An Open Letter On Health Care Reform

This is an open letter written by my good friend Rebecca Reale. She has given me permission to publish it here.  I agree 100% with her position and think this needs to be spread to as many people as possible.

The passage of the recent healthcare bill has spurred me to speak up with my friends and family in an arena where I traditionally have not. Some of you know and understand my philosophical and political positions well; others may not know them at all; some are aware that my opinions oppose their own, but may not know how or why. I have always been reticent by nature, and despite my certain and sometimes unorthodox positions, I have remained uncomfortable with confrontation and debate. And I have often thought it better to leave the debating to more eloquent and informed speakers and writers, lest I harm my position by presenting it poorly. But while there are many excellent presentations of my ideology out there, I realize these arguments may not reach or influence many of the people in my life. Faced with the passage of what I consider the most destructive piece of legislation produced by the United States in my lifetime — and fearful for my children’s future — it has become of paramount importance to me that I explicitly present my case for liberty to those who know me. If you respect me as an honorable human being and a competent thinker, and most especially if your position is at odds with mine, I ask that you consider what I have to say and try to understand my concerns as our nation embarks on a new age in which many people I’ve befriended and loved may manifest as people against whom I need to defend myself.

Put simply, the main points of my position are as follows:

(1) Healthcare in the US is in bad shape and getting worse. Many changes need to be made. However, the changes I advocate have to do with removing government interference in the industry, thus replacing the current government-backed healthcare “crony capitalism” with true free market capitalism. If insurance companies were left to compete unfettered, if medical personnel were less regulated, if states reformed their tort law to reduce over-use and abuse of lawsuits, and if there were no government incentives for people to acquire through their employers full-benefit health “insurance” (not true insurance, but a third-payer scheme which encourages careless spending), healthcare innovation and insurance options would blossom, prices would drop, quality would improve, and most important, people could retain the freedom (and the responsibility) to choose an approach that worked best for them.

(2) I am aware that some people legitimately need help with medical expenses and may not be able to afford top-notch or even adequate care. It is my opinion that a free market in healthcare would reduce the number of the needy to a size that could be managed by private charities and voluntary pro bono care. Our country has effectively managed to provide universal food coverage by allowing competition in the marketplace and providing vouchers for the poor (alongside soup kitchens and food pantries provided by churches and other voluntary community efforts). Healthcare could be no different.

(3) For every government “entitlement”, there exists a group of people who are forced to provide it, and thus such entitlements are akin to theft or slavery. Like most other services or goods, medical care is provided by a group of individuals (working in concert within a very complex and coordinated economy of specialized skills), who have motives much like your own — to be productive, earn a good living, and take care of their families. Medical care is not a resource that is simply out there and needs to be divvied up fairly. Our government cannot provide us medical services if doctors refuse to do so, and will not develop life-saving devices, medicines, and procedures when the companies that produce these innovations – soon stripped of their ability to profit — decide to make money elsewhere instead. Unless one advocates slave labor, one cannot claim a “right” to goods and services created by other human beings.

The monstrous new healthcare law is a recipe for healthcare shortages and economic ruin. On this last point, many people with whom I’ve spoken so far agree – or are at least extremely wary, given government’s tremendously poor track record of maintaining programs anywhere near their projected costs. Nancy Pelosi said of the law: “Health insurance reform will stand alongside Social Security and Medicare in the annals of American history.” On this, she and I agree. At its 1966 inception, Medicare cost $3 billion per year and The House Ways and Means Committee estimated that it would cost about $12 billion by 1990 (a figure that included an allowance for inflation). Though supposedly a conservative estimate, in 1990 Medicare actually cost almost 9 times that much (107 billion). Current Medicare liabilities are estimated somewhere around $35 trillion. Social security is similarly bankrupt and unsustainable. It is a Ponzi scheme that Bernie Madoff could envy, and one that is about to collapse under its own weight. It already accounts for 23% of the federal budget, and the amount the system has promised to pay beyond what it actually has is now $17.5 trillion. Far from the retirement safety net it was intended to be, social security forces workers to cede ownership of their retirement “benefits” and leaves them completely dependent on the decision of 535 yet-undetermined politicians (and future generations of workers) to return these involuntary “investments” during their retirement years – or not. Consider for a moment that these are the two programs that supporter Nancy Pelosi proudly holds up alongside our new healthcare program.

But the economic devastation that is destined to occur when the government takes over our healthcare industry is not what makes this bill wrong, and is not the primary reason I oppose it. It is wrong because it is – at its core – unethical. And in a way that no amount of bipartisan post-passage tinkering will ever fix. It is morally wrong for a government to force individuals to purchase insurance, whether or not they want it, can afford it, or need it. Think you’ll be able to choose a cheaper plan that won’t cover maternity, infertility, or pediatric care because your family is complete or you can’t have children? Think again. Want to save money by opting for a high deductible plan which, while requiring you to responsibly budget for regular expenses, will still prevent financial ruin in the rare case of a serious illness? Sorry. No longer will Americans have the liberty to preserve and care for their own bodies in the way they deem best. This healthcare scheme takes the worst of our system (the “crony capitalism” encouraged by the current government regulation of the industry), and holds it up as a panacea. But governments’ attempts to price control always backfire. Shortages emerge, quality declines, prices rise, and black markets develop. Then government invariably responds (as ours just has) by insisting we need more regulations to fix the very problems its prior regulations created. Such is the future of healthcare in the US if this law takes hold.

