Should Congress Impose Health Care on Us?
12. Jul, 2009 
17 Comments
by Sheldon Richman, Foundation for Economic Education
In the debate over medical reform, everyone can find a public-opinion poll to support his or her position. Robert Reich, who favors deeper government involvement in health care than we already have, wrote recently, “In the most recent Wall Street Journal/NBC News poll, 76% of respondents said it was important that Americans have a choice between a public and private health-insurance plan. In last week’s New York Times/CBSNews poll, 85% said they wanted major health-care reforms.”
Yet Catherine Rampell, economics editor for nytimes.com, reports there has been “no sea change in public opinion” about healthcare reform. She cites Nolan McCarty of Princeton University, who shows that public support for a government overhaul of the medical industry was higher in 1993, when the Clinton plan failed, than it is today.
Of course, we always have reason for suspicion about public opinion polls, since pollsters can get the results they want by how they frame the questions, especially the all-important preliminary questions. People aren’t laboratory rats, and some respondents may be as interested in impressing the pollster as in speaking their minds. Definitive proof of the case for suspicion was provided some years ago by an episode of the satirical BBC television program Yes, Prime Minister, the key scene of which is here.
So What?
But let’s not stop there. We may grant that “the public” want (as the British would say) the government to set up an insurance program to compete with private insurers and are even willing “to pay higher taxes so that all Americans have health insurance that they can’t lose no matter what.”
So what? By asking this question, I am not displaying naïveté. Politicians of course will use a favorable poll for cover when they do what they want to do anyway.
I mean something else: Why should the people get something through government–that is, at the point of a gun–simply because they want it? We make that assumption reflexively, but why? Fifty-seven percent may be willing to pay higher taxes for universal health insurance, but let’s not overlook what else they are willing to do: tax the 37 percent who aren’t willing to pay higher taxes. (Six percent don’t know if they are willing or not. Sigh.)
H. L. Mencken long ago defined democracy as the “the theory that the common people know what they want, and deserve to get it good and hard.” The problem is that those who don’t want it get it, too. When it comes to government programs, there’s no opt-out provision. Alas, what distinguishes “free” from unfree countries is the freedom to speak out, not to opt out. In the latter respect, all are unfree.
What about that 37 percent who would be ignored? If they don’t count, they needn’t have had their time wasted by the pollster. As Bruno Leoni wrote, “[I]n assuming that 51 voters out of 100 are ‘politically’ equal to 100 voters, and that the remaining 49 (contrary) voters are ‘politically’ equal to zero (which is exactly what happens when a group decision is made according to majority rule) we give much more ‘weight’ to each voter ranking on the side of the winning 51 than to each voter ranking on the side of the losing 49.” (See my article “The Crazy Arithmetic of Voting.”)
Well, it might be said, in our system the majority rules. Standing alone, this principle sounds rather ominous, so the speaker usually hastens to add, “but the rights of the minority are protected.” But really now, which is it? Do the majority rule or are the rights of the minority protected? I really don’t see how you can have it both ways.
Misrepresentatives
Our “representatives”–more aptly, our “misrepresentatives”–are supposed to sort out all this complicated stuff, but don’t bet on their squaring the circle any time soon.
The upshot is that they will decide what kind of healthcare system we will have. To the extent they take into consideration what some of the people whom they “represent” want, it is only because they are looking to the next election.
All of which leads me to the question of why we even see these decision-makers as our representatives rather than as our rulers. Think about this: The average congressional district has a population of well over 600,000 people. In Montana, one congressman allegedly represents the state’s entire population of 967,440. The populations of the states range from about half a million (Wyoming) to 36.7 million (California).
Honestly now, who really believes that anyone can actually represent such large and diverse groups of people? (Credit the Antifederalists, or anti-Rats, with another legitimate concern about centralized power.) Are we playing games when we talk about representation under those circumstances?
The Fiction of Representative Government
What got me thinking about this the other day is an essay by the highly respected historian Edmund Morgan, emeritus professor of history at Yale University and prolific author of books on America’s colonial and revolutionary era. His latest book is a collection of previously published papers with the self-explanatory title American Heroes: Profiles of Men and Women Who Shaped Early America. (Hat tip: Jeffrey Rogers Hummel.) But Morgan departs from that theme in a couple of chapters, including Chapter 15, “The Founding Fathers’ Problem: Representation.”
Morgan begins by noting that all governments rest on consent; specifically, the governors are few and the governed are many and thus potentially more powerful than the governors. Therefore the governed must be persuaded to believe that obeying the government is the right thing to do. This is the role ideology plays: It constitutes “opinions to sustain their consent.”
