Yesterday an editor at New York Magazine tweeted out a link with the note “Republican states content to keep poor blacks away from expanded health care.” The link went to a New York Times story about, well, how Republicans have it in for poor black women. Why this extreme language in the paper of record? Seems that Republican states are less likely to view a dramatic expansion of Medicaid as a good idea.
This assumption of horrible motivations is a great example of one of the worst parts of being a conservative.
Over at Quora, folks were asked what the worst part of being a Republican was. One guy began his answer with his tongue firmly planted in his cheek:
It’s so hard to get poor peoples’ tears out of the handmade silk shirts that I wear while I subjugate women, carry concealed weapons into schools, churches, and Starbucks locations, and vote to enrich myself by ripping the social safety net into tatters and processing the resulting impoverished people into a proprietary nutritional goo.
More seriously: the worst part about being a Republican is quite simply that too many Democrats view Republicans as morally and intellectually deficient by virtue of their very existence, without knowing anything at all about what an individual thinks or believes.
Whether you’re a Republican or not, anyone with conservative instincts will agree that one of the most frustrating aspects is people mistaking preferring different methods for seeking different results. Contrary to popular belief, conservatives care for the poor and downtrodden just as much as liberals. We simply think that tasking government to care for them is a terrible idea.
And the past few days illustrate why.
It’s not just that the exchanges don’t work. Or that the government is shut down. Or that it will remain shut down for weeks because of needless failures of diplomacy. Or that it went for a public relations score on the memory of fallen heroes. (The WWII Memorial is an open section of park. With no shutdown, it’s open 24 hours a day, whether National Park Service employees are there or not. It takes work, money and monitoring to close it off. Threatening to arrest World War II veterans for visiting their memorial is indefensible.)
It’s also that the problems with health care in this country are the result of inappropriate government intervention in the first place. Why is US healthcare so expensive and in need of reform? In part, Medicare drives up pricing by leading providers to charge more outside Medicare and claim higher costs on procedures within Medicare to cover other costs. (While other countries ration healthcare, we find the money from somewhere.) In general the layers between the consumer of health care and the provider lead to inefficiencies and lack of information.
Have you ever wondered why insurance is tied to employment? Employers started offering health coverage as a work around FDR’s wage caps. Under the 1942 Stabilization Act, Congress set limits on what employers could pay employees — but they permitted employers to offer benefits as a recruitment tool. Prior to that, health insurance wasn’t a big thing, mainly because healthcare had been mostly palliative. With the convergence of advances in medicine and wage advantages, it doesn’t take a degree in economics to see how employer provided insurance shaped our health insurance market.
And then in 1945 the War Labor Board ruled that employers could not modify or cancel group insurance plans during the contract period. And in 1949, the National Labor Relations Board ruled, more or less, that the union was allowed to negotiate benefit packages on behalf of workers as well. The employment based health insurance system became set in stone. For everyone.
Later, employment-based health insurance became a way around taxable income. Under the 1954 Internal Revenue Code, employer contributions to employee health plans were exempt from employee taxable income. As a result, the demand for health insurance further increased throughout the 1950s.
What if we got our cars from our employer? Or our food? We could envision a situation where choices were limited. We could only buy groceries at one store or we could only buy one of a few different types of cars. Health insurance being tied to employment restricts the health insurance market in a way that reduces freedom of choice.
Furthermore, that tie has led to many pre-existing condition denials for simple situations, such as a pregnant woman switching jobs, and it has allowed health insurance policy to have unwelcome influence over employment trends.
US health insurance is a mess because of government intervention. If Obamacare made health care more efficient, more personal and less costly, it would be the first time a bureaucracy had ever managed these things in history.
Government ineptitude is nothing new. Running though my head today is the opening of the musical 1776. Many of the lines and lyrics were taken from contemporaneous writings of the Founders. At the start, John Adams storms into the Continental Congress chamber, railing, “I have come to the conclusion that one useless man is called a disgrace, that two are called a law firm, and three or more become a congress!” Instead of even entertaining debate on the issue of independence, the Continental Congress was tackling the weighty question of whether or not the militia should wear matching uniforms.
Details change. The nature of committees does not.
The majority of the country doesn’t oppose Obamacare because we want to see people die or be in pain. It’s silly to even think such a thing. We all seek solutions that actually work. We are just wary of the “three or more useless men” problem. Government solutions are usually cruel, open to corruption, inefficient and costly.
If we want truly to help the poor, the sick and the needy, we must understand that massive increases in the government bureaucracy aren’t the preferred solution. They aren’t a solution at all, in fact. In the future, we will only need to look back to the early days of October 2013 to remember that.