Our mandated future

Ann Coulter took a lot of heat for her “Three Cheers for RomneyCare” column last week, in which she suggested Governor Mitt Romney’s health care program for Massachusetts should be properly viewed as “a massive triumph for conservative free-market principles.”  A number of very detailed, and sometimes very angry, rebuttals to her column were written.  I wouldn’t dream of walking into the crossfire between Coulter and her critics, but I would humbly suggest that we should be much angrier about the contentions in her column that were indisputably correct.

Broadly speaking, health care – not just in Massachusetts but around the country – has been in a sorry state for many years.  There was indeed a time when serious conservatives thought mandating the purchase of privately-sold health insurance was a better, more liberty-minded solution than a single-payer socialized health care monstrosity, which Left correctly views as the trump card in the long struggle between individual liberty and the State. 

As Constitutionally offensive as the “individual mandate” concept may be, you’ve got to admit it can look pretty good compared to the horrors of a British-style top-down nationalized system.   After all, at least the mandated purchase of private insurance keeps some semblance of capitalism and competition in the picture… for a little while.  It wouldn’t last.  Those onerous government mandates tend to drive private insurers out of business, dumping more and more people into centrally managed “public exchanges” at budget-busting expense – until one day, in the not-too-distant future, we would be told that a top-down single-payer nationalized system was the only way to salvage the wreckage created by ObamaCare.

That’s what we should all be angry about.  It’s common to describe the United States as a “center-right” country, but the “center” has moved so far left that it’s almost a cruel joke to talk about orbiting to the “right” of it.  Statist impositions that would have been laughed off as the paranoid fantasies of the far Right are commonplace “centrist” ideas today.

In a December speech in Osawatomie, Kansas, President Obama described the opponents of his micro-regulatory, nanny-state mega-government as harboring the savage Darwinian belief that “we are better off when everybody is left to fend for themselves and play by their own rules.”  Leaving aside the unintentional comedy of suggesting that anyone in America is even slightly in danger of being “left to fend for themselves” by our titanic debt-riddled government, Obama’s remarks illustrate just how far left the pendulum has swung.  Everything to the right of, say, George W. Bush or Bill Clinton-sized government is now unthinkable.

Among the worst and most dishonest hammers used to whack the “center” of our discourse so far to the Left are mandates.  We’re swimming in them.  They’re dishonest because they allow the government to compel private citizens to fund the statist agenda, without any tax money changing hands.  Under the tax-and-spend liberalism of yore, it was – at least, theoretically – possible to analyze whether a particular government program was working, and hold somebody accountable if it wasn’t. 

In our mandated future, few political fingerprints will be left at the scene of the crime.  Massive government programs, with the power to warp our society in terrible ways, will be presented as virtually “cost-free” and “deficit-neutral,” because the government won’t be spending the money.  It will be telling you to spend the money.  Precisely this sort of trick was pulled to pretend ObamaCare wouldn’t pile trillions onto the national debt.

Look at the very problems the “individual mandate” for health insurance was meant to address.  The most commonly cited of these is the question of “free riders.”  Hospitals are obliged to serve patients who don’t have insurance, and can’t pay for their treatment.  These losses are then shifted onto the people who do have insurance, driving up the cost of both insurance and medicine.  And why does all this happen?  Because of the mandate that hospitals have to dole out free treatment to people who can’t pay.  But instead of challenging that notion, we end up promoting more mandates, of increasingly dubious constitutionality, as the relatively “free market” solution to outright socialized medicine.

The other, and actually far more expensive, problem addressed by the individual mandate is the necessity of offering affordable insurance coverage to people with pre-existing conditions.  Because insurance companies would lose a fortune doing so, they must be compensated by forcing everyone to buy insurance.  But when you’re forcing a company to commit to paying the bills of someone who is known to be sick, and certain to be making expensive claims, you’re not talking about “insurance” any more.  Confusing that sort of guaranteed liability with the concept of selling insurance against risk, in the pursuit of profit, corrupts the entire system.  It even corrupts the plain meaning of words like “insurance.”  We can’t have a reasoned discussion about such weighty issues when we can’t even accurately describe what we’re talking about.

Instead of solving the problems from the old mandates with a raft of even more oppressive mandates, we should be moving in the other direction, toward both greater clarity and increased economic liberty.  (It’s funny how those two blessings go hand-in-hand, isn’t it?)  For example, the concepts of “insurance” versus “treatment plans” should be separated.  Insurance shouldn’t be sold under a mountain of mandates that make it prohibitively expensive, and it shouldn’t suffocate free-market competition in medicine by completely obscuring the true cost of medical care.

Our society isn’t going to tolerate the indigent dropping dead in the streets for lack of medicine, but they should be assisted with honestly labeled – and locally administered – welfare programs, not a murky maze of shifted costs, and tortured attempts to mix assistance for the destitute with the routine health insurance needs of the middle class.  Among other things, this would allow us to determine exactly how many people are truly uninsured, or uninsurable – a clarity that was completely lost during the drive to pass ObamaCare, and will never return, in a mandated future where the State pretends certain costs don’t even exist.

Sadly, the ”center” has moved so far Left that you can’t even talk about welfare for the truly needy any more.  Blurring the distinction between the poor and middle class is one of the great projects of the Left, and it approaches completion.  We are made to pretend there’s a great, formless mass of “working Americans,” toiling beneath the silvered whips of the Evil Rich.  Everyone has to be lumped together and treated the same, except for the “millionaires” who will be taxed ever higher to pay for it all.  And beyond the visible arteries of confiscatory taxation and irresponsible spending lies a swelling tumor of unfunded mandates, which allow the ruling class of the most indebted nation in history to wield even more power than they can afford.