“The few who govern take care to nourish those opinions, and that is no easy task, for the opinions needed to make the many submit to the few are often at variance with the facts,” Morgan writes. “The success of government thus requires the acceptance of fictions, requires the willing suspension of disbelief, requires us to believe that the emperor is clothed even though we can see that he is not.” (Emphasis added.)
In democratic countries such as the United States, those fictions include the idea of representation, as well as the idea that our “representatives” are mere members of the governed like the rest of us. It doesn’t take a lengthy visit to Washington, D.C., or even a state capital, to be disabused of that latter fiction.
Fictions endure only as long as they are useful, and the one regarding representation is quite useful. Morgan writes, “And just as the exaltation of the king could be a means of controlling him, so the exaltation of the people can be a means of controlling them. …In locating the source of authority in the people, they ["the men who first promoted popular government"] thought to locate its exercise in themselves. They intended to speak for a sovereign but silent people, as the king had hitherto spoken for a sovereign but silent God.”
Morgan is unequivocal: “Representation from the beginning was a fiction. If the representative consented [to the king's taxes or laws], his constituents had to make believe that they had done so.” The problem was not only that often a perfect stranger deigned to represent individuals he knew little about, but also that he had a conflicting mandate: to represent his district while also looking out for the welfare of the whole country. This second part was useful in making representative bodies into modern aristocracies. (We leave aside the further problem that for much of the history of representative government, many people were not allowed to vote.)
“The sovereignty of the people was an instrument by which representatives raised themselves to the maximum distance above the particular set of people who chose them,” Morgan adds. “In the name of the people they became all-powerful in government, shedding as much as possible the local, subject character that made them representatives.”
Morgan connects these considerations to the American Revolution, the Articles of Confederation, and the goals of the Constitutional Convention. But bear in mind that he is not a radical critic of the American political system. He’s no anti-Rat. Yet he concedes that centralization of power under the Constitution was intended to restore representation to its fictive status, since it had become more real in the small legislative districts within the states during the Confederation period. As he writes, “The fictions of popular sovereignty embodied in the federal Constitution may have strained credulity, but they did not break it.”
Alas, that topic must be left for another time. For now, as the Senate and House of “Representatives” deliberate whether to give even more control over your health care to bureaucrats, ask yourself what taxation with representation has wrought.
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These people in our government do not care about the individual having health insurance. As they call it, “health care”, there are no real guidelines for the issueance of caring for the sick. It’s all about garnering for themselves ultimately the power to say who gets this care and who does not. It ties in with depopulation of the part of civilization that is no longer productive. Workers that participate will do so without choice and at a cost initiative demand. More qualification and less coverage is their goal. A bigger part of the workers paycheck will be taken by mandate.
Most of the problems we face as a nation can be solved by returning power back to states. All of these “experts” just complicate the issue, they keep putting different angles on a problem and it clouds the obvious solutions. To Government, The nut on the bolt problem is studied for it’s tensile strength, measured for it’s size, put up for opinion from the experts and discussed in depth, while the Citizen simply finds the tool and turns the nut. The problems we face in this country are not complex, they are very simple to fix, if we put them within reach.
Let the states sort out and solve their own social issues, and let the Federal Government sort out and solve their issues with other countries.. we don’t see the State of Idaho in talks with countries. why do we see internal interference from the feds?
I can barely make heads or tails out of this article. Much of it, I concede, is probably my own fault. But there’s a lot of incoherence here, including (but definitely not limited to) the parenthetical remark stating (We leave aside the further problem that for much of the history of representative government, many people were not allowed to vote.). Umm, newsflash: many people are still not allowed to vote. We call it “discrimination,” and it’s not necessarily a bad term simply because it’s a negative term. But I’ll argue the point with anyone who cares to…
Larry wrote:
Most of the problems we face as a nation can be solved by returning power back to states.
Larry is right. It’s a simple way of stating it, but no less profound or important. But then again, as I’ve said a gazillion times before (make it a gazillion and one now), “worldview is everything.” Meaning this: If your worldview doesn’t support Larry’s and my claims, then you’re never going to believe them irregardless. So, it is a futile exercise to attempt to convince anyone of anything whose worldview doesn’t support the elements or the conclusion. “Reason” notwithstanding.
If only it was so easy. As a 10th supporter, I will still concede that many of the same problems we expereience will persist – even under a return to strict Constitutional principles.
Oh well, Jeff, when I refuse to comply witht the federalis’ demands, they will come to get me, or not. I personally do not care at this point. Others are slower to come to this realization, but productivity and producitve people are inseparable. Therefore, the welfare state will most definitely fail in the U.S. So be it. And thank you Almighty God for the principle…
I would much rather face these problems of a less then perfect, constitutional republic, then this future farming of all human conditions, under a federal tyranny.
