We are about to enter into the next chapter of what I have called “the mother-of-all healthcare battles—the battle between total government control of healthcare versus individual control in a free market. Medicare-for-All, or national single-payer healthcare, has been kicking around Congress for perhaps two decades now. Recently, Senator Bernie Sanders reintroduced the bill, with numerous, mostly far-Left co-signers.
But not all. One co-signer, the otherwise “moderate” Democrat New Jersey senator Cory Booker, just signed on. Booker’s decision was the subject of a NJ Star-Ledger column by Tom Moran. Moran is a single-payer supporter, but considers it politically impractical. On that basis, he wrote “Booker's bromance with Bernie Sanders. Let's hope it's just a fling” criticizing Booker's move to Sanders:
It didn't surprise me that Sen. Bernie Sanders chose this moment to press for a single-payer health system.
He's a good man, and he's dead right that a single-payer system like Canada's makes a lot of sense, delivering better care at lower cost. But he is as nutty as Ralph Nader when it comes to practical politics.
Sanders is handing Republicans a club they can use to beat Democrats over the head. Because a single-payer system would require a huge tax hike, and force wrenching change for everyone at a time when 70 percent of Americans are happy with their current arrangements.
Sanders has never been impressed by cold political calculations like that. That's why he ignored warnings that his endless personal attacks on Hillary Clinton might help Donald Trump win by depressing the Democratic vote in the general election.
Sanders, like Nader, is a romantic. Which is great, if you're a poet.
The surprise to me is that our own Sen. Cory Booker has joined this hapless parade.
Moran goes on to quote Booker:
"We have to stop thinking about political calculation," he told me on Friday morning. "And focus more on 'Morally what's the right thing to do?'"
Moran acknowledges that Booker’s move is itself a political calculation designed to curry favor with the hard Left to pave the way for a 2020 run for Democratic presidential nomination. “Booker is not an orthodox Democrat,” Moran writes,” and “the left is skeptical about [him].” Nonetheless, he’s critical of Booker’s move.
On Sanders’ new Medicare-for All bill, which I have dubbed SandersCare to distinguish it from previous bills, I’m not so sure Booker is on the wrong track, politically. At this time, he’s probably on the right side of the long-term political momentum in this country when it comes to healthcare.
"We have to stop thinking about political calculation," he told me on Friday morning. "And focus more on 'Morally what's the right thing to do?'"
If Booker were really concerned with what’s morally right, he wouldn’t be joining Sanders in his crusade to put government dictators in charge of deciding who gets what healthcare, and when—and that effectively enslaves the doctors. He would be a huge champion of rolling back government involvement in medicine, and expanding individuals’ freedom to make their own choices about their own healthcare.
How is it morally justified to strip the remaining half of the American population that still has health insurance and force them into a one-size-fits-all government monopsony? In a word, altruism. Altruism holds a person has no moral right to his own life, because being moral consists of living for others. The opposite morality, rational self-interest, upholds the individual’s moral right to her own life and liberty; to spend the money she earns, her property, as she, not some government bureaucrat, sees fit; to make her own healthcare choices—all as sanctioned by the guarantee to all men of the equal unalienable right to the pursuit of personal happiness stated in America’s philosophic blueprint, the Declaration of Independence.
And the moral is the practical. Consequently, SandersCare is economically unworkable, and will lead to severe restrictions on healthcare, especially for seniors and the elderly, as costs explode when SandersCare clashes with the laws of economics. On the other hand, all of the incentives in a free market—consumers seeking the best value for their money from profit-motivated providers seeking to expand sales and grow—are aligned toward better care at lower prices supplemented by continuous innovation. The laws of economics compliment this freedom. That’s why free markets, by allowing all people to self-interestedly think and act freely, work to the benefit of all economic levels of society, not in some miraculous instantaneous fashion, but over time.
