Distributism and Health Care Reform II
Economics, Politics — Posted by David W. Cooney on September 15, 2010 3:03 AMIn Part I of this article, I discussed the process of how the Patient Protection and Affordable Care Act (Obamacare) was passed, the fallout that has occurred since its passage, the arguments being used by the current administration to defend it, and the greater implications of the law. In this part, I want to address the conservative and libertarian alternatives that opponents to the Democrat plan put forward. Rather than just focusing on what was proposed by the Republicans in Congress, I will also look at some other proposals that were, and still are being, advocated.
There seems to be a general opinion that, while the Republicans did a lot of complaining about what was in the various versions of Obamacare leading up to its passage, they really didn’t offer much in the way of alternatives. I know that in my own area, the conservative media hardly talked about any alternatives beyond allowing insurance companies to do business across state lines. Instead, they seemed more interested in scoffing at the administration’s claims that Obamacare would be able to cover the currently uninsured (and “under-insured”) without raising taxes on the majority of Americans, increasing the public debt, or negatively impacting existing coverages. They took great delight in the use of inflammatory language like “death panels” when, in my opinion, that criticism should have been balanced by a detailed explanation of the alternatives they supported.
It would certainly be wrong to say that those opposed to Obamacare offered no alternatives, or even that there was no coverage of them, it just didn’t seem to get nearly as much emphasis as the attacks against Obamacare even in those media outlets that supported them. Even today, with the election coming up, the Republicans are running strongly on the idea of repealing Obamacare, as well as other things implemented by the administration, but there doesn’t seem to be a lot of discussion of what alternatives they are offering. In fact, they are being criticized for this even by Republican-friendly media (This link will eventually require registration for viewing.). So what alternatives have been proposed? Some of these will be addressed below, and some will be addressed in the next part of this article.
Among the proposals put forth by the Republican Party, the only alternative consistently offered by the “conservative” (monopolistic) capitalists was to allow insurance companies to compete across state lines. The real irony is that they were frequently denouncing the monopolies in the states as a reason for insurance costs being so high, but their solution was still based on the principles of monopolistic capitalism that would ultimately result in larger and more powerful monopolies.
For those who criticize the Democrats for constantly expanding the role and power of the central federal government, the next few proposals will show that the Republicans are not as different as many on the conservative side like to claim. The Republicans proposed to crack down on waste, fraud and abuse in Medicaid and Medicare. While it is certainly a noble cause to cut down on fraud, waste, and abuse in government, it appears that the days of the conservative movement searching for responsible ways to bring these and other unconstitutional federal programs to an end are long gone. It seems they are now content with just “cleaning up” the system. It is very rare indeed to hear “mainstream” conservatives, Republican or not, calling for a way to end these programs. It leads one to question whether they will have the fortitude to really bring an end to Obamacare.
If you are still in doubt about the expansion of federal power and authority by Republicans, the remaining proposals might clarify the issue. It may be true that the Republican proposals will not create nearly as large a bureaucratic structure as Obamacare, but a quick glance at what they proposed will make it obvious that they are not proposing something that will reduce government power from what is was before the passage of Obamacare. This is because more federal regulations and bureaucracies will be needed to manage things like new state high risk pools or reinsurance programs, enhancing Health Savings Accounts, incentives to encourage states to enact regulatory reforms that reduce premiums and expand coverage, and allowing dependents to remain covered through age 25. Additionally, Republicans show that they are not beyond using the federal taxing power to coerce states and private companies to get with the program. For what other “incentives” can the federal government really offer to encourage states to enact regulatory reforms that reduce premiums and expand coverage, or to encourage employers to sponsor “wellness programs,” which will guarantee lower insurance premiums for employees?
While the Libertarian Party also proposed deregulating the health care industry and removing barriers to safe, affordable medicines, they also advocated establishing Medical Savings Accounts. It would seem to me that the regulations that govern such accounts would require a power many libertarians would find objectionable.
You can see that the two main groups that stood in opposition to Obamacare offered proposals that would still have increased the size and power of the federal government. I say this, not because Distributists necessary think that the federal government has no role in the issue, but because these groups are always accusing their liberal opposition of expanding the power of government. The reality seems to be that the “conservative” movement of today is not truly the movement of smaller government with the federal government strictly bound by the limitations of the United States Constitution. Instead, it appears to be the movement of those who don’t mind bigger government, just not as big as the liberals. It is no wonder that the TEA Party movement is frequently as critical of the Republican Party as it is of the Democrat’s.
Digg It
Bookmark
Stumble
17 Comments
Wellllll, Republicans and Conservatives were completely left out of all Obamacare discussions. It’s hard to fault them for being ignored. After all Obamacare was the(massive) legislation on the table and that was what was up for vote. At least Republicans are willing to take steps not to burgeon the already booming abortion industry.
