What Dems Have Won
In the debate over health care, neither side defends freedom
THE debate over the healthcare bill in the House of Representatives has come to center on a single topic: How many Americans will be covered under its auspices.
For the left, the answer to this question has always been: Every single American.
The right’s riposte has always been: The cost of such a policy would be larger than this country can bear unless the government literally runs all of national health care directly in what’s known as a “single payer” system.
The left’s answer: Yeah, so? We should have single-payer but you guys won’t stand for it.
The right’s reply: Single-payer nationalizes health care, which is philosophically inimical to the American experiment and would as a practical matter be destructive. It would drive the best people out of medicine, retard the medical innovations that are improving our lives every year and create a horrifying system of rationing.
The left’s rejoinder: We already have rationing — rich people get the best care and the poor don’t. A national health-care system ensures fairness in the distribution of health and socializes the cost across 320 million people far more efficiently.
The right’s response: Our political system isn’t designed to ensure parity of outcome. It exists to enshrine the freedom of the individual from coercion by the state and to provide for the working of a free society outside government control. And aside from the threat single-payer poses to these bedrock principles, government management of one-sixth of the economy will be inefficient, corrupt and arbitrary.
Let’s leave the debate stage and return to practical political reality. The current health-care bill was dealt a terrific blow by the Congressional Budget Office, which estimated on Monday that by 2026, 24 million fewer people will have health-care coverage.
The consensus headline: “24 Million Will Lose Coverage.”
As a simple matter of fact, that isn’t right. The verb “lose” suggests these 24 million will unwillingly be booted out of the system. No: The CBO says that most of those people will not be covered because they will not buy an insurance policy when it’s no longer the law of the land that they must do so.
In other words, they’ll be exercising their freedom of choice as adults to opt out of the system — and should they try to get back in only when they get sick, they will have to pay a 30 percent penalty for their effort to game the system.
Also as a matter of fact, the people who now have coverage under ObamaCare who did not before it was passed are in a degenerating system. Their premiums have risen by double digits a year, and their deductibles have risen to such an extent that many of them don’t get a cent back from insurance even after they make some use of the system.
No matter. That 24 million number is devastating to the political hopes of those who designed and are shepherding the bill in the House.
They may be able to muscle through its passage, but what they are proposing will almost certainly be dead on arrival in the Senate. It will likely pass its own bill, and then some magic will have to happen to “reconcile” the two versions to create some final compromise President Trump can sign. If it can even get that far.
In the process, something even more devastating to the right’s argument has arisen, and that is the rise of populist critics who have decided that the left’s great desideratum is closer to their hearts than the classic conservative critique of ObamaCare and national health care.
The best example of this comes from Christopher Ruddy, the publisher of Newsmax and a close friend of the president’s.
In a stunning March 13 op-ed, Ruddy argues that the private health-care system is a mirage and that Trump should ditch what he calls “Ryancare” to protect Medicare and push for a huge expansion of the Medicaid system to make it the provider for far more people than just the poorest Americans.
Ruddy’s goal is, he says, what Trump has promised: universal coverage. What’s notable here is that Medicare and Medicaid are, effectively, single-payer healthcare systems run by the government. So what Ruddy is advocating is, in effect, the same long-term goal Teddy Kennedy had in 1969 when he first proposed a national health-care system.
The case for liberty is in desperate straits. The left opposes it, and now the right is splitting over it. Barack Obama and the Democrats may have lost the House in 2010, the Senate in 2014 and the presidency in 2016, but they may be winning the most important argument they’ve ever made.