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Health-Care “Reformers” Duck the Hard Questions


Advocates of what is called health-care “reform” must lack confidence in their case. Were they sure that more government control of medicine and medical insurance was a good thing, they would answer the opposing arguments rather than marginalize their adversaries as corrupt or crazy.

In debating a controversial issue, a good-faith participant rebuts the strongest possible opposing arguments. He doesn’t focus on easy targets, such as self-serving or ill-informed opponents, while pretending that legitimate arguments don’t exist.

But that is exactly what most proponents of the Obama approach to health-care regulation do. Having watched this discussion closely, I am struck by how doggedly they avoid the toughest criticism.

The proponents act as if only two kinds of opponents exist: shills for big pharmaceutical and insurance companies, and know-nothing (and most likely racist) extremists who “fear change.” Good-faith opposition based in economic, political, and moral theory is subtly ruled out as impossible.

The benefit of this for the Obama backers is that they never have to respond to the real case against government control. Sneering ridicule and dramatic exposés take the place of argument.

A good number of media pundits are guilty of this evasion. Keith Olbermann, Rachel Maddow, and Chris Matthews of MSNBC take it to the extreme, but they are not alone. They spend their time attacking apologists for corporate profits and mocking the ill-informed people who disrupt congressional district meetings. The former are portrayed as cynically protecting their companies at the expense of people who cannot afford medical services; the latter are portrayed as manipulated — if not dangerously unbalanced — people who show up at meetings because they are pawns of phony grassroots organizations and are fanatically anti-government. (By the way, which is it?) Throw in some congressmen who seem not to know what they are talking about and you have an opposition unworthy of serious attention.

But there are problems with the pundits’ picture. The commentators conveniently ignore that President Obama regularly meets with representatives of big pharmaceutical and insurance companies, which support most of what he wants. They are even paying for ad campaigns in behalf of so-called reform. These companies stand to make huge profits from new health-care regulation, including one, GE, which owns MSNBC, whose commentators relentlessly attack Obama’s opponents as corporate shills.

It is true that many people who attend congressional meetings have little more than a gut-level aversion to further government control of health care and repeat inaccurate allegations about the various bills in Congress. Pointing out those inaccuracies is proper, but Obama’s defenders need to do more: They need to answer the critics who offer solid arguments for why government control would harm, not help, most people.

According to these critics — mostly economists — the Obama program is flawed because it is not possible to expand medical coverage through subsidies and regulation and control costs without interfering with free choice, that is, without rationing. That’s not a charge based on fear or conspiracy-mongering. It’s economics. If government subsidizes demand, prices will go up. If government also wants to lower prices, it will have to ration in some way, as governments do in other countries.

There’s no alternative. Those, like Obama, who say the government will save money by making the system more efficient miss the point. Prices would still go up under the pressure of new subsidized demand. Obama backers: where are your counterarguments?

Anyway, promises of cost savings are wishful thinking. We’re talking about the government, remember? Who would be willing to bet his own money that the bureaucracy can lower the overall medical bill without rationing?

The most outrageous claim that Obama’s supporters make is that all opponents of “reform” are satisfied with the status quo. That’s nonsense. The strongest critics of Obama-ism are those who argue that the current system is objectionable precisely because it is a government-business cartel built on anti-competitive regulation, rigged tax laws, licensing, patents, and other privileges. While the “reformers” accept this status quo, proposing only marginal adjustments, the economist-critics demonstrate that free-market competition — the separation of medicine and state — is the only way to lower costs and improve service while protecting liberty and privacy.

When will Obama’s supporters stop ducking the tough arguments?

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    Sheldon Richman is former vice president and editor at The Future of Freedom Foundation and editor of FFF's monthly journal, Future of Freedom. For 15 years he was editor of The Freeman, published by the Foundation for Economic Education in Irvington, New York. He is the author of FFF's award-winning book Separating School & State: How to Liberate America's Families; Your Money or Your Life: Why We Must Abolish the Income Tax; and Tethered Citizens: Time to Repeal the Welfare State. Calling for the abolition, not the reform, of public schooling. Separating School & State has become a landmark book in both libertarian and educational circles. In his column in the Financial Times, Michael Prowse wrote: "I recommend a subversive tract, Separating School & State by Sheldon Richman of the Cato Institute, a Washington think tank... . I also think that Mr. Richman is right to fear that state education undermines personal responsibility..." Sheldon's articles on economic policy, education, civil liberties, American history, foreign policy, and the Middle East have appeared in the Washington Post, Wall Street Journal, American Scholar, Chicago Tribune, USA Today, Washington Times, The American Conservative, Insight, Cato Policy Report, Journal of Economic Development, The Freeman, The World & I, Reason, Washington Report on Middle East Affairs, Middle East Policy, Liberty magazine, and other publications. He is a contributor to the The Concise Encyclopedia of Economics. A former newspaper reporter and senior editor at the Cato Institute and the Institute for Humane Studies, Sheldon is a graduate of Temple University in Philadelphia. He blogs at Free Association. Send him e-mail.