Last week, I posted on Ricochet a piece asserting that the individual mandate – first proposed in the early 1990s by the social engineers at the Heritage Foundation, enthusiastically embraced at the time by Newt Gingrich, and put into effect in Massachusetts, to Gingrich’s applause, by Mitt Romney – is tyrannical. In defense of that claim, I advanced the following argument:
Government exists first and foremost for the sake of our protection. Without it, our lives and our property would not effectively be our own. Government exists also to promote our well-being. For its support, however, taxation is necessary, and we have tacitly agreed that, to be legitimate, these taxes must be passed by our elected representatives. By our own consent, we give up a certain proportion of our earnings for these purposes.
The money left in our possession, however, is our own – to do with as we please. It is in this that our liberty largely lies. Romneycare and Obamacare, with the individual mandate, changes radically our relationship vis-a-vis the government. The former presupposes that state governments have the right to tell us how we are to spend our own money, and the latter presupposes that the federal government has that right as well. Both measures are tyrannical. They blur the distinction between public and private and extend the authority of the public over the disposition of that which is primordially private. Once this principle is accepted as legitimate, there is no limit to the authority of the government over us, and mandates of this sort will multiply – as do-gooders interested in improving our lives by directing them encroach further and further into the one sphere in which we have been left free hitherto.
Managerial progressives see only the end – preventing free-riders from riding for free. And they ignore the collateral damage done by way of the means selected. Mitt Romney and Newt Gingrich have no understanding of first principles. For both of these social engineers, citizens are subjects to be worked-over by the government for their own good. Both men are inclined to treat us as children subject to the authority of a paternalistic state under the direction of a benevolent and omniscient managerial class. . . .
Raising taxes to reward free riders is, of course, objectionable. We should oppose it on principle. But it does not in and of itself narrow in any significant fashion the sphere of our liberty. It is a question of the proper use of the public purse. The individual mandate sets a new precedent. It extends government control to the private purse.
This provoked a response on another website from Orin Kerr – a nominally libertarian law professor at George Washington University who once clerked for Anthony Kennedy, who is himself a firm advocate of the individual mandate, and who has predicted that Justice Kennedy and the U. S. Supreme Court will find the individual mandate constitutional. In his response to my piece, Kerr asserts that I argued “that conservatives should prefer a government-run health care system paid for by higher taxes over an individual-mandate approach.” In this context,he writes, “I’m curious: Did any conservatives express this view before President Obama embraced the individual mandate? Or at these sorts of arguments something that conservatives didn’t assert until long after the legislation was passed?” Then, he notes, “On April 3, 2010, a week or so after the individual mandate was passed, Rahe appeared to strongly endorse the following statement of Mark Steyn that was part of a broad criticism of the new law:
Whatever is in the [health care] bill is an intermediate stage: . . . the governmentalization of health care will accelerate, private insurers will no longer be free to be “insurers” in any meaningful sense of that term (i.e., evaluators of risk), and once that’s clear we’ll be on the fast track to Obama’s desired destination of single payer as a fait accomplis.
“That’s the kind of criticism," Kerr continues, "I remember at the time: Obamacare was really bad on its own, the argument ran, and even worse it was likely to lead to a government-run system in the future. As I recall, the thinking was that Obama really wanted a government-run system but didn’t get enough support for it outside the left, so he had to compromise with moderates and that resulted in the mandate.”
The answer to Professor Kerr’s question is that, in abbreviated form in the post which he cites, I advanced the very argument against the individual mandate that I stated more fully last week and that Mark Steyn did the same in the long article in National Review that I cited in that post. Here is what I said:
If the program passed in the House of Representatives on March 21st and signed into law thirty-six hours thereafter is fully implemented and left in place for any considerable length of time, it will complete the project begun by the Progressives when they first took control of the federal government in 1912. We will, as Mark argues, be indistinguishable from the Canadians and the Europeans; our character as a people will change; we will be transformed into subjects and wards of the state, and we will no longer be citizens; our economy will stagnate; and we will have neither the resolve nor the resources with which to defend our country and its way of life. If we acquiesce, we really are doomed.
I first outlined this argument on 1 July 2009 in a post on Powerline entitled The Tyrannical Ambition of Barack Obama. It was my position then, as it is my position now, that Obamacare was objectionable in and of itself and not merely on constitutional grounds. It was also my position then, as it is my position now, that it was intended by its Democratic proponents in Congress as the forerunner for a full governmentalization of healthcare.
