Quick note regarding nationalized health care

2009/06/15

The President continues his perpetual campaign, continuing to focus on promoting his vision for health care reform. [1] Additionally, he assures us that Fedgov will be able to pay for the massive spending required to fund such initiatives, at least in part due to “greater efficiencies” in the health care system, and through cutbacks in the massive entitlement programs, Medicaid and Medicare. [2] As to the latter, it is difficult to disagree with cutbacks in these programs (or any Fedgov entitlement programs, for that matter), but given the massive support enjoyed by seniors’ advocacy groups (most notably, AARP, which is widely acknowledged as one of the most powerful lobbying organizations in Washington), such cutbacks to Medicare may likely end up going the way of Social Security reforms in the past. It is worth noting that many of the President’s proposals for funding his reform initiatives hinge on expectations of greater future efficiencies, and future decreases in various medical costs; granted, optimism is not a sin, but it is probably not wise to bank on such predictions, either, particularly when said predictions are not guaranteed to occur.

Additionally, last night, I heard an comment on the news regarding how to fund a national health care system: cut 70% of discretionary spending (not bad, but probably not entirely wise, either) and 70% of defense spending (very, very bad). Now, I will be among the first to support efforts to cut down on truly wasteful spending, but defense spending? Sorry. I am not buying that argument. What this comes down to, of course, is what you want Fedgov to do. National defense, despite my smoldering concern for standing armies, is explicitly stated as a responsibility of Fedgov in the Constitution; it is also something that I do not believe the individual states could handle for themselves as effectively as a national organization could. This is not to say that we could not find more cost-effective means of defense procurement, but arbitrarily cutting 70% of the national defense budget strikes me as irresponsible, at best, and suicidal, at worst. Unless, of course, one believes that war will never again threaten our Republic. Conversely, if one believes that Fedgov should be responsible for providing entitlement benefits to all citizens (regardless of whether or not said citizens could provide these for themselves), then of course, a large, intrusive government would be a good thing. If one willingly abdicates personal responsibility for one’s own security and survival, then naturally, someone or something else must provide for such pesky matters, right? In that vein, perhaps Fedgov should start investing in intravenous nutritional systems; after all, chewing one’s own food is such a hassle. Would not our lives be greatly improved by not having to suffer the indignity of macerating our own food, when someone else could do it for us? [3]

For my part, I favor referring to the delegated powers specifically granted to Fedgov by the Constitution (seriously, read the document, and it will be very obvious how much of Fedgov’s current responsibilities are not explicitly granted to it). Of course, there are certain issues that were truly unforeseen by the Founders when they first wrote the Constitution; interstate economic relationships, for example, were far less common due to the difficulties involved in travel and communication in the 18C; regulation of electronic communications and standards is another. One will quickly note, however, that both of these are issues that would not be handled as effectively were each state to have their own (potentially conflicting) laws and regulations for such things; in these limited cases, Fedgov authority is the lesser of two evils and (ironically) possibly the more efficient. Where I draw the line, however, is on issues that individual citizens, groups of citizens, or cities, groups of cities, or states themselves could handle with equal or better efficiency as a Fedgov agency. One could argue, of course, that our nation could benefit from a nationwide standardized health care system, but I suspect that one could just as easily argue the contrary, i.e., that the competition between many smaller organizations would be equally efficient, if not more so.

For example, I have heard in recent days about so-called health care co-operatives, which are based on the model of community service utility co-ops (such as electricity co-ops). Methinks that this idea is not without its merits. It is already well known that large corporations often get better “group” rates for health insurance than smaller companies with fewer employees; efficiency of scale works in favor of the former in such cases. While I do not know the pertinent regulations regarding cooperative insurance coverage, it seems sensible that groups of similar small businesses should be able to collectively apply for group rates of the sort that traditionally benefit larger companies. For that matter, why not allow such co-ops for groups of families, friends, etc.? At the very least, such smaller, cooperative groups would likely provide greater support mechanisms for promoting preventative care of the sort that often does not happen on individual initiative alone. In any event, while I am no expert on the economics of such situations, these sorts of “home-grown” solutions are, in my opinion, far and away more preferable than an overbearing, inefficient national system that may or may not be better than the slew of systems we currently have.

Additionally, when one considers the full implications of a trillion dollar [4] national system that, thus far, is only partially funded – and, at that, only through some rather optimistic assumptions about the future of an industry that is probably too large for simplistic predictions, it seems much more preferable to promote more proactive citizen-backed initiatives, rather than immediately launching into new and unprecedented levels of Fedgov bureaucracy expansion and spending. Of course, the administration now seems to be addicted to “swift and dramatic” Fedgov intervention, so I suppose there will be no convincing them that better options might exist. Alas. Prepare to bend over and take it, folks; one way or another, all of these trillion dollar initiatives must be paid for, and I can guarantee you that your representatives in Washington won’t be paying for the extra cost of such projects out of their pockets.

Notes:

[1]: CNN article, 15 June 2009.

[2]: CNN Money article, 13 June 2009.

[3]: Yeah, yeah, I know. Reductio ad absurdum [*] does not necessarily invalidate a positional statement. On the other hand, sometimes, it is eminently helpful for illustrating inherent absurdity. And most of the time, it is so very fun.

[*]: Don’t know what that means? Learn Latin (or look it up on your search engine of choice). Also, the clever amongst you will likely be able to puzzle it out based on similarities to modern English words.

[4]: Seriously, this appears to be the favored budgetary number for the Administration! How did it come to this?!? Oh, right. His Divine Mandate. Urg.

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