Some of the main ideas I talk about a lot around here are those of limits, frugality, modesty, smallness and simplicity. These are, in my view, the building blocks of a good life and so I tend to be extremely skeptical of large scale institutions – be they government or corporate – that tend to undercut those values. Yet I have to admit that when I heard about last week’s ruling that upheld the individual mandate, I was pleased. Why? A few reasons:
a) On a big picture, a political thinker who lacks a pragmatic side is a dangerous thinker. My preference for the United States is that we distance ourselves from the many excesses of industrialized modernity and consumerism in favor of a return to small communities, an emphasis on local places and a resurgence of small family-owned farms and other businesses. But that dream is a long way off. And while I’m banging on like a good crunchy con about the evils of Wal-mart, fast food, consumerist sexuality, and standardized testing, there are more immediate problems that need to be resolved for the sake of our commonwealth or we won’t last long enough to see a localist resurgence (or, more frightening, we might have such a resurgence brought on out of necessity).
One of those problems is healthcare. As a Christian, I cannot help but arrive at the conclusion that every person in this nation ought to have access to affordable healthcare, which means I cannot align myself with the apparent position of many Republicans, which is that universal access to healthcare is in itself undesirable. Though I would add that this view only came into being after Obama was elected, which makes me think the wide-scale acceptance of this view is more a product of cynical, partisan hatred of a president rather than any actual basis in principle. Some libertarians have always been saying this – the Cato Institute amongst them, I would imagine – and they deserve respect for their consistency. But until 2008, theirs was a decidedly minority view in the GOP. After all, Mitt Romney circa 2000 is celebrating last week’s ruling, as is the Heritage Foundation, circa 1991. Oh, and Newt Gingrich, circa 1994.
That leaves me with a frustrating dilemma: The only party playing ball on this issue happens to be one that favors large-scale bureaucracy and that is home to a number of technocrats who have never met a state program they didn’t like. It’s home to a congressman who once said that “Government is simply the name we give to things we choose to do together,” as if families, churches, local businesses, and private schools don’t exist and the only form of social organization is the state. Their president released a campaign video that suggested much the same. In short, I do not trust the good intentions of the Democratic party. I think they are mostly technocrats who think they can solve all our problems if the unenlightened plebes beneath them would just quit their fussing and give them the money they need to fix everything. And as much as I like him as a person, I do worry that President Obama himself tends to think along those lines. But like I said, they’re the only ones that care about insuring everyone has access to healthcare. So what choice do I have but to try in some way to go with them?
To be fair, David Brooks’ offers something more hopeful as far as the GOP and healthcare is concerned. Personally speaking, I’d much rather see something like the conservative plan he’s describing over Obamacare – but where are the GOP leaders making the case for such a plan? He cites two think tank authors and mentions that Romney has a similar plan, but where is the substantive policy discussion amongst Republican leaders? All I hear from them is whining about Roberts and vague threats about repealing Obamacare. But where is the actual alternative and why aren’t they discussing it?
b) Just to be clear: This healthcare issue is a major problem. A few statistics: We spend twice what most European nations spend on healthcare, yet have lower life expectancy. Healthcare spending doubled from 1997 to 2009. And at the rate we’re going, the system will be bankrupt long before I am old enough to collect social security or benefit from medicare. (Those are all from this story in The Atlantic.) We spend more on most procedures than most any other western nation. (An MRI here costs five times what it does in France.) And even when you factor in what people in countries with single payer pay in taxes, we still end up spending roughly twice what they spend. Something had to be done, if simply because of the completely insane amount of money we spend.
c) But let’s not forget about the abuses of the system, particularly the ability of companies to turn people away for pre-existing conditions. This story sums up the difficulty here quite well, I think:
I heard a peal of delight and turned around — that’s the picture at the top of this post. Hilary Matfess, a young policy analyst, was jumping up and down, yelling out details.
“The mandate is constitutional! It was upheld! Roberts went for the swing vote! Yes! Oh my God! The individual mandate survives as a tax!”
Did you work on passing the bill? I asked.
“No!” said Matfess. “I just have lupus!”
d) Therefore, because I’m still waiting to see the GOP elected leaders actually advance an idea (something, it’s worth noting, they had several years to do back during the Bush administration) and because Obamacare helps fix some of the problems, I’m relived it was upheld. I certainly think we could have done much better and I wish we would have. And if the GOP came into power in January and repealed it while advancing a less centralized version of healthcare reform, I’d be on board. But that isn’t the reality now and as long as Obama’s in the White House, I don’t expect much from a GOP congress. So for now, I’m grateful that Joie and I won’t get rejected for insurance because of pre-existing conditions and that many of my recently-graduated friends struggling to find work in a crap economy can stay on their parents’ plan. Those are significant improvements to the system and I’m grateful for them. If the GOP starts being proactive, I’ll listen. But as long as they’re just going to obstruct and or whine, I’m not going to listen to them (and I’m not the only one).