Our founders carefully and deliberately set strict limits to the scope of the federal government, which they rightly considered to be the biggest threat to citizens’ liberty. Patrick Henry said: “The Constitution is not an instrument for the government to restrain the people, it is an instrument for the people to restrain the government.” Fleeing from tyrannical governments, our founders built America as a bold exception to the historical rule: it was to be a land of individual rights, a land where individuals would be protected from boundless governmental power. The new healthcare law is a gross abrogation of the principles set forth in the US Constitution. Under this law, our government will control what type of insurance we can have, where we purchase it, how much we pay, and what kind of care we will receive in return. The law itself empowers the government (in 1,990 mind-numbing pages of legalese) to write thousands more pages of regulations and force Americans to comply with all of them. The law is rife with passages such as “The term ‘applicable condition’ means…a condition or procedure selected by the Secretary”, and these passages empower future bureaucrats to determine or change the very meaning of the law. Given that the law grants power without definition or limits and most every behavior can be said to affect personal health, managing the system can and will become an excuse to limit our rights to engage in behaviors deemed by the government as unreasonably risky to our health. The law also specifically references wait periods more than once, indicating that the need to ration care has already been anticipated by its writers. And (of course) The Secretary will be the one to determine who gets immediate care and who has to wait (Sec. 101 “the Secretary shall make adjustments as are necessary to eliminate such deficit, including reducing benefits, increasing premiums, or establishing wait lists.”). Moreover – even beyond the broad governmental powers established by the law itself — if this law passes constitutional muster in the eyes of our courts, it will set the precedent for virtually any sort of government intrusion into our lives. The safeguards of our liberty for which our founders fought will be effectively abolished.

Our government has passed (most especially during the past century) many, many immoral laws that encroach on citizens’ individual rights to life, liberty, and the pursuit of happiness. Until now, I have generally considered it in my best interest to comply with these policies that infringed upon my liberty because (1) defying them did not seem worth the personal negative consequences and (2) in general, I felt that my freedoms were protected by the Constitution and Bill of Rights. Things have changed with the passage of this single sweeping law, and I have reached the end of my willingness to tolerate the immoral ideology that underlies it. Those who support this law are declaring their intent and right to exert unlimited power over my life. Anyone who understands the ethical foundations of this law and also values liberty, should find it repugnant. To tolerate this law is to sanction tyranny, and I will not do so. Thus, I am professing my intent to resist this law. For now, this will mean speaking out and supporting those working to achieve a repeal or nullification through all political and legal channels available. But if the law is not repealed or nullified before the individual mandate goes into effect on Dec. 31, 2013, resistance will require a more courageous stand. If it comes to that point, I may find that I become part of the largest US civil disobedience movement since the civil rights era.

I have been tolerant of others’ political positions throughout my adult life (especially as I’ve known and loved many, many people who hold opposing positions), and to some extent, I still am. I do not support claims that members of one or another political party are differentially evil or stupid or ignorant, and I am disgusted by the continual mud-throwing and name-calling that masquerades as political debate. Despite flaring tempers and other digressions from reasoned arguments, I believe that most people are genuinely trying to do what’s right and only want the best for themselves and their communities. I know that I do. It is my experience that the people who support this law are primarily guided by compassion. They see suffering and have a sense that people “should” be taken care of when they’re sick or injured. But these well-intentioned supporters don’t see the rest of the reality around them and the fact that wishing something does not make it so. And far too often their compassion contorts into the delusion that forcing others to do things is proper and just so long as they believe it is for their own good. Their position fails to consider, however, the motives of the people who provide healthcare or the rights of those who do not choose to trade the fruits of their labor for the benefits of a particular brand of health insurance. There are many ways to help the poor, but this law is not one of them. All the government entitlements in the world could not save the people of the USSR, and Mugabe’s recent attempts to control food prices in Zimbabwe led to shortages that rendered staples like salt, bread, and oil unimaginable luxuries. The same mistakes here will yield the same results.

Progressives may be complacent about the loss of liberty that comes with our new healthcare law, but they shouldn’t be. I have seen claims that the opposition’s cries of tyranny are unwarranted and/or exaggerated, that the law represents just a minor loss of liberty that is worth its perceived benefits. But as Benjamin Franklin wrote: “Any people that would give up liberty for a little temporary safety deserves neither liberty nor safety.” He understood all too well the tendency for governments to grow and liberties to die. If you disagree with Franklin and think the benefits you’ll reap from this law are worth the cost of your liberty, the next question you need to ask yourself is: why do you think I would tolerate being forced to make the same trade against my better judgment?

Note from Shannon: If you agree with this post and think government is over-extending their reach, please add your blog link to my roll call of Libertarian bloggers.

Tagged as: big brother, government, health care, libertarian