Thursday, May 31, 2007


From George Will today:

Liberals tend, however, to infer unequal opportunities from the fact of unequal outcomes. Hence liberalism's goal of achieving greater equality of condition leads to a larger scope for interventionist government to circumscribe the market's role in allocating wealth and opportunity. Liberalism increasingly seeks to deliver equality in the form of equal dependence of more and more people for more and more things on government.

Hence liberals' hostility to school-choice programs. Hence hostility to private accounts funded by a portion of each individual's Social Security taxes. Hence their fear of Health Savings Accounts (individuals who purchase high-deductible health insurance become eligible for tax-preferred savings accounts from which they pay their routine medical expenses, just as car owners do not buy automobile insurance to cover oil changes). Hence liberals' advocacy of government responsibility for and, inevitably, rationing of health care.

Elsewhere in Today's Dispatch:

While the Novaks and their two oldest children have health coverage, six major insurers have refused to cover 3-year-old Seth because he has Down syndrome, a pre-existing condition.

They tried to enroll their son during an open-enrollment period but were quoted premiums ranging from $1,200 to $1,800 a month just for Seth. Coverage for the rest of the family already costs $444 a month.

"It's really kind of a joke, because insurance companies can say they're offering coverage to uninsurable children, but at a price tag that is not realistic," Mr. Novak said.

"I look at myself as a pretty conservative person. But when you have a child where they won't insure him at all, you're compelled to look at what various states offer."

The Novaks supported insurance expansions in Gov. Ted Strickland's proposed budget. He wants the State Children's Health Insurance Program (SCHIP) to cover children in families earning up to 300 percent of the federal poverty level, instead of the current 200 percent.

The House, however, rejected Strickland's proposal to offer a "buy-in option" for children in families with incomes between 300 percent and 500 percent of the poverty level.

Some also say the Senate could create a committee to study the issue. Now, the Senate is talking about a partial restoration of that buy-in for children with pre-existing conditions such as Down syndrome, autism or cystic fibrosis.

Mr. Will's piece deserves a long rant in response, but maybe later. Instead, a brief summary of the juxtaposition - Safety Nets: BAD when abstract people don't need them and should be able to opt-out. GOOD when real live conservatives figure out that real live people making rational choices actually sometimes do suffer greatly in their absence.


Paul said...

I think the debate may not be so much about if there should be safety nets, but rather a disagreement about scope.

In most things, I believe the free market should be allowed to sort things out, and the government's role limited to make sure it's a fair playing field -- acting as a referee, not a player.

There was a reality TV show on a few years back called "Frontier Family" or something of that ilk. The idea was to take some typically suburban families and plunk them down in the middle of the prairie with the same equipment and supplies as a family might have had circa 1880.

In one family, the father was a guy who looked reasonably healthy and trim. But after a few weeks in the prairie, he began complaining that he had lost a lot of weight and was therefore convinced that he had some serious illness. He was evaluated in a medical center and the doctors said he was in probably the best shape of his life. All the lab tests looked great, his blood pressure and pulse rate were excellent. The doctor said the father had simply dropped to a body fat ratio typical of a hardworking farmer in the 1880s.

One would think that if our society was advancing that our healthcare system would by now be treating only the rarest and least preventable diseases (and of course trauma). Instead, the leading causes of death are mostly preventable, and I would argue that it's in part due to the disassociation between behavior and consequences, in this case health care costs.

For example, I am a morbidly obese middle aged man with an occasional irregular heartbeat which I am confident is in part due to my weight. I fear that there is a health event in my future which, if I would not insured for medical costs, would wipe out my retirement nest egg. So even though I have the resources to retire, I must continue to work to gain access to health insurance. Without a doubt -- and to your point -- I am a big fan of nationalized healthcare at this point in my life.

In other words, I want everyone else to bear the risk of my bad decisions relative to my personal healthiness. So do all the other obese people, and the smokers and the alcoholics, etc.

Maybe our safety nets are too big these days, and maybe we don't hold people accountable enough individually. We're already seeing employers saying that you can't work here if you smoke. I think that's pretty reasonable, but then I've never smoked. What if they say you can't work here if you're obese? Maybe I'd move to the prairie and lose a few.

Anyway, the extremes here are to insure everyone, or to ensure no one. Many would like to see the former happen. Not me, not really. We can't let safety nets take away the incentives to do better.

Nor do we want to take the safety nets away.

It's the scope that's in question.


bonobo said...


Once again you and I have quite a bit of common ground. My complaint is not so much with the Ohio Legislature or the family on this one, as it is with George Will, the one advocating the more extreme position.

Paul said...

That may be unfair to Mr. Will - I don't think he really advocates complete removal of all safety nets. He's making a point which I think is valid: There is one camp of folks out there who wants to solve social problems by giving the government more control over a wider scope of things. And there is a camp, of which I am a member, which says you should attack social problems with as little government involvment as possible.

Big government, big corporations and big labor are all breeding houses for corruption. Not all politicians, bureaucrats, corporate executives and labor leaders are corrupt, but enough of them are to screw up the works.

The best way to take control from these folks is to give it to Joe Consumer and let him vote with his spending power.

I'm okay with safety nets for everyone, with all who can being required to contribute to the funding. But you can't be allowed to live in the safety net. The motivation has to be to get out and never return.