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Health care debate masks real issues

Ben Linskey | Monday, September 7, 2009

If you’ve been following the news for the past few weeks, you’re probably getting tired of hearing about health care reform. Democrats and Republicans have managed to avoid much serious debate about this crucially important issue, instead launching inane charges of extremism at each other. The caricatures produced by the leaders of both parties would be laughable if they weren’t bandied about with such frequency and earnestness. Republicans accuse Democrats of being socialists intent on creating death panels to arbitrarily kill senior citizens, while Democrats counter that Republicans are un-American fascists in the pocket of health insurance companies. This nonsensical political circus obscures the true significance of the health care debate: While health care reform is an important and consequential matter, Americans are primarily concerned about the rapidly expanding size and role of government in everyday life.

Talk of “rationing” health care provides an important insight into the fundamental issues underlying the debate. Conservative politicians are fond of warning that Democrats’ proposals will ration care, conjuring up the image of impersonal, bureaucratic agencies limiting Americans’ health care options. There is an element of truth to this claim – a government-run “public option” would naturally have to make hard choices about which forms of medical treatment would be covered and which would be excluded. What Republicans usually neglect to mention, though, is that all health care is rationed. All goods, in fact, are rationed – this is a basic truth of economics. Just as there does not exist an infinite supply of Lamborghinis or ice cream, an endless reservoir of health care is not available. Thus, we must find a way to distribute, or “ration,” this scarce good.

There are two basic means by which to do this. One option is to establish a free market, in which the “invisible hand” famously identified by Adam Smith works to distribute goods in the most efficient means possible. The other is to place all economic goods in the hands of a single governing agency and entrust it to use its presumably superior wisdom to determine who should have what. This latter method, of course, is fraught with problems. America has long favored free markets over central planning, but in recent years, the United States have abruptly and dramatically shifted course, bringing many formerly private sectors of the economy under government control and spending at an astonishing rate.

The past year alone has seen a series of Wall Street and auto industry bailouts, culminating in the federal government’s takeover of General Motors. These expansions of government power were accompanied by hundreds of billions of dollars in “stimulus” spending, boosting the total national debt to well over 11 trillion dollars. Meanwhile, the U.S. is engaged in two major conflicts in Iraq and Afghanistan, which combine to produce a significant drain on the U.S. treasury. In this context, Democrats’ proposed health care reform appears as less of a radical shift than a continuation of the present course.

What, then, are we to make of the heated debate over health care? Americans are beginning to become alarmed at the nonstop expansion of the federal government, and they’re worried about the prospect of lawmakers and bureaucrats in Washington, D.C. becoming involved in the intensely personal issue of medical care. Politicians would do well to note, however, that the real issue at stake is not merely health care, but the relationship between U.S. citizens and the government. Americans have a long, proud tradition of individualism. We prize our liberties, and we place great value on the virtues of self-sufficiency and personal responsibility. That is not to say that opponents of the Democrats’ health care reform proposals are unconcerned about the plight of those unable to afford health care – they simply recognize that government expansion into the medical industry will significantly, and likely irreversibly, expand government while bringing with it a host of new problems. Yet at a time when Americans are clamoring for a serious conversation about the size and scope of the state, politicians in Washington rarely engage in serious debate.

Whether the Democrats’ health care reform efforts succeed or not, voters will go to the polls next year with a new perspective on politics. After years of ballooning government under the Bush administration and a Republican-controlled Congress, Barack Obama and Democratic legislators promised to usher in a new era of change and responsible leadership. What Americans have gotten, though, is more of the same. While Democrats push to expand government further, GOP leaders who formerly supported the “big-government conservatism” of the Bush administration mouth small-government platitudes. If President Obama and members of Congress are to achieve long-term political success, they will have to cut out-of-control spending, move beyond empty rhetoric and truly embrace Americans’ desire for limited, responsible government and individual freedom.

Ben Linskey is a junior majoring in political science and philosophy. He can be contacted at blinskey@nd.edu

The views expressed in this column are those of the author and not necessarily those of The Observer.