A Reasonably Comprehensive Overview And Argument Against The Healthcare Reform
Much has been made recently of the new healthcare legislation, which includes things like individual mandates (ie criminilization) requiring people to buy health insurance under penalty of law, lots of new subsidies, new taxes on both "cadillac" insurance plans and tanning salons, of all things, all in a not so compact 2700 page package.
This legislation is a disaster, and it is wrong for a multitude of reasons, both practical and principled. I want to show why, in as detailed a way as possible, addressing as many legitimate arguments against as possible. Several of my friends on the left have griped about the lack of honesty from the bill's opponents, and I think to an extent they have a point-much has been made of "death panels" and blanket screams of "SOCIALISM!1" without anything to back it up. I, on the other hand, believe the bill falls apart quite well on its own with facts and law as examples, and with the founding principles of this country as a guide. My politics are libertarian, and unabashedly so, and this does color my thinking, but libertarians in general have a tendency to do their homework when they rip something to shreds.
One clarification, with all that in mind: just because government does it, doesn't necessarily mean that it's a bad idea. Educating our children, encouraging people not to fry their brain on LSD or cocaine (or more legal drugs for that matter), keeping toxins out of our water supplies, and yes providing healthcare are all generally Good Ideas. The real question at the heart of the debate though is how much of this government should do.
Arguments From Practicality
Government's track record is very poor
-Historically, in this country especially and in others generally, government is simply not very good at doing anything other than hitting people. Federal government involvement in education (such as No Child Left Behind) has resulted in billions spent, but it's turned public schools into a multiple choice test driven mess. Laws like the PATRIOT ACT cost billions, but don't make us safer. Farm subsidies are supposed to make the lives of farmers better, but instead they're $16 billion per year (just at the federal level) of wasted money, an environmental disaster, and regulated prices that ultimately screw the poor (and don't make life easier on the rest of us either). Foreign aid actually makes things worse or goes to support scumbag regimes of one stripe or another. And then there's war, which is probably the ultimate failed government program.Government involvement in healthcare will politicize healthcare
-This argument is far more anectdotal than the first, but I believe education (where I have very direct experience) offers a very good parallel. In education, as a friend of mine is so fond of putting it, "there are so many ways to skin the cat", and different students respond better or worse to different teaching methods. In a free market, all of these alternatives would proliferate, and the best ones would triumph over time. But instead, because of the government run system, it takes educational questions and turns them into political ones. Bilingual education is the classic example-Proposition 227 in my state of California mandated English immersion rather than bilingual education. For those students that respond better to English immersion, great! For those that don't though, instead of being able to pursue an alternative (or than bilingual magnet schools, which are rare), or have their regular school provide one, they are now faced with the force of law, rather than just finding another provider. Right now the healthcare industry is ridiculously overregulated, but it's free enough where alternative treatments and new ideas do proliferate-in part because of the profit motive, in part because of compassion, and in part because the government is not looking over everyone's shoulder nearly as much as they could be telling people to only do it their way.The current bill merely adds a new layer to the existing system, rather than starting over
-We got here primarily through federal involvement and overregulation in medicine-from FDR making insurance premiums tax deductible for employers, but not employees, to the HMO Act Of 1973, to laws that require mandatory coverage of specific treatments that most patients won't use (thereby eliminating the possibility of multiple, differently priced plans) to the hidden cost of FDA regulations, to locking insurance companies into each state, and probably many more things I'm not aware of-foreign policy tends to be my focus, not healthcare. The result, I think people on all sides can agree, is a system that doesn't work. The problem is that an unworkable system needs to be scrapped completely. Either all of the laws, regulations, and subsidies need to be torn down and replaced with a completely free market, or all of the laws, regulations, and subsidies need to be torn down and replaced with a completely government run system where every doctor is a government employee and every hospital is a government building. I have my preference of course, but either way yet another layer of hybridization won't work, especially given that the main effect of the individual mandate is to create a guaranteed-FORCED-market for private insurance companies. It will result in a very similar situation to what we have in California auto insurance, where everyone who drives is forced to have insurance, and thanks to state regulations auto insurance companies have to ask the state permission not only when they want to raise rates, but when they want to lower rates as well.Socialized medicine is based on an unsustainable economic theory
-In the private sector, when dividends are paid soley out of the buyin of new investors, and not for actually making anything or providing any service, it's called a Ponzi scheme. When the government does it, it's called Social Security. Mandatory coverage for all, absent a real price structure to accurately distribute risk and adjust prices accordingly, will prove economically unsustainable, especially absent new people to artificially prop up the system. The speed and details of care in Europe and Canada can be debated, but in general I think they can reasonably be agreed to be in the same league as the US, and the personnel just as dedicated as their counterparts here. However, as Europe's population grays, they're learning the cost of a welfare state the hard way, and in fact Denmark is experiencing a boom in private health insurance. While it may save money in the short run, in the end its a trillion dollar government program, when we're broke and massively in debt, primarily to foreign countries. This will come back to haunt us in the end.