How do you know God’s not sending you a health care law?
Because I’ve read the whole Bible, unlike most people who claim they have.
And where does it say God wouldn’t ever send you a health care law?
My friend, that is a bonehead argument which you’re too damn smart to pursue. Where in the Bible is the term “bible” to be found? I’m here to tell you that it isn’t there, but I’m looking at one as I write. But that’s beside the point…
Whatever you personally think of the Bible, it claims to be God’s Word to his intelligent moral creatures. If God is who He transmits to us through his Word that he is, not only wouldn’t he ’send us a healthcare law,’ it would be impossible of him to do so because such a thing would be a violation of his nature. Now, dependent beings like human beings have potentiality. In other words, we can be better or worse. But that’s our nature, not God’s. He is not a dependent being. Rather, he is a singular being wholly independent. Therefore, independent singularity that He is, he absolutely cannot violate his own nature (Yes, contrary to popular opinion, certain things are even impossible for God.). If he could, he would no longer be God, which is impossible.
Anyway, I don’t really care to get into a theological argument with you. I will, if that is your ultimate desire, but I’ve argued it so many times in the past that it really doesn’t even interest me anymore.
Realizing, after the fact, that my answer to Jeff above may be confusing to some (particularly to those who have little or no background of biblical scholarship and Christian apologetics), allow me to explain it this way:
These arguments about what God might and might not do always come down to God’s existence and His eternal nature. I know, I’ve argued it a gazillion times with as many personalities. In my answer above I’m simply bypassing all of the fodder, and getting down to where the conversation is ultimately going to lead anyway. And, yes, I’m also trying to back out of the discussion, because I can already see the handwriting on the wall. We ain’t going to get anywhere, in other words. So I really don’t see the point. I already have enough practice.
Jeff wrote:
If only it was so easy. As a 10th supporter, I will still concede that many of the same problems we expereience will persist – even under a return to strict Constitutional principles.
I don’t think anyone’s suggesting that it’s going to be ‘easy.’ Including Larry, and certainly not me. I won’t presume to speak for Larry any further than what I’ve just said. But I’ll give you a bit of my own perspective on the matter…
When I agreed with Larry’s statement I was agreeing with what the statement implies, not what it doesn’t imply, and certainly not what it can be twisted to imply. Anyone who thinks there’s a ‘quick fix’ for our current situation, including the tenth amendment and a return to state sovereignty, is an utter fool. We didn’t get ourselves into this mess overnight, and we’ll damn sure not get ourselves out of it overnight either. Genuine overnight conversions are so rare that they’re negligible at best. In this particular case, it ain’t gonna happen. Period. (not that I wish it to)
Hell, in my state (arguably the most consistently “conservative” state in the union) we have our own huge welfare apparatus which will take decades to dismantle if we start on it tomorrow. Someone once said (come to think of it it might have been me) that it will take at very least two full generations to undo the damage we’ve done over the course of the last 120 years or so in this country. And that’s if we start now.
So, yes, you’re right that our problems will persist, even with a return to State sovereignty under the constitution, or, as some call it “Balanced Constitutional Government.” But Larry is also right to say that our problems can be fixed by that method. Indeed, I see no other way to fix it, and to relegate the destructive (yet dominant) ideology of liberalism to the far corners where it belongs. But neither I nor Larry is suggeting that it’s going to be some kind of a cake walk. The alternative, however, is simply not an option.
I agree with all the recent responses. Arguing theology will get us nowhere, and getting back to Constitutional restrictions will allow local governments to speed up the process of disbanding welfare, if they choose to do so. (e.g. California might have little hope in this regard. Until this administration, it has been more welfare prone than the federal government itself.)
I’ll Just add that the only way to solve our domestic problems, whatever they are is to scale the problem down to a manageable size. It doesn’t matter what the issue is, health care,pollution, crime,drugs, welfare, unemployment.. pick your poison..in order to actually be effective, you must be able to identify with the problem..for instance, pollution in Montana cannot be effectively dealt with in Washington DC because they dont understand the importance of wood heat to Montanans. People in Chicago cannot even fathom for an instance, someone walking down the street with a pistol strapped to their side, yet In Idaho, it’s a common sight.Because of these unique ways of life, it’s only logical to legislate according to the environment.
Problems will persist to be sure, But problems will also be unique to the area.. and because of that they can be effectively addressed.
Larry, good post. A man after my own heart. Try this on for size.
Some great comments here. How about just overturning the 17th Amendment and return the Senate back to the states? My view is our founders had great intuition. Each state will pursue the advancement of a free society under the Constitution.Regardless the long and arduous journey, we will eventually witness the good, bad and the ugly.