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A Fling with the Welfare State

From the best of intentions to bankruptcy and recriminations

Jul 25, 2011, Vol. 16, No. 42 • By NOEMIE EMERY
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And of course, their intentions were laudable. But so are those of most people, within the bounds of what they think is realistic, is feasible, and is likely to work out in real life. Two times in recent memory Americans have tried to “fix” health care, and each time the script is the same. They start out, according to pollsters, by trying to think it’s a right. They think it unfair that income can alter the access to treatments. They bleed for poor people whose children are sick. They know they are one diagnosis or car crash away from financial as well as from medical challenges. They want everyone to be covered, no one turned down due to pre-existing conditions, want no limits on payments for medical treatments. Encouraged, Democrats draw up their bills, proudly present them, and wait for the thanks of the rapturous public. Then the fine print is revealed, and people are shocked at the expense and conditions. It’s then that their attitudes change.

What the fine print reveals beyond disputation is that health care is a good, not a right; that goods involve trade-offs, and that the trade-offs are high: higher costs and less choice for those covered already, rationing inflicted by government bureaucrats, interference by bureaucrats in medical doings, doctors threatening to leave the profession, less incentive (and money) to develop new treatments and drugs. They still want what they wanted before, but not at the cost of the harm it will wreak on the system in general. They vote their concerns, and 1994 and 2010 turned out very badly for Democrats. Stunned, Democrats fall back on their noble intentions, and say their opponents are mean.

They aren’t mean, of course, merely weighing their options, and finding that the costs to be paid by all of the people outweigh the gains made by the few. It would be mean indeed if standards declined, hospitals closed, cancer patients had to wait months for surgery, or if life-saving treatments stopped being developed. It would be mean indeed if the burdens of welfare brought down the economy. And nothing would be meaner than if Medicare remained unreformed and ran out of money, or if Social Security also ran out of money, because trimming benefits, raising the age of retirement, or imposing a means test is “mean.”

It was not wrong to have a fling with the welfare state sixty-five years ago, when it was a noble experiment that had not yet been attempted. It is wrong to ignore the evidence that in some ways it is failing, that the model set up has become unsustainable, and that renovations are needed if its critical functions are to survive. Goods are not rights. Pensions and access to health care remain social goods that a decent society will try to provide to its -people. But goods are not rights, and the old model, which claimed that they are, is broken. We need a new one, which provides sustainable ways to convey social goods to those who most need them. Good intentions are fine, but without means they are useless. They are the things with which the road to Gehenna is paved.

Noemie Emery is a contributing editor to The Weekly Standard and a columnist for the Washington Examiner.

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