Noblesse Obliged to Whom?

Filed under:Politics,Priorities — posted by Anwyn on January 5, 2010 @ 8:12 pm

A Facebook status meme going around for a while last year read: “I will proudly pay more taxes if that means someone less fortunate than I receives health care.”

If it were that simple, I’d cheerfully pay those extra taxes too. (Subject to a conversation on percentages, of course.) It’s not just about that. That’s only where it starts.

I responded to one person sporting the status, “And even if it reduces your health care and your family’s, too?” And he said, “Yes.”

I should also have asked, “And are you also willing to proudly fork over more taxes for people who are not less fortunate but who are just lazy freeloaders?” It’s not just about “fortunate.” He didn’t get to be an expert engineer through luck. He went to college, worked hard, and has been with the same company for over ten years.

I have a couple of unpalatable options here. I feel the more charitable is to assume that he only says that because he doesn’t really believe it would come to that. Like most utopian, semi-utopian, or somewhat utopian liberals, he probably doesn’t really believe it would pan out that way. We’re America! We’re smart! We have a lot of crappy socialist models to learn from! Surely no bureaucrat is going to put off my son’s operation six months or more because the doctors have no room in their schedules!

I have no trouble at all believing government-run health “insurance” would indeed come to that. I am angry about the current system as it is–it’s not “insurance,” it’s a service that pays your doctor on your behalf for which you pay far more than you’re ever likely to need to pay doctors and hospitals. It’s throwing bad money before good, and in my unexpert opinion it has driven up prices far beyond where they’d be without it. Health “insurance” should no more pay for routine doctor appointments than auto insurance pays for oil changes–that’s not insurance. Insurance is protection against something catastrophic and unforeseen, like a car accident or a chronic and critical disease. I’d far prefer to pay my doctors as I go, with a catastrophic-coverage backup, which is not really an option under our current employer-centric “insurance” system, because of government interference that doesn’t tax employer-provided coverage but only that bought privately. But even if we could do that, that won’t satisfy liberals who believe that everybody has an obligation to pay into a system that covers people who are too poor or too sorry to either buy health “insurance” or pay for their own health care. (“Sorry,” in this context, just means disinclined to take care of one’s self and responsibilities–the lazy freeloader.)

But that’s beside the current point. Government-run health “insurance” would come down to some bureaucrat postponing my friend’s kid’s operation, for the simple reason that while doctors and hospitals are not necessarily finite resources, the operation of government would provide heavy incentives for them to be self-limiting. The government, in its zeal to cover every person for every condition–i.e. make all medical care “free,” would find itself limited by the amount of money available and would have only two choices: Stop covering certain medical services or pay the doctors and hospitals less–probably, in the end, both. Who wants to enter a business where the government decides what you get paid for your services (excluding professions where the government is actually paying you for service rendered the government, not to a third party), giant student loans be damned? Only people with a truly high calling to heal people for healing’s own sake–a self-limiting pool. The number of doctors goes down. The number of people wanting to see doctors goes up. The federal government controls the purse strings. Conflicts of interest, to put it mildly, are inevitable. (more…)

image: detail of installation by Bronwyn Lace