The Washington trajectory hasn't changed in 75 years. That's why the final health law will remain costly and lousy.
Two things come to mind in the wake of the Republicans' Obamacare fiasco:
• No. 1: An American patriot who died four years ago at age 87 told me shortly before he left this world that in all of his adult life — consider that 70 years — nothing has changed in Washington, D.C., and with the federal government ... nothing, no matter which party ruled.
In all that time, he said, the federal government has continued to grow; continued to intrude more and more into his and other people's lives; and continued to take more of his money.
Make that almost 75 years.
• No. 2: Why would anyone with a rational mind — and anyone who has witnessed the totality and modern history of the federal government — ever think that having Congress make rules for and the federal bureaucracy manage one-sixth of the nation's economy is a good idea and would be successful? Or that they could do so better than the private sector. This is beyond comprehension.
Cynical and pessimistic as this may sound, it really doesn't matter if the Republicans in the Senate and House ultimately agree on legislation that modifies Obamacare or repeals it. Nor does it matter if the final legislation includes that vaulted notion of bipartisan support, with some Democrats supporting it. It doesn't matter.
Whatever they ultimately devise, it still will be lousy, wasteful and cost far more than it should. And it's still going to take us another step closer to what the Democrats (and many Rhino Republicans, e.g. Sen. Susan Collins) ultimately want: 100% socialized, government-controlled health insurance and medical care.
Count on it. Because nothing in Washington ever changes the long-term trajectory toward an expanding Leviathan.
The only way it will reverse is if there are two unlikely changes — in the incentives that govern legislators' behavior and/or if the majority of Americans had an intellectual epiphany and understood economics.
To the first: incentives. Senators and House members are rewarded (re-elected) for bestowing benefits (corporate subsidies; mandated health benefits; mortgage interest deductions; keeping unnecessary military bases open; ad infinitum). They are punished for taking benefits away.
What's more, the takers and recipients of government largesse are the majority. And in a nation whose voters are split ideologically roughly 40%-40%-20%, U.S. senators especially need large enough blocks of the 20% independent voters or the moderates on either side to win election. They especially cannot be perceived as insensitive and uncaring to the needy (e.g. mandated coverage for pre-existing conditions).
Indeed, as Ayn Rand associate and friend Harry Binswanger explains below, that sense of altruism in America overwhelmingly blinds reason: “The public thinks its essence — protection of the needy — is our highest moral duty.”
Perhaps it is. But here's the mystery: Given the remarkable private charity of Americans, inexplicably they are willing to cede health care to a government that has failed miserably at assisting the poor.
Add to that the entitlements of Social Security, Medicare, prescription drugs, food stamps, Medicaid, etc. They are such embedded social institutions that when Sens. Rand Paul, Mike Lee and Ted Cruz talk of a capitalistic health care system, that is apostasy.
But there is another way — if only Americans and their representatives would be willing to be rational, not emotional. Consider the case that Jeffrey Tucker makes. He is director of content for the Foundation for Economic Education, a think tank that educates young people on individual freedom and free markets. Like Binswanger, he doesn't blame Republicans, either, for failure to repeal Obamacare and come up with something better. Tucker writes on FEE's website (fee.org):
“Who or what is at fault? ... There is only one underlying source of failure: the failure to understand. The root reason why Obamacare will last the current regime is intellectual.
“We should take it for granted that everyone in this debate wants more, better, cheaper health care for all. The intellectual failure is a lack of clarity about how to get there.
“A real free market in health care would provide affordable, high-quality health care for all, not as a matter of right, but rather as a matter of market logic.
“How do we know? Look at any market that is largely free. The impossibly brilliant and complex smartphone went from luxury to mainstream in a mere 10 years. The same is true for millions of services, from groceries to clothing to home appliances to software. The driving logic of competitive markets is to provide universal access.
“Even in other forms of health care that are free of government control, we see this trajectory. Pet care is affordable, universal and available at so many levels. Cosmetic surgery is the same. You can get nearly anything done to your body for less than the typical deductible of standard insurance. And consider free health care markets abroad: in a place like Lebanon, prices are one-tenth of the U.S. prices for great service.
“In today's peer-to-peer economy, I can get a burrito delivered to my desk for $6, with no advance subscription service. I can get my groceries brought to my home for a small service fee. I have access to all the world's information in my pocket, most of it provided for free. But, at the same time, I and everyone else must pay exorbitant fees just to gain access to simple medicines to fix a sinus problem, and even then we risk being on the hook for more money than it would take to buy a nice car.
“The system is not working, but there is no mystery about what would fix it: an open and competitive market. The free market delivers prosperity to all. It would do the same with conventional health care. The evidence for this assertion is everywhere around us...”
Sadly, we reap what we sow. We have conditioned our representatives to respond to the incentives that keep them in power. They love power. But power is an opioid. It prevents them from seeing that liberty, capitalism and rational selfishness have proven for centuries to be more effective — in cost, widespread positive results and especially for the poor — than altruism that comes from the force of law.
There's no reason to be hopeful Washington will change. But we also can't give up.