What Sanders understands that most of his opponents don’t is that the healthcare fight is fundamentally a moral fight. Morality is not pie-in-the-sky. Morality, not political or economic calculation, is where this will be decided. Politics reflects the dominant morality of the culture. And while Americans still have a decent amount of respect for a person’s right to act in his own self-interest, altruism is generally considered—wrongly, in my view—the essence of morality. Sanders, like all statists who want power over people’s lives, cashes in on altruism. If you have no moral right to your own life, then you have no moral right to oppose SandersCare. How will you oppose it? By standing for your political rights? A right to what? The very thing altruism says you have no moral right to, your life? To stop SandersCare, the final step in the half century long trek to end America’s role as the last bastion of freedom in healthcare, the individual’s moral right to her own life must be upheld.
Self-interest is not just a practical necessity. It is right—morally right—to work to make your own life better and more fulfilling, not by exploiting others, but by your own effort. Only on the basis of rational self-interest can SandersCare be stopped—and reforms begun toward a truly moral path, a fully free market where providers, medical products makers, health insurers, and consumers/patients can contract freely and voluntarily with each other, to mutual advantage—and the government protects those contracts against force and fraud.
So SandersCare is not just politically impractical. It is economically impractical. It is, most importantly, immoral. Freedom is moral and practical, because it leaves people free to pursue their own self-interest unmolested by the lakes of Bernie Sanders. Never mind the usual rationalizations about the needy who can’t afford this or that healthcare service. That’s the job of private charity to fulfil according to the value judgments of individuals. The needy are not a justification to coral the vast majority of Americans into a chain gang of government dependence financed by their own money. Totalitarian control or freedom and individual rights—not helping or not helping the needy—is the ultimate choice that lies at the end of the healthcare debate.
The current disfunction of American healthcare is the result of decades of ever-growing government involvement. Sanders offers up Medicare-for-All as a “fix” for what ails America’s heavily regulated, part-socialist, part-fascist, part-free healthcare industry. But that’s just doubling down on the cause of the problems. The government has had its chance at micro-managing our healthcare, and SandersCare is the final proof that it has failed. The moral high road belongs to defenders of individual rights and its corollary, free market healthcare. The “right thing to do” now is defend every individual’s right to act on his own judgement, for his own benefit. It’s time for more freedom and individual rights in medicine.
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For the Left, the issue of single payer is not philosophical. It is a matter of political practicality. Moran himself says at the outset that “a single-payer system like Canada's makes a lot of sense.” Moran explains:
The idea that answering moral demands should force us to set aside political calculation is insane. Without political calculation, Abraham Lincoln could not have won the Civil War and freed the slaves. Franklin Roosevelt couldn't have enacted Social Security. Nelson Mandela might have died in his cell on Robben Island.
None of them charged straight at their goals. They maneuvered towards them, step by step, over years. They calculated.
In a nutshell, this is how the socialists moved America from an almost fully free market in healthcare to the verge of total socialistic government control.
Philosophically, they believe they’ve already won. As Sanders now says openly and with few challengers, “health care is a right.” That’s an unequivocal altruist moral statement. There’s no way to counter that assertion without properly upholding individual rights, and there’s no way to properly uphold individual rights without denying altruism and upholding self-interest.
But while they’ve been content to take one small bite out of our freedom at a time, the one thing they didn’t do is compromise on the basic, altruist/collectivist convictions that underpin those steps. “Step by step,” as Moran, one of the Left’s ranking members, readily acknowledges, they road the altruist “ideal” to a steady growth in government programs like Medicaid and Medicare and SCHIP and a steady growth of strangling government regulations on the private insurance market to the point where it now “makes sense” to engineer a full government takeover of healthcare.
There’s a lesson for the Right here. We’ll not fully reinstate Americans’ individual healthcare liberty in one swoop. But we’ll never get there if we can’t go beyond the economic case and properly defend free markets morally. Moran may be right that the “Sanders virus” is politically premature. But single payer is inevitable, barring a proper moral strategy from the free market Right.
Related Reading:
Moral Health Care vs. Universal Health Care, by Lin Zinser and Paul Hsieh for The Objective Standard
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