The Illusion of Design

The basic argument in favor of government-run health care, among people who sincerely believe it’s the best way to reform the medical system, is that a program designed and administered by the State will provide health care to more people. As things stand, a certain number of people have no health insurance, and this is held to be unfair and dangerous… to the extent that the rest of us must endure a radical overhaul of the entire system, as the State takes control of the insurance industry first, and eventually all of medicine.

Why do these uninsured people lack coverage? The ostensible reason is that they cannot afford it, although in fact a sizable portion of the uninsured are young people who choose not to purchase expensive insurance, and many more are illegal aliens. Also, the nature of the laws surrounding health insurance make it very expensive to purchase privately, instead of receiving it as part of employment compensation, so rising unemployment (the signature feature of the Obama economy) means more uninsured. Still, the popular conception of the case for health care reform is based on the haunting image of millions of poverty-stricken sick people, wasting away from the lack of health insurance. As the slogan tossed around through Twitter earlier this year put it, “no one should have to die because they can’t afford health insurance.”

Why is health insurance so expensive that the poor cannot afford it? The Left believes this is a failure of the free market, with greedy health-insurance companies callously pricing their product out of reach, and slapping exorbitant premiums on anyone who isn’t the picture of health. The true answer is that government is primarily responsible for distortions in the health insurance market, dating back to the wage controls that made it commonplace for employers to offer health benefits as a means of attracting skilled employees. The law preventing the sale of health insurance across state lines is an example of government-induced price distortions. For a contrasting example of medical services becoming more affordable in response to free-market competition, consider the constantly falling price of Lasik eye surgery. The Left refuses to think clearly on this subject, and maintains that health care is a “human right” that should be available “free” to everyone.

Liberals insist it is simply unthinkable to allow financial considerations to impact the distribution of this essential human right. As Kirsten Powers put it recently, “Americans will die if we don’t provide universal health insurance.” Because money is the instrument through which free people express their will and make choices, the argument for socialized medicine boils down to the superiority of design and control over competition and choice.

So, in summary, the case for nationalizing health insurance is that health care cannot be entrusted to the unpredictability and greed of the free market. The individual purchasing decisions of free men and women are too chaotic. The only way to ensure access to health care for everyone is for the State to install a massive, strictly enforced system, complete with huge fines and jail time for those who fail to comply. This system would be superior to the free market, because it would be carefully designed by brilliant minds… engineered to deliver an incredibly complex, ever-changing service to hundreds of millions of Americans.

Is anyone stupid enough to think a “carefully designed system” is what the Democrats are about to drop on us?

Senator Ben Nelson (D-Nebraska) held up the Senate reform bill over his heartfelt concerns over abortion funding… until he was bought off with hundreds of millions of dollars in enhanced funding for Medicaid in his state. In a similar vein, language worth over $100 million was added to the bill, targeting the state of Louisiana, to purchase the vote of “moderate” Democrat Mary Landrieu. In other words, this “carefully designed” health care bill has different rules for people who happen to live in Nebraska or Louisiana, because this was necessary to buy the votes of their senators.

The Congressional Budget Office scoring for the health care reform bill is based on tricks and gimmicks, including Medicare reductions and cuts of over 20% in physician payments, that no one seriously believes will actually happen. A great deal of this health care reform package is a delusional fantasy, if not an outright fraud.

Socialist senator Bernie Sanders of Vermont jammed a 767-page amendment into the bill, then violated Senate procedures to suddenly withdraw it when Republicans forced the entire amendment to be read on the Senate floor.

Far from being a brilliant plan constructed by top doctors and financial experts in a government brain trust, this health-care bill is a twisted, deformed political document, seen in its entirety by only a few high-ranking politicians belonging to a single political party. Its components have not been precisely crafted as part of a fantastic system calibrated to ensure the maximum access to quality health care for all Americans.

The bill is not being examined with transparency and careful deliberation by representatives who behave as humble servants of the people and their Constitution. Instead, it’s being hastily rammed through in the dead of night, over the objection of powerful majorities of the American people, with desperate last-minute deals cut to acquire the necessary votes, financed by vast sums of taxpayer money. The primary consideration is not crafting the most sophisticated and intelligent health care reform… it’s getting a bill pushed through before angry voters have a chance to blast the Democrats out of Congress. Look at it this way: if the average middle-class American paid about $5000 in federal income tax last year, then you might be one of the 20,000 people who paid for Mary Landrieu’s vote, in the hope of giving Barack Obama a bill to sign as a Christmas present.

Aside from the nauseating payoffs, this kind of legislative taffy pull is to be expected in a representative republic. That’s how it works. People elect Congressional representation to look out for their interests. Legislation is modified by demands that can range from mild objections to stubborn intransigence. Parliamentary procedures are invoked by experienced politicians to shape the debate. Regional interests and passionate beliefs are poured into a bubbling stew of sections and sub-paragraphs. All of this is inevitable, and therefore good reason to avoid the absolute madness of allowing the President and Congress to nationalize industries, or posture as wise stewards of a high-performance command economy.

The moral imperative for socialized medicine is the belief that government can design a system to distribute health care more efficiently than the free markets. I challenge anyone who sincerely believes this to review the recent events in the House and Senate, and realize that representative government is utterly incapable of designing any such system. The merciless and tyrannical enforcement techniques required to ensure hundreds of millions of people comply with health care reform are utterly indefensible in the service of a monstrosity stitched together from back-room deals and nine-figure bribes.

The only logical way to maintain the integrity of a vast, complex program designed to control a trillion-dollar industry is to dispense with the “representative” part of our government model. Those who seriously believe the State must control health care, which is tied into the bulk of our economy and technological development, should stop fooling around with half-measures of tyranny. If health care is truly a “human right” that must be provided “at any cost,” then take a cold, hard look at the tortured gestation of the rough beast slouching from Harry Reid’s office to be born… and understand that liberty, democracy, and representation must be sacrificed, as part of that cost.