To ask Professor Kerr’s question – whether “conservatives should prefer a government-run health care system paid for by higher taxes over an individual-mandate approach” – is, I believe, to pose the wrong question. The right question is whether the government of the United States or the government of any state should take responsibility for the healthcare of individuals residing within its boundaries – except in matters of public health (where the irresponsibility of one individual is a serious threat to the health or life of another). In my opinion, the answer that conservatives should give is that this is something for which the individual citizens of the United States and resident aliens should themselves take responsibility. We live in a republic – a political regime that presupposes a modicum of virtue on the part of its citizens. The supreme modern republican virtue – the one most necessary to the survival of the regime – is self-reliance, and the public provision of private goods inevitably erodes that essential virtue.
There are, of course, those who vigorously reject this argument. In the last century, they have variously called themselves Progressives, Liberals, and New Dealers, and for the most part they have dominated both of our political parties. Thomas E. Dewey, who was the Republican presidential nominee in 1944 and 1948, proudly called himself “a New Deal Republican,” and, in the sphere of public policy, Dwight D. Eisenhower followed his lead – as did Richard M. Nixon, the man who brought us the Environmental Protection Agency, the Occupational Safety and Health Administration, and affirmative action, and the same can be said for Bush père, Bob Dole, Bush fils, and John McCain. They were all men who could have justly said what Mitt Romney told the people of Massachusetts nine years ago, “I have progressive views.”
To get a sense of where this all began, you might want to examine the Commonwealth Club Speech that Franklin Delano Roosevelt delivered in September, 1932. It was tellingly entitled Of Progressive Governance, and in it the future President attacked the free market, blaming it for the Great Depression, and called for a new economic regime. It was his claim that circumstances called
for a re-appraisal of values. A mere builder of more industrial plants, a creator of more railroad systems, and organizer of more corporations, is as likely to be a danger as a help. The day of the great promoter or the financial Titan, to whom we granted anything if only he would build, or develop, is over. Our task now is not discovery or exploitation of natural resources, or necessarily producing more goods. It is the soberer, less dramatic business of administering resources and plants already in hand, of seeking to reestablish foreign markets for our surplus production, of meeting the problem of under consumption, of adjusting production to consumption, of distributing wealth and products more equitably, of adapting existing economic organizations to the service of the people. The day of enlightened administration has come.
FDR did not stop, however, at a call for “enlightened administration” and a redistribution of “wealth and products.” Citing not only his heroes Woodrow Wilson and Teddy Roosevelt but also Thomas Jefferson, he took the old Progressive vision, which argued for governance by an elite distinguished by the expertise of its members, and he gave it a new twist intended to make it seem consistent with the American Founding, recasting the argument in terms of rights:
As I see it, the task of government in its relation to business is to assist the development of an economic declaration of rights, an economic constitutional order. This is the common task of statesman and business man. It is the minimum requirement of a more permanently safe order of things.
Every man has a right to life; and this means that he has also a right to make a comfortable living. He may by sloth or crime decline to exercise that right; but it may not be denied him. We have no actual famine or death; our industrial and agricultural mechanism can produce enough and to spare. Our government formal and informal, political and economic, owes to every one an avenue to possess himself of a portion of that plenty sufficient for his needs, through his own work.
Every man has a right to his own property; which means a right to be assured, to the fullest extent attainable, in the safety of his savings. By no other means can men carry the burdens of those parts of life which, in the nature of things afford no chance of labor; childhood, sickness, old age. In all thought of property, this right is paramount; all other property rights must yield to it. If, in accord with this principle, we must restrict the operations of the speculator, the manipulator, even the financier, I believe we must accept the restriction as needful, not to hamper individualism but to protect it.
These two requirements must be satisfied, in the main, by the individuals who claim and hold control of the great industrial and financial combinations which dominate so large a part of our industrial life. They have undertaken to be, not business men, but princes-princes of property. I am not prepared to say that the system which produces them is wrong. I am very clear that they must fearlessly and competently assume the responsibility which goes with the power. So many enlightened business men know this that the statement would be little more that a platitude, were it not for an added implication.
