Posted by
Andrews on Thursday, February 12, 2009 1:16:28 PM
I have been reading the many arguments for socialized medicine made by the left wing posters on TH, and I have to say they are uniformly weak. And not just because they ignore all the evidence for the failure of socialized medicine wherever it has been tried. Instead they are weak because they have only two real arguments, either they argue by comparing incompatible examples, yet pretend they are somehow analogous. Or else they resort to appeals to class envy.
First, let us look at the arguments by analogy. Whenever someone mentions government rationing of health care, it appears the formulaic response is either to mention HMOs or to point out how long someone has to wait to see a doctor or wait in an emergency department.
Allow me to rebut the HMO analogy with an analogy of my own. If I walk into McDonald's, they have a limited menu. I cannot order black truffles or falafel. However, McDonald's is not restricting my choice, as I can walk into a different restaurant. However, if the government decreed that every restaurant MUST serve McDonald's menu, THAT is a restriction of my freedom. See the difference? I can choose to join an HMO and restrict my own choices in exchange for lower premiums, or I can choose some other coverage or pay out of pocket. Once the government decrees what coverage will be provided, I have no choice. Thus their analogy between managed care and government managed care is inappropriate.
Similarly, a wait and rationing are worlds apart. One need only think about breathing to see the difference. If the government decrees you cannot breathe, it is a lot different than holding your breath for a minute. Yes, the free market has only limited resources as well, but in the free market, when demand exceeds supply there is incentive to expand. In the government, when demand exceeds supply there is no incentive. In fact, to have "underplanned" is a fault, and so workers take efforts to hide a lack of supply to save their jobs, making the government prone to actively deny a lack. All of which means the free market is much more likely to correct any shortfall than the government ever is. (Visit a government office waiting room and one for a fully private company, not a pseudo-private one like a utility, and tell me which one has adequate staff and which doesn't.)
Of course when analog fails, then class envy begins. When someone points out, even if in an HMO you can still pay out of pocket,t he reply is "The poor can't". And that is the
voice of envy. If you start to think about this, you will see why. Rather than arguing for elevating the poor, this argument amounts to "the poor have to take what they can get, so everyone else should have equally lousy coverage." It is the same as a blind man arguing everyone else should have their eyes put out. And just as we would not accept the latter, we should not accept the former. The misfortune of one should not be used as an excuse to drag down the rest. That the system does not provide perfection for everyone does not mean the best alternative is to provide inadequately for all.
And when both of those fail, they fall back on the last refuge of all big government advocates, arguing the
free market is not perfect, and thus proposing an even more imperfect government solution. Worse still, most fot he flaws they describe are either the result of
prior government interference or of our runaway tort system. So, they are not even blaming the free market for imperfection, but using the fruits of past government meddling
to argue for more.
It is not very convincing, at least I hope not. I know I don't see it as persuasive. I just hope the rest of America sees through it as easily.
UPDATE (08/27/2009): Welcome Hedgehog Report readers! If you find this post interesting, you may also enjoy my more recent writing on this topic. Specifically, you might like "
Who Will Decide", "
Government Efficiency", "
High Cost of Medical Care", "
Clarification of My Argument for a Free Market in Medicine", "
The Inevitability of Bureaucratic Management in Government Enterprises" and "
Shameless Self-Promotion". Most are on the same theme, though some are more general arguments about government management of previously for-profit enterprises and the consequences of that management. But they all do directly relate to the current plans to either openly or gradually nationalize health care.
Again, welcome to the blog.