In times of “healthier” economic activity (lower unemployment figures, growth, etc.) the charge against a public option is that government would propose to establish an unnecessary and burdensome feature in the life of the average citizen. When our economy experiences a decline Republicans are hostile to a public healthcare option based on that decline, the expansion of government spending during crises and recession, etc. It is a convenient position to be in and their lack of initiative during the past 17 years since HilaryCare is very telling. I highly doubt the Republican hierarchy considers abortion a factor to be honest.
The ObamaCare machine was an unstoppable tank and as you correctly observe, conservatives were essentially left out of the discussion. Democrats were going to vote in favor of ObamaCare regardless of the details. To the credit of some Democrats and Republicans, they didn’t swallow Pelosi’s “vote now, read it later” nonsense.
I think that if we really want to solve the health care problem, particularly for the poor and destitute, we are going to have to build from scratch and start organizing.
BadgerCatholic, I did not fault them for being ignored by the mainstream media. I was pointing out that even conservative media failed to spend much time on the various Republican proposals. That is incomprehensible to me. Even in this run-up to the mid-term elections, I hear a lot of “let’s repeal Obamacare” and very little of “here’s what we’re proposing in its place.” That is what has been missing from the Republican Party – and the overall conservative movement – for many many years. Their campaigns don’t seem to be “here’s where we stand” as much as “we are not Democrats.” Quite frankly, that’s not enough.
Well one of the problems is how the heck does someone get elected running to END medicare? There is no way to avoid looking like you are ruthlessly going after senior citizens. Once these programs get established it’s almost impossible to dismantle them. They come to symbolize the problem they were supposedly established to solve; no analysis of the solution’s efficacy seems to be able to stand against the alleged altruism of the program, even when it is creating the exact opposite of its stated intent. Obamacare was supposed to control healthcare costs when before it has even been full enacted it’s already pushing them upwards. Then there is the Krugman defense of such liberal big government programs–things may be getting worse but they would have been even worse than that if we weren’t here. How in the heck do you prove THAT–or even contest it? It’s an an argument ad ignorantiam.
Ehhhh..except they weren’t completely left out of the discussions. The Senate Finance Committee “Gang of Six” negotiated for months before the Republican Party told their members to stop participating. The Republicans had their chance to help shape the legislation and in the end they picked up their ball and went home.
http://thehill.com/homenews/senate/57285-gang-of-six-negotiations-on-verge-of-collapse
And their strategy hasn’t changed a bit. Just look at their use of the filibuster. They’ve redefined themselves as the party of the Anti-Democrat. They’re not sure what they’re for but they sure know what they’re against.
Jennifer, One thing I have advocated something like the following since I was in my mid-twenties. It is true that we cannot simply tell people who have been paying into a system for years that their money is simply gone. We are ending the program and that’s all there is to it. We certainly cannot do this to the people currently depending on the program having already paid into it and who are now left without the means of providing alternate coverage for their medical needs. However, saying this is not the same as saying that we cannot find some responsible method of bringing the program to an end. For example, a law could be passed establishing that; (1) on January 1st of next year, citizens who have not completed their 40th year (or some other age to be determined) are no longer eligible for Medcare (Social Security, Medicaid, etc.); (2) the payroll taxes for those who are no longer eligible for these programs will no longer be collected from those people; (3) the taxes already collected, including employer contributions, from those who are no longer eligible for those programs will be returned to them; (4) any imbalance in funds for those programs may only be balanced through a general tax that is part of the General Fund (on-budget). The reason I believe this is a reasonable and responsible way to end the program is that it does not cut off those who are already dependent on it, nor does it cut off those who do not have sufficient time to make alternate provisions for themselves and their families. It will end the program through attrition. Eventually, those on the program will pass from this life leaving only those who are not eligible; thus bringing the program to an end. I am open to alterations or alternatives to this idea, but I think it can serve a the starting point for real debate on the fact that these programs CAN be brought to an end in a responsible and reasonable way if only we had the philosophical backbone to insist on it.
Oh no doubt it can be done responsibly. I’m just saying how the move would be CHARACTERIZED by opponents and in the media. The sound byte sounds something like: GOP ending medical care for the elderly. It’s a tough sell for the mainstream, even if they could be persuaded that the system is failing which of course it is.
Plus–these programs are like heroin–which is why I think some of the programs the GOP are proposing are sort of like methadone.
Why didn’t the Democrat’s do the responsible thing? I was raised that if you wanted something you saved up for it and then bought it with your hard earned money. Why, won’t our governments follow the same, pay off the national debt, and then save up for a program or programs that they think will be a benefit for the country. Speaking of government programs that need to be ended, such programs were started as an unfair burden on someone and an end of such a program should be expected to be unfair burden on someone else. That doesn’t mean that the program shouldn’t be ended.
Hi all,
I realize that David hasn’t given HIS proposals, or those of other Distributists as yet, but i must say that i’m rather disappointed at the lack of localized, decentralized, subsidiarist possibilities being advocated. I think that’s part of the problem with both our major parties, that they just assume it should be nationalized programs which dominate. Or perhaps it’s the electorate largely at fault here, as Jennifer suggests.
Btw, David, noticed that you put “conservative” in quotes, but not “liberal”. The latter seems to have migrated quite as much from its origins as the former, being now more a quasi-socialist thinking than a classical liberal one.
Viking
Very true about the quotes. My own reasoning is that the modern liberal made the switch from what it once was long ago. Today’s conservatives still cling to names like Goldwater and Reagan while being much more like Bush I and Bush II.
Proposals – mine and others – will be the topic of Part III.
HA HA HA!
The Democrats won’t do it for the same reason as the Republicans. Even in their opposition, both parties have worked for years to win votes by promising benefits from the public purse. Their back-room cooperation on this even extended to the fiction that the budget was balanced during the Clinton administration. (How can you say the budget was balanced when the national debt increased during the years of “surplus?” Only by engaging in accounting tricks that would have landed the common man in prison.) How many politicians on either side of the aisle have the guts to act like the current governor of New Jersey? Even he is not necessarily cutting programs not properly the responsibility of government; he is merely refusing to go further into debt to support those programs at the levels they were previously being funded.
Hi David,
Thank you for your reply. I’m far from satisfied with the term “conservative” myself, as it just means one with some resistance to change, and the former Soviet Union had its own conservatives by that definition. Indeed, its doubtful to me that anyone since the Industrial Revolution can truly meet the requirements of being conservative, as even those who would reverse it would be in the very different category of “reactionary”. I have a problem with the term “liberal” when applying it to most modern users of the term, as that term is related to “liberty”, the philosophy of a free person, and don’t feel that the modern “liberals” qualify. Btw, modern liberalism seems to me to have changed about as much as modern conservatism since Goldwater. Reagan himself changed significantly during his two terms.
Did you or anyone else want to address the first part of my original letter about local vs. national laws, the former being preferred in my case?
Best,
Viking
Hi Viking,
I have mentioned the need to build a plan from the bottom-up. Finding local solutions which can provide alternatives for the unemployed, disabled, destitute, and the broader community is exactly what we need. Bringing local government, private companies, charities, and families to the table is instrumental.
However, I stand by the article I wrote months ago. Subsidiarity is about competent authority; the smallest competent authority. And while I believe we must plan for a localized, decentralist solution, it is not –at every time and place – the competence of local communities to solve a problem which at present they are incapable of solving. When this occurs we must look to the individual states, and when the problem is national it should be met with a national response.
Until local communities are prepared to tackle this problem, the central government must respond. Now, should a national plan be long term? No. Ideally, the central government should only offer a short term alternative until regional and local options could be brought up to snuff. But it is not beyond the scope of the central government to provide a short term plan in the interim.
This is not an endorsement of Obama’s plan nor am I suggesting we should adopt any plan. But if the right plan does come along we shouldn’t be reflexively against it.
We may disagree here, but I know we certainly agree on one thing. Regardless, we need to work together to build a localized and decentralist plan. An imitable plan. This is the only way to undo the tangled web our President has gotten us all into.
Hi Richard,
Which article are you referring to that you wrote a few months ago? And yes, i realize that not every community, particularly not small ones, is capable of administering a health care plan. My use of “local” basically meant considerably smaller than the “national”, at least with regard to a nation as large as the US. I regret my probably lax use of such terms.
Best,
Viking
I’m new to this site but just finished reading a few of Hilaire Belloc’s books. I’m in great sympathy with much of his views but have to say I have a great deal of problems with some of the comments here. It’s wrong and I believe immoral to tear down structures like social security or medicare that are critical to the vast majority of people before putting in place something better. It would only strengthen the forces of capitalism at the horrible expense of the average family.
To throw out socialist oriented programs without first eliminating capitalism can only hurt the cause that I assume most on this site shares.
Jim
http://commentsongpe.wordpress.com
Jim, I appreciate the concern regarding “tearing down” things like Social Security and Medicare while people depend on them. If you review the comments again, you will find that this was not advocated. My comment was that it must be continued for those who are currently on it and for those who do not have time to provide for alternatives. Other comments mentioned finding alternatives to these programs. Keep in mind that having these types of programs at a national level was never a necessity for society as a whole. Societies have always had to deal with how to treat the aged and, historically, have handled it without resort to government managed programs. In fact, this country managed for over 100 years without them. However, I disagree that these programs are truly socialist. Belloc pointed out that Capitalism would have to establish these types of programs to provide for “those in times of idleness.” I think that this fact shows that Capitalism and Socialism are really two sides to the same coin; the concentration of the control of productive capital to the few. These programs only got implemented due to the problems caused by the factory conditions and the depression of the early 20th century. They are solutions created by Capitalism to preserve Capitalism. Capitalism cannot be eliminated first; and implementing socialist programs is never an antidote to the ills of capitalism. Socialism itself is immoral and one cannot justify simply substituting one immorality for another. Capitalism will only be eliminated by dismantling it; which involves systematically undoing the structures established to support it by keeping the masses placated. However, as I stated in my previous comment, this needs to be done in a responsible manner. Therefore, we must establish alternatives to these programs that are more local; and we must continue to provide these programs for those who are dependent on them as well as those who will become so before the alternatives are established.