This implication is, briefly, that the responsible heads of finance and industry instead of acting each for himself, must work together to achieve the common end. They must, where necessary, sacrifice this or that private advantage; and in reciprocal self-denial must seek a general advantage. It is here that formal government-political government, if you choose, comes in. Whenever in the pursuit of this objective the lone wolf, the unethical competitor, the reckless promoter, the Ishmael or Insull whose hand is against every man’s, declines to join in achieving and end recognized as being for the public welfare, and threatens to drag the industry back to a state of anarchy, the government may properly be asked to apply restraint. Likewise, should the group ever use its collective power contrary to public welfare, the government must be swift to enter and protect the public interest.
The full ramifications of what he had in mind when he spoke of "a reappraisal of values" FDR did not reveal until the last year of his life – when, in the message the ailing President sent Congress on 11 January 1944 in lieu of delivering a State of the Union Address, he elaborated in complete form what he meant by “an economic declaration of rights” in the process of calling for “the establishment of an American standard of living higher than ever before known”:
We cannot be content, no matter how high that general standard of living may be, if some fraction of our people—whether it be one-third or one-fifth or one-tenth- is ill-fed, ill-clothed, ill housed, and insecure.
This Republic had its beginning, and grew to its present strength, under the protection of certain inalienable political rights—among them the right of free speech, free press, free worship, trial by jury, freedom from unreasonable searches and seizures.
They were our rights to life and liberty.
As our Nation has grown in size and stature, however—as our industrial economy expanded—these political rights proved inadequate to assure us equality in the pursuit of happiness.
We have come to a clear realization of the fact that true individual freedom cannot exist without economic security and independence. “Necessitous men are not free men.” People who are hungry and out of a job are the stuff of which dictatorships are made.
In our day these economic truths have become accepted as self-evident. We have accepted, so to speak, a second Bill of Rights under which a new basis of security and prosperity can be established for all regardless of station, race, or creed.
Among these are:
• The right to a useful and remunerative job in the industries or shops or farms or mines of the Nation;
• The right to earn enough to provide adequate food and clothing and recreation;
• The right of every farmer to raise and sell his products at a return which will give him and his family a decent living;
• The right of every businessman, large and small, to trade in an atmosphere of freedom from unfair competition and domination by monopolies at home or abroad;
• The right of every family to a decent home;
• The right to adequate medical care and the opportunity to achieve and enjoy good health;
• The right to adequate protection from the economic fears of old age, sickness, accident, and unemployment;
• The right to a good education.
All of these rights spell security. And after this war is won we must be prepared to move forward, in the implementation of these rights, to new goals of human happiness and well-being.
America’s own rightful place in the world depends in large part upon how fully these and similar rights have been carried into practice for our citizens. For unless there is security here at home there cannot be lasting peace in the world.
One of the great American industrialists of our day—a man who has rendered yeoman service to his country in this crisis-recently emphasized the grave dangers of “rightist reaction” in this Nation. All clear-thinking businessmen share his concern. Indeed, if such reaction should develop—if history were to repeat itself and we were to return to the so-called “normalcy” of the 1920’s—then it is certain that even though we shall have conquered our enemies on the battlefields abroad, we shall have yielded to the spirit of Fascism here at home.
I quote this document at length – chiefly, because I believe that, if you read it twice and think about it, you will recognize that it is the founding document of the administrative entitlements state and that Roosevelt’s program of positive economic rights has dictated American public discourse and public policy now for almost sixty-eight years. In fact, apart from Barry Goldwater and Ronald Reagan, no Republican Presidential nominees have articulated a principled argument against this program. Instead, the Republicans in high office have served the function that the New Dealers intended for them. They embraced the administrative entitlements state, and they intervened from time to time to tweak the system, to expand it on the margins, and to make it work more efficiently. They served as the tax collectors for the welfare state, and they prided themselves on their managerial competence.
It is no wonder that Professor Kerr thinks it appropriate to ask whether “conservatives should prefer a government-run health care system paid for by higher taxes over an individual-mandate approach.” He takes FDR’s second bill of rights for granted. Once one has accepted the legitimacy of the younger Roosevelt’s program, the only question left to be answered in current circumstances is what are the most efficient and effective political arrangements for guaranteeing that everyone is covered by health insurance.
