mandates in the 1970s which almost left the state without any auto insurers. He relates that experience to the individual health insurance mandate and its logical consequences. He concludes:

“ ‘It just becomes a never-ending game of cat-and-mouse,’ said [the Cato Institute’s Michael] Cannon. ‘When you force people to behave in these ways, some do what they’re told, but enough of them do what they can to avoid the mandates so that you end up doing more harm than good.’ ”

“Of course, that depends what you mean by ‘harm.’ Liberal Democrats will look over the wreckage and say, ‘See? We told you this would happen if you left it up to private insurers.’ Then we’ll get the public option after all. And eventually it will grow to become something close to a single-payer system.”

“But if the individual mandate survives, the government takeover of the health care system will arrive as surely as death and taxes, but in the opposite order.”

This is classic statism creep – American style. First cripple an industry and hamper its market segment with a government monkey wrench. Then, when it can’t function, declare it a failure and hold government up as the “solution” of last resort. In this case, the public “option”.

So how does an opponent fight back? Mr. Mulshine reports on one method - the legal challenge:

“The only way to halt this is to halt the individual mandate. Many conservative legal scholars are now working on ways to challenge it in the courts. Their central argument is that the federal government lacks the authority under the U.S. Constitution to order a citizen to enter into a contract with a private commercial entity.

“Whether the Supreme Court will accept that argument remains to be seen.”

The individual mandate certainly is unconstitutional, and perhaps the courts will agree … perhaps. But for the past century plus, the courts have on balance undermined and ignored the constitution. Nowhere does the constitution grant to the government what President Obama calls “redistributive change” authority. Wealth and income redistribution is the economic essence of socialism. In other words, the entire welfare state establishment is unconstitutional, as even Obama implicitly acknowledges. That hasn’t stopped its advance.

This leads us to the second, and more fundamental, question that we must answer. For that, I would point to a recent IBD op-ed by Yaron Brook and Don Watkins entitled Memo To Foes Of Health Reform: Repudiate The Morality Of Need. After a brief description of the utilitarian argument opponents of “reform” have relied on to demonstrate the practical failures of socialized medicine, they write:

“[The opponents] were right — yet it looks like Obama will get his bill.

“Why? Consider the history of government involvement in health care.

“In the 1960s there was a perception that some elderly were not receiving adequate health care. To meet this need, Congress passed Medicare. The same concern was voiced about the poor. To meet their need, Congress passed Medicaid.

“The same concern was voiced about those too destitute (or too irresponsible) to buy health insurance, and in the '80s Congress passed the Emergency Medical Treatment and Labor Act, forcing emergency rooms to treat anyone who needed medical attention, regardless of their ability to pay.

“The same concern was voiced about parents who were too well off for Medicare, but who nevertheless couldn't meet their children's health care needs, and in the late '90s Congress passed the State Children's Health Insurance Program.

“The message is clear: If you have a need, you are entitled to have it fulfilled at others' expense.

“The reason we continue to move toward socialized medicine is that everyone — including the opponents of socialized medicine — grants its basic moral premise: that need generates an entitlement.”

The God of Need is my phrase to describe that moral premise. This is the crucial point that free market forces need desperately to grasp. The battle for freedom in medicine will not be won or lost on the utilitarian argument of what “works” best. Nor will it be decided in the courts (although a victorious legal challenge can buy us time).

The decisive arena is the moral battleground. All of the Democrats’ artillery is positioned there. It’s all they’ve got. They completely ignore the fact that government is the cause of all of the problems of the healthcare status quo. They won’t allow in the argument for the free market/individual rights alternative to the status quo. They lose on both counts. They know they can’t win in those arenas. But, they don’t have to. As long as their Republican opponents operate under a self-imposed unilateral moral disarmament, the Democrats can wield the most potent political weapon around – the moral high ground.

Mr. Brook and Mr. Watkins write:

“So long as that principle goes unchallenged, government intervention in medicine will continue growing, as each new pressure group asserts its need and lobbies for its entitlement, until finally the government takes responsibility for fulfilling everyone's medical needs by socializing the health care system outright.

“The only way to effectively oppose socialized health care is to reject the morality of need in favor of a genuinely American alternative. According to the American ideal, men are not their brother's keeper — we are independent individuals with inalienable rights to support our own lives and happiness by our own efforts.

“That means taking responsibility for your own medical needs, just as you take responsibility for your grocery shopping and car payments. It means no one can claim that his need entitles him to your time, effort, or wealth.”

One saving grace in the bill is that enactment will be a long, drawn-out multi-year affair. There is ample time to build the kind of individual rights-based political strategy that I have been advocating. This requires a rejection of the God of Need. As we move toward enactment of ObamaCare, there is little sign that the GOP will base their 2010 election strategy on challenging the altruistic moral premise it is based upon.

But rolling back and repealing not only ObamaCare but also all of the destructive government intrusions into medicine that have built up over the decades will require the kind of political courage needed to pick up the challenge Brook and Watkins hurl at the American Right:

“Where is the willingness to defend this ideal by saying, ‘Your health care is your responsibility — and if you truly cannot afford the care you need, then you must ask for private charity — not pick your neighbor's pocket to pay for it’?

“Those who truly want to fight against socialized medicine in America must realize that it's time to drop the morality of need and proudly say: I am not my brother's health care provider.”

No comments: