On the Contrary

I have been trying to understand the Republican objections to government run health care (single payer system).  They run something like this:  “Don’t let the government get between you and your doctor; all government systems in other countries are a disaster; competition between the government and the private sector is not really competition; government run anything is a train wreck.”  The bottom line here is that anything government will be a disaster.    Of course the only insurance available to any of them that are over 65 is Medicare and I don’t see them turning it down.

I have a personal story here.  I have a friend (and a conservative) who is a principal in his law firm who has just turned 60 and his plan was to work till 65, retire and then get Medicare since an earlier bout of cancer made him uninsurable in this wonderful free enterprise system we have.  But shit happens and his cancer has returned with vengeance.    His firm, like many businesses, will not cover his medical care if he retires so he must work 30 hours a week to keep his medical coverage.  He will keep that up until he can’t drag himself in anymore and only has a few weeks to live.  It is the only way he can keep his coverage and not bankrupt his family.  Isn’t this the greatest system on earth?  This is the best free enterprise can offer?

Now looking back at the Republican objections to a government payer system let’s see how it would affect my friend Mike.  First, there is no government between him and his doctor, just an insurance executive that would rather maximize profits for his company than let my friend Mike have some peace and some time with his family before he is no longer with us.  If he were in any other system in the industrialized world, he would get the same care and not lose his coverage when he retired to live out his last few months in peace with his family.  Just as an aside:  Note that the first face transplant took place in France.  Their facilities and doctors are quite capable.  If he could have the option of selecting a government system, then he would now be fully covered even if he did retire.  And what part of the government run Medicaid which has administration costs running 20-30% less than the insurance companies don’t you understand Mr. Republican?  Same doctors and hospitals, just a government payer.

Of course none of these objections make any sense.  What does make sense is that Republicans and conservatives really believe that government run anything is a disaster.  I listened to them lament a government run GM and Chrysler.   Here would be my question:  What is your alternative?  Private enterprise has run the banking system, auto industry, and our health care system in the ground while their executives have made off with a bundle of money.  It is the government that keeps them honest.  So what is wrong with government competition?  Why isn’t that real competition?  Why are jobs created by government spending not real jobs?  Why is government run anything a disaster?  Does it have to be?

The military is the largest government bureaucracy there is and yet most of us turn to them when things break down to re-establish order (think Katrina).  There are tons and tons of successful government programs.   Most of us take them for granted.  Airplanes don’t crash (FAA), highways are reliable, we all get a free high school education, criminals aren’t roaming the streets, our drugs and food are relatively safe, your air and water are clean, and most workplaces are safe.  You could think of hundreds more so where does this irrational hate of government run programs come from?  Another aside:  Most farmers are Republicans and you don’t see them complaining about their subsidy.

I know where this irrational belief comes from.  Many have some bad experience with government where the government has a rule or regulation that impacts them and seems mindless.  Actually many are mindless because the same people who hate government made it mindless.  In order to make rules fair we pass or make comprehensive rules that someone abuses, and then instead of punishing the abuser, we demand more regulations to further limit the flexibility that led to the abuse.  But in pushing for these tighter and tighter rules, we are tying the hands of the administrator of these rules so that the outcome is no longer rational.  He no longer has the discretion to apply the rule where it makes sense.

Look at mandatory sentencing.  The injustices that followed are astounding.  The unintentional consequences of this desire to punish the few, end up punishing all of us.  Yes governments do stupid things sometimes, but we can change that.  Private enterprise doesn’t do stupid things, just things that only reflect their bottom line which in many cases is for their best interest, not ours.  Note that whenever these business fail us, we always want to know why government let them do it.  Well in things like health care or regulation, the profit motive should never be part of the equation.

So the debate becomes more and more irrational because conservatives really have no alternative but to return to the status quo.  I heard a commentator the other day state that the best tactic for an opposition party was to criticize the party in power, but don’t take the risk of offering your own alternative.  I think the Republicans are following his advice, but they have badly misread the nation.  The nation knows the status quo got us into this mess and the new guy is trying new things.  If you haven’t got an alternative, we may not be totally in love with the new guy’s ideas, but we know letting you return us to the status quo will be a disaster.  Better start offering some alternatives besides your old solutions that didn’t work.