I would suggest, instead, that FDR’s economic bill of rights is inconsistent with limited government and republican liberty – which presuppose a distinction between public and private that cannot be sustained in a world in which employment, remuneration, housing, education, and medical care are matters for public provision. The proper question to ask and wrestle with is not the question that Professor Kerr posed. We should not ask how we can most prudently expand public provision. We should, instead, ask, “How can we gradually and prudently roll back the administrative entitlements state? We face a crisis. That the regime founded by Franklin Delano Roosevelt and gradually articulated by his successors – Democrat and Republican alike – is bankrupt is now clear. In what order should we prune the welfare state and how quickly should we move?”
These are the prudential questions we must face. Instead of embracing FDR’s bill of economic rights, we should begin thinking about when to repeal the minimum wage law, when and how to abolish Food Stamps, Medicaid, federal aid to education, and federally-financed student loans, how we should reform Social Security and Medicare, and when and how to eliminate public housing.
In November, 2012 – if all goes as it almost certainly will – Americans will once again have an opportunity to choose between Tweedledum and Tweedledee – between a utopian progressive disinclined to concern himself with how programs will be paid for and a managerial progressive who agrees with him about the ends and purposes of government but knows that the books must be balanced. It is conceivable that the latter, who is a political chameleon, will recognize the bankruptcy of the administrative entitlements state, abandon the progressive “views” that he trumpeted in 2002, and take on the administrative entitlements state. But this is unlikely.
Whether the unprecedented political opportunity now within our grasp will recur it is hard to say. There has never been a Democrat as contemptuous of practicality as the current presidential incumbent, and there may never be another. The one thing that is clear is that tweaking the system is not going to make the bankruptcy of the administrative entitlements state disappear. At best, it would kick the can not very far down the road.
In the interim, in the absence of a better presidential candidate, our task should be to box Mitt Romney in, to bend him to our will, to give him every incentive we can devise for jettisoning his progressive “views,” and – when these efforts fall short (as they surely will) – to make sure that he is the last managerial progressive nominated for the Presidency by the Republican Party.
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Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
Here, I disagree. We need to return the Republican Party to its founding principles.
Dec '10
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
Paul A. Rahe
A government gone astray will produce a people gone to pot. Adopt Social Security and you get demographic decline. Establish public provision, and fewer people will want to work. Of course, it goes the other way as well. · Jan 2 at 10:34am
Were I to completely mix metaphors in a blender I'd say that this is a chicken and egg situation in which we have the cart directly before the horse.
Jul '10
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
"tax collectors for the welfare state"
Who said that?
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
ShellGamer:
Imagine we magically extracted government from the healthcare system altogether. A member of our republic, virtuous though of modest means, is struck in the prime of her life by cancer. The costs of her treatment are beyond the means of private charity. Should she die now and decrease the surplus population? Or does her case warrant collective action (i.e., governmental response)?
The progressive impulse is: "Here is something we all agree is a problem, and through collective action we could mitigate it or eliminate it altogether. Why should we let any mere principle stop us?" Debating the program on utilitarian grounds (collective action won't work or will create a larger problem than it solves) concedes the impluse. Prof. Rahe tries to provide a more principled response. But how do we reconcile such principles with the "better angels of our nature;" our lauditory impulse to aid our fellow citizens (at least) during times of privation and want? If we allow an exception, must we then slide all the way down the slippery slope to government health care? · Jan 2 at 10:30am
Well-stated. Are these cases really more than charity can handle?
Oct '10
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
The great virtue of Plato, I often think, is that he was so wrong about so much so early.
I've been reading some Thomas Sowell over the break, so I'm feeling a bit more optimistic. It's not so long ago that accepting charity was a shameful thing. If we, as conservatives, believe in the fundamental constancy of human nature (fallen as it is), then we should believe that a sustained campaign of truth telling can reverse a hundred years or so of magical thinking - albeit not overnight.
Feb '11
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
Ralph Baskett: To win this argument, conservatives need to provide an attractive alternative that exemplifies their principles.
Current tax law has led to employers controlling their employee’s healthcare. To remedy this injustice healthcare expenses should be tax deductable for the individual. The average spending on employee healthcare is over $8,000 per employee so individuals should be allowed a tax deductable contribution of up to $10,000 to their own private health savings account (HSA).