Arguments From Principle
More important than any argument of economics, however, is whether this law is moral, and whether it is legal. I believe it fails miserably on both counts, and represents a very well intentioned (as stated, healthcare is a good thing. Healthcare for more people, unless one is a devoted Malthusian, is an objective good) but utterly wrong way of thinking, and course of action.
Healthcare is a commodity, not a right
-Healthcare, like education, like butter, like cheese logs, like Transformers toys, like legal services, and just about anything else, is an economic good. It must be produced, and people generally must receive some form of compensation for producing it, or at least some way of covering their costs. Liberty, as understood by the founding fathers, was generally of the negative variety, not the positive-ie a free society is one where you are free from coercsion and regulation (assuming you harm no one else of course), not where you are free from want. As an aside, before anyone gripes about "dead white men slavery blah blah blah", I will point out that most of the Founding Fathers, even if they didn't have the courage to rise above their times completely, knew exactly what was coming. I also believe that almost all of them (except maybe Franklin, who'd be either lost in Wikipedia or lost in internet porn) would be quite happy to see the free, multiethnic society we have today as a promise fulfilled. More to topic though, it is this conception of liberty, as freedom from coercion, that I believe is our strength as a people and as a country. It's what makes us great, and what has allowed us to innovate, create, and simply make our own destiny as individuals for the past 230 plus years.Much of the law is coercive
-The ten percent federal tax on tanning saloons, of all things, is a minor point, though it is coercive as all taxes are. The individual mandate is even worse. George Washington said that "government is force, like fire" and even today the most commonly accepted definition of a state is an entity that claims a monopoly on the use of initiatory force in a given geographic area. With that in mind, what this law is putting a gun to your head and telling you to pay for someone else's healthcare, while you hold a gun to someone else's head and say the same.
Think about that for a minute.
As stated, more healthcare for more people is an objective good. If you wish to choose to provide healthcare for someone else, whether through directly buying someone's insurance, or donating to the Red Cross, Medicines San Frontieres, or any number of other private charities, or if you're a doctor or nurse or somesuch volunteering your time, more power to you. If you can recruit others through persuasion or financial incentive, even better. This is not only your right as a free human being, it is also an act of the highest honor and compassion.
Until you force someone else to join in.
That is much of the real consequence of this law. It strikes at the heart of individual liberty, the same as the PATRIOT ACT, or the Defense Of Marriage Act, or any of the myriad gun control laws in this country. Economic freedom and personal freedom are two sides of the exact same coin, and ultimately inseperable. Their death is preceded by the exact same thing-someone with a gun and a badge showing up at your doorstep saying "do [or don't] do this".It is illegal
-While I have seen an interesting argument based on the 16th Amendment, I believe this law still fails any real test of Constitutionality. The 10th Amendment, poor, abused thing though it is, blatantly disallows any federal law not expressly delegated in the Constitution, or directly relating to the powers delegated in the Constitution. As such while the tax might pass, what it goes to fund should not, as there is no guaranteed "right" to healthcare in the Constitution, nor is there any specific authorization for government provided, subsidized, or mandated healthcare. The Ninth Amendment points out that the listed rights of the people are merely a list, and not an exhaustive one, and as stated, I believe the Founders were very much in favor of more liberty, not less, and negative liberty, not positive liberty. Unfortunately it's not like a little thing like legality has ever really stopped the federal government before, but on its face all of this law should be struck down immediately, as soon as it gets to the courts.
Conclusion
There you have it. All of the arguments I can make against this bill in a hopefully concise, yet detailed fashion. In the end it may be well intentioned, but it's fantastically expensive, destructive, and utterly incompatible with American principles and with one's existence as a free human being.