The argument from federalism: One of the great benefits of federalism is that the states can act as the laboratories of democracy. If a new public policy is tried in the states and works (as happened with welfare reform in Michigan and Wisconsin), then a similar program has a good chance of succeeding at the national level. The welfare reform went national and proved to be one of the most successful public policy initiatives of the last half century. On the other hand, major governmental healthcare initiatives have been tried in Tennessee and Massachusetts. Neither of those have panned out. That should be a cautionary sign to avoid rushing ahead to just get a bill done!
The argument from misery: I cannot think of any encounter with my government that I willingly seek out. I hate going to the DMV. I hate going to the post office. I hate getting my car inspected. I hate getting a passport renewed. All of these things eat up productive time in my day and are filled with useless, inefficient waiting. This basic situation also applies to people who rely on the government for their healthcare. When my wife did indigent care in Houston, her clients did not pay for her services. They paid with their time. LOTS OF WAITING. I don’t need more waiting in my life. And because government employees are typically unionized, I don’t need to be at the mercy of a bunch of unionized employees any more than I already am.
The argument from incentivization: If the government provides the care too cheaply, then there will be a glut of clients who overwhelm the system and create the nightmare of waiting as the price to pay. If the government offers the care too expensively, people will opt out which is exactly what they wanted to avoid. If the government tries to control utilization by deciding what services you can and can’t have, then you are up against a far worse foe than the worst HMO you ever faced. And the government will go where the insurance companies fear to tread. They will decide who should live or die.
The argument from missing the verdammten point: It is exceedingly clear that a huge reason for the skyrocketing costs of medicine is the problem of predatory litigation driven by lawyers looking for 30-40% of a bloody fortune from an industry thought to be able to afford it. Between the cost of malpractice insurance, the payouts, and the defensive medicine that must be practiced to ward off lawsuits, it is easy to see why healthcare is outrageously expensive. Yet, the president very clearly said he would not seek to deal with that problem in the legislation. WHAT? WHY? Because the trial lawyers are very good political donors? Not a compelling reason for the formation of a particular public policy.
The argument from economic theory: Look at two sectors of the healthcare market that are typically paid out of pocket without the influence of insurance providers or the government. I am thinking of plastic surgery and lasik procedures for improving eyesight. Both of those services are becoming less expensive in real dollars rather than skyrocketing out of control. This happens to be the portion of the healthcare industry where actual market conditions apply. Customers pay for and receive value at a price that is becoming more reasonable all the time.