Ralph’s post illustrates the one way ratchet of progressive policies. We are already dependent on an implicit subsidy for health insurance under the current tax system. So it is not feasible to extract government from healthcare. The best we can do is to mitigate the intrusion: HSAs that preserve the tax benefit while increasing individual autonomy. This merely shifts the focus of government administration: how much can go in to HSAs, what withdrawals are tax-exempt or taxable, what if people are not making sufficient contributions (notwithstanding the tax deduction) to cover their expected medical expenses. Certainly this is better than ObamaCare (this may be the faintest praise currently possible in the American lexicon), but it is still a progressive policy.
Oct '10
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
ShellGamer
Ralph’s post illustrates the one way ratchet of progressive policies.
Indeed. Tax policy should be about raising revenue. Start trying to use it to 'nudge' behaviour and you impinge upon the liberty (from the State - society is entitled to punish and reward) back towards which we are groping our way.
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
Freesmith: Ron Paul may or may not have written those newsletters. What is important is that he was behind them. You may be willing to support a man who for years fomented the hatred of African-Americans, Jews, and the homoerotically inclined and still welcomes the support of those who continue to do so. I judge such a man vile and could never under any circumstances support him.
You may also be willing to embrace a man who wants to cripple this country's capacity to project power and defend itself by cutting its defense budget by forty percent. I am enough of an historian to know that weakness invites attack.
It is appropriate that we judge candidates on their records and on their public stands. Ron Paul's record is that of a scoundrel, and his stand on the single most important issue that any President must address is simply insane.
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
Michael Tee: "tax collectors for the welfare state"
Who said that? · Jan 2 at 10:48am
Would that Newt had followed through on the logic of his observation.
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
The King Prawn
Paul A. Rahe
A government gone astray will produce a people gone to pot. Adopt Social Security and you get demographic decline. Establish public provision, and fewer people will want to work. Of course, it goes the other way as well. · Jan 2 at 10:34am
Were I to completely mix metaphors in a blender I'd say that this is a chicken and egg situation in which we have the cart directly before the horse. · Jan 2 at 10:44am
Your friend Plato (and mine) understood that political regimes shape those within them.
Dec '10
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
Paul A. Rahe
The King Prawn
Paul A. Rahe
A government gone astray will produce a people gone to pot. Adopt Social Security and you get demographic decline. Establish public provision, and fewer people will want to work. Of course, it goes the other way as well. · Jan 2 at 10:34am
Were I to completely mix metaphors in a blender I'd say that this is a chicken and egg situation in which we have the cart directly before the horse. · Jan 2 at 10:44am
Your friend Plato (and mine) understood that political regimes shape those within them. · Jan 2 at 11:12am
But, how much of the regime we currently have reflects the character of its citizenry? As we function as a representative democracy I would say quite a bit. Yes, the street runs both ways, but I think the character of the people has a greater influence on the regime than vice versa. To argue otherwise is the very definition of progressivism.
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
The King Prawn
Paul A. Rahe
The King Prawn
Paul A. Rahe
A government gone astray will produce a people gone to pot. Adopt Social Security and you get demographic decline. Establish public provision, and fewer people will want to work. Of course, it goes the other way as well. · Jan 2 at 10:34am
Were I to completely mix metaphors in a blender I'd say that this is a chicken and egg situation in which we have the cart directly before the horse. · Jan 2 at 10:44am
Your friend Plato (and mine) understood that political regimes shape those within them. · Jan 2 at 11:12am
But, how much of the regime we currently have reflects the character of its citizenry? As we function as a representative democracy I would say quite a bit. Yes, the street runs both ways, but I think the character of the people has a greater influence on the regime than vice versa. To argue otherwise is the very definition of progressivism. · Jan 2 at 11:16am
No, it is the view advanced by Herodotus, Thucydides, Plato, Aristotle, Cicero, and Montesquieu. The regime educates and shapes the citizens.
Oct '10
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
What is Burnham's rule?
How can they be beyond private means but within public means?
Feb '11
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
Paul A. Rahe
Are these cases really more than charity can handle? · Jan 2 at 10:53am
I inserted the condition to avoid the deus ex machina presumption that charity will always suffice. Whether charity will be enough depends on the range of problems addressed and the circumstances at any point in time. Although I believe that charities would deal with unemployment more effectively than government (because charities try to fix problems, rather than administer them), it’s not clear that charities would necessarily have the capacity to deal with the financial crisis we are experiencing. In any event, I think we should address the possibility that charity may not be enough; are we willing to live with the consequences in order to preserve our principles?
