Socialized medicine: inefficient, unfair

Recently a message was sent to President Barack Obama’s supporters under his name that urged them to get behind his proposal for universal health care and castigated his critics. I share with him a desire to reform our health care system, but along lines completely different from those which he only vaguely explained. It is not very helpful, as Obama did, to sum up health reform in terms of "core principles" (reduced costs, guaranteed choice, and quality care for every American) when the means employed to fulfill them are unspecified. Nor does it help to oversimplify the issue, as he did, by equating support of the dreaded "status quo" with "half measures and empty talk."

Obama stigmatized critics, moreover, for "spread[ing] fear and confusion about the changes we seek." And then he proceeded to spread genuine "fear and confusion" about "spiraling health care costs" and failed to acknowledge how much government programs such as Medicare and Medicaid have contributed to those rising costs.

The President told the story of his late mother's battle with ovarian cancer, "spending too much time worrying about whether her health insurance would cover her bills," which is very moving but also verging on exploitation. Ovarian cancer presents a major challenge which even the most lavish health insurance cannot mount. No government program can end these worries.

We are responsible for our health. I'm no less mindful than Obama of the persons without health care, but dealing with that deficiency does not require socialism. As his opponent, John McCain, advocated last year, substantial tax credits for health savings accounts will help people who lack employer or government plans.

Before there was massive government involvement in health care, and before third-party payers dominated the field, costs were actually more manageable. Forty years ago my oldest son needed surgery that cost us, a young married couple of modest income, $500. I am sure it would cost many times more than that today, not only because of inflation but because of the proliferation of third-party plans, which shield consumers from the true cost of their care.

In any case, there is no more reason to socialize health care costs than the cost of food, transportation or housing. Obama may not want us to know that what he is proposing is socialism, but many of us don't need to have it spelled out. It is not fear-mongering to point to the experience of nations that already have government care, which entails artificial caps on costs and rationing. Only a free marketplace can bring consumers and providers together and enable them to agree to reasonable terms.

The President is only worsening the current difficulties by proposing more of the same government intervention. We must oppose him in order to preserve, and even return to, the limited government bequeathed to us by our founding fathers.

As a friend of many years has reminded me, however, for millions of Americans justice is central to the health care debate. He wrote: "We will end up with ‘socialized’ medicine unless our people are convinced that justice and fairness are better served, and good medicine is better provided, in a non-socialized system of health care. Many good Americans are willing to accept lesser care (up to a point) if they are persuaded that the promised new system would be more just and fair for each and all of us."

I think he is right. Liberals believe they have a monopoly on justice and fairness, erroneously equating equality of condition with equality of rights. The truth is, the free market exemplifies reciprocity in exchange, a form of justice, as doctors and hospitals provide a service for which they deserve to be paid, and patients deserve a say over costs. They have that say now for virtually all other commodities (automobiles now conspicuously excluded, thanks to President Obama), which makes them largely affordable.

But there is no justice in making some Americans subsidize the health care of others, nor is it fair to deny people health care because some bureaucrat decides that their needs aren’t as worthy as someone else’s. Imagine if food production, distribution and sales were socialized, and the government determined what we ought to be eating!

The American idea of justice is not, as Obama evidently believes, "From each according to his ability to each according to his need." Rather, it is our right to govern ourselves. It is better, as the early Pilgrims learned the hard way, for each person and/or family to use their abilities to provide for their needs. Justice and utility are in perfect alignment.