We are berated, ad nauseam, with imprecations that America is the only advanced nation that fails to have universal health care. This statement is often followed by the rueful remark that the debate over government controlled health care has been going on without progress for 60 years and, ipso facto, it is time to settle it.
All right, let's do that. Let's look a little deeper. Why is there no settlement of the issue, and why is America unique in its obstinate reluctance to follow the example of our older cultural brothers in Europe?
When a debate continues for decades without resolution, it is prudent to consider the deeper underlying assumptions. Principles which underpin the arguments are likely being ignored and marginalized rather than addressed in a forthright manner.
America is the only advanced country whose founding assumption is popular sovereignty. This is a proposition that stands with hardly a seconding voice throughout the contemporary international community. Yet it is the taproot of American exceptionalism.
Even here, however, the principle of government subordination to the people is by no means universally accepted. It has never been firmly ratified by our political class, those spiritual descendants of Europe's nobility. Our soi-disant elite appear to view with dismay their countrymen's continuing preference for self-rule.
Thus arises the question of corporal ownership. For Americans, the answer has been settled. Since the terrible bloodletting of the Civil War, and now excepting military service, ownership of one's body is a matter between the individual and God, with no intermediation by government.
Yet assertions are now being made that government should have responsibility for, and thus authority over, the maintenance of our bodies. It necessarily follows that government must have the power to approve or withhold care. This concept collides destructively with the founding principles of individual responsibility and autonomy upon which popular sovereignty depends.
This is the reason that the debate never ends. It is also the reason that any resolution of the question will necessarily either confirm or deny the original intent of the Founders.
So let's make up our minds. Does the government, in the last analysis, own your body, or do you? If your answer is the former, be aware that you have opted for veterinary medicine, for you are now accepting the moral status of a domestic animal. If your answer is the latter, you must accept responsibility to make mortal decisions for yourself, and pay for the care that you want with money that you have reason to see as your own.
Such money is not out of reach. Medical savings accounts, amalgamated with catastrophic insurance, could take the place of the ad hoc hodgepodge of plans, schemes, dissimulations, and promises under which we are now burdened and threatened.
And there would be greater efficiency and encouragement of individual choice. We all have an enhanced interest in thriftiness and fair value when we, and not third parties, are the payers.
The wisdom expressed in the Federalist Papers began with the insight that men are not angels. The system that the authors designed placed liberty at the head of other considerations. The Founders were determined that concentrations of power should be confounded.
The system now congealing in Congress for health care is not informed by such principles. Access to the most intimate personal information, direct interaction with bank accounts, and mandated Procrustean protocols remain features of the various schemes under consideration. Such programs would be managed by impenetrable, impersonal, and unaccountable bureaucracies. Do we wish to place such profound coercive powers in the hands of anyone, much less those who now stand expectant and eager to receive them?
The view of human nature recognized by the Founders is now in grave peril. Whither goes America? Was liberty merely an 18th-century fad, or is there still something exceptional about our country?
William Anderson, a retired physician,
teaches at Harvard University and consults to the intelligence community.