One virtue of charity is that it forces progressives to sell and pay for their programs, rather than co-opting everyone's support. The question is when we should use governmental power to compel support. The risk of free riding generally favors a governmental approach to collective action rather than a voluntary one. Governments, not foundations, build and maintain our roads to avoid, among other problems, literal free riders.
Jul '10
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
Paul A. Rahe
Michael Tee: "tax collectors for the welfare state"
Who said that? · Jan 2 at 10:48am
Would that Newt had followed through on the logic of his observation. · Jan 2 at 11:10am
You should read the article, if you haven't already. It dovetails nicely with your premise.
Dec '10
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
Paul A. Rahe
The King Prawn
But, how much of the regime we currently have reflects the character of its citizenry? As we function as a representative democracy I would say quite a bit. Yes, the street runs both ways, but I think the character of the people has a greater influence on the regime than vice versa. To argue otherwise is the very definition of progressivism. · Jan 2 at 11:16am
No, it is the view advanced by Herodotus, Thucydides, Plato, Aristotle, Cicero, and Montesquieu. The regime educates and shapes the citizens. · Jan 2 at 11:20am
Is this not the whole of the progressive scheme, to educate and shape the citizens in the imagine envisioned by our enlightened betters? I agree that the regime can educate and shape the citizens, but aren't we arguing over whether or not it should? Isn't that the crux of the debate over limited vs. expansive government?
Feb '11
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
genferei
What is Burnham's rule?
How can they be beyond private means but within public means? · Jan 2 at 11:20am
James Burnham helped William Buckley start NR. I read in NR at some point that "Who says A must say B" was one of his stock expressions. I always understood this to mean anyone who proposes a program must accept (and defend) its natural and probable consequences.
We may have the means to address a problem, but choose not to use them. This is the premise of any progressive governmental program: left to our own devices (including charity), we will never address the agreed upon problem. What the media (and most of the public) never asks progressives to explain, however, is why we are obligated to fix the problem.
May '10
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
Paul A. Rahe
...the only things that genuinely fall under the rubric of public health are objects such as safe water and situations where self-defence is legitimate... · Jan 2 at 10:32am
Ah, but conservatives like you, Prof. Rahe, haven't been able to define public health policy. As my husband says, "problem definition drives policy formulation." Healthcare policy is not and has not been studied or defined in large measure by conservatives, but instead by liberals, particularly is a macro sense. Many grew up in Europe and studied at the Ivy Leagues. Some of Prof. Kerr's colleagues at GW have been at forefront of healthcare policy formation.
In a society where most communicable diseases are controlled through vaccination or education, the primary drivers of healthcare costs are/will be lifestyle diseases: obesity, heart disease, diabetes, etc. As healthcare costs continue to rise, lifestyle choices will be subject to government oversight.
Until health policy's redefinition is accepted by voters, legislative intervention is impossible. And that could take decades. That will be one of the great challenges for GOP going forward.
Edited on Jan 2 at 11:47amOct '10
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
Thank you.
For others who are interested, Terry Teachout has a brief post on Burnham's Laws:
1. Everybody knows everything.
2. Who says A must say B.
3. Just as good, isn't.
4. You cannot invest in retrospect.
5. Wherever there is prohibition there's a bootlegger.
6. In every project there's a Schlamm.
vii. You can't divorce yourself.
viii. Every member must pay his dues.
ix. No excuse, sir.
10. If there's no alternative, there's no problem.
Included is a link to an Orwell essay Second Thoughts on James Burnham.
Re: Which Species of Socialized Medicine is Preferable: Single-Payer or the Individual Mandate?
Michael Tee
Paul A. Rahe
Michael Tee: "tax collectors for the welfare state"
Who said that? · Jan 2 at 10:48am
Would that Newt had followed through on the logic of his observation. · Jan 2 at 11:10am
You should read the article, if you haven't already. It dovetails nicely with your premise. · Jan 2 at 11:29am
Yes, it does. I read it when it first came out. What I did not remember was the source of that pungent operation.
Incidentally, Charles Kesler has a book coming out -- this summer, I think -- on Obama.