By Craig J. Cantoni
Sept. 19, 2006
At a recent conference of the Association of American Physicians and Surgeons, liberal Jonathon Cohn of The New Republic debated libertarian Michael Cannon of the Cato Institute about the pros and cons of nationalized health care. (My kick-off address at the conference was well-received and is attached.)
Both gentlemen agreed on many points, including the fact that 80 percent of medical spending takes place in the last 20 years of life. This means that unless people save either voluntarily or involuntarily throughout their lives for the infirmities of old age, they will not have the means to obtain medical care when they need it the most.
Both also agreed that the current medical care system is broken. Cohn’s position was that the free market will never work effectively in medical care and medical insurance, because companies will cherry-pick the healthiest and wealthiest customers, leaving the poor and chronically ill without quality care and insurance coverage. Cannon’s position was close to mine: that because the government destroyed a consumer market in medical care/insurance over 60 years ago, it’s conjecture to say what the market will or won’t deliver, although there is indisputable proof that the market has been much better than socialism in providing other necessities of life.
Like most debates on the efficacy of markets versus socialism in providing medical care, the debate was a draw, with each gentleman quoting statistics and studies to support his position, especially statistics and studies on the cost of market-based medical care versus the cost of socialized medical care. Thus, as Cohn admitted, the issue comes down to one of values. To paraphrase what he said about his values, Cohn does not want to leave the poor and the elderly without proper medical care.
Cohn’s values are not the problem. In fact, I agree with his values. The problem is that he wants to impose them through government force on other people.
Therein lies the difference between contemporary liberals and classical liberals/libertarians: The former want to impose their values on other people, but the latter don’t. In that sense, contemporary liberals are similar to members of the Religious Right, who also want to impose their values on other people.
Because values are subjective and limitless, a government that responds to values du jour instead of being anchored in liberty is a leviathan that floats in the currents of popular opinion, trying to be all things to all people, until it eventually sinks from the deadweight of government spending and bureaucracy.
The ship of state is already listing to port to a dangerous degree. Over the last 60 years, regulatory compliance costs and government spending at all levels have grown from 25 percent of national income to nearly 60 percent. And looking forward, the net present value of the unfunded liabilities for Social Security and Medicare alone are over $70 trillion. That’s a fancy way of saying that the elderly are robbing children of their future earnings. Where does that fall on Cohn’s values scale?
Cohn’s medicine for fixing what ails American medical care/insurance would be less bitter if his proposals were counterbalanced with proposals to reduce the size and reach of government in other areas. Or to express it in personal terms, I might be able to swallow the medicine if he and other liberals ever agreed that my wife and I shouldn’t have half of our income taken in taxes, as is the case today. But they never say that. Their proposals are always additive and never subtractive in terms of taxes, thus revealing that they have no limit on what the government can confiscate.
I don’t want to stop Cohn from helping the sick with his own money through private charity or contributions to voluntary government programs. But he wants to force me to give my money to the government instead of letting me realize the self-satisfaction of voluntarily giving the money to the sick.
Cohn’s values are healthy, but his psychological needs for control and coercion are sick.