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Tuesday, November 20 , 2018, 5:12 pm | Fair 66º


Randy Alcorn: The Freedom to Suffer and Die

America's either/or political-economic thinking hinders workable solutions to our health-care dilemma

If the Patient Protection and Affordable Care Act, Obamacare, should be euthanized by the U.S. Supreme Court, as many now believe it will be, the nation may be back to square one in finding a way to provide health care for all Americans.

With tedious predictability, the opposing sides on Obamacare muster around the two political poles: conservative and liberal. The complicated issues of health care, especially as examined by conservatives, are reduced to a simple, mutually exclusive choice between the evils of big government and the blessings of personal freedom. I wonder where the ardent defenders of personal freedom were when government declared war on drug choice.

Meanwhile, arrayed across the battle lines of economic philosophy are the forces of suffocating socialism versus the forces of wealth-expanding free-market capitalism. That’s it, everything in America these days comes down to a choice of either/or — liberal or conservative, socialist or capitalist.

OK. If we like simple dichotomies, let’s get right to it. If we do not want to provide universal health care then we must accept casualties. The magical thinking on the conservative side is that a free market in anything will bring the blessings of plenty to most people. The rarely spoken element in this thinking is that some significant number of people will be kicked to the curb. The conservatives argue that these casualties are just those who are not responsible or self-reliant enough to provide for their own well being.

Maybe, but maybe they just ran out of time before the magic of the free market provided the needed supply of medical care at a price they could afford. Oh well, in the economic jungle there are always winners and losers.

So, who are the winners and losers if Obamacare is gone? The winners are the major shareholders and executives of certain portions of the health-care industry. And the losers? With the exceptions of the economic elite and many elected officials, the latter have lifetime health care courtesy of the taxpayers. The losers are pretty much everyone else. It is easy to be opposed to universal health care if you are among the economic elite or the fortunate who have coverage.

Without Obamacare, insurance companies do indeed kick people to the curb; we already have health-care rationing. The real fault with Obamacare is not so much the philosophical and legal sophistries about freedom and constitutional limits on government, it is incorporating parasitical insurance companies into health-care reform in an attempt to placate free-marketeers, so solicitous of those who grow wealthy from the status quo. They wouldn’t want anyone to miss their multimillion-dollar bonus so some peasant can have chemotherapy. With a single-payer system the insurance companies could have been eradicated from the health-care system like ticks from a dog.

The free-marketeers are willing to accept the inevitable casualties that come with strict economic affordability. In their world, those who can afford health care will get it, those who cannot will suffer and die. Is this really our only choice? Consider who it is that may suffer and die. It could be you or someone you love. It could be folks whose only fault is that they did not get rich enough quick enough to treat an illness or injury.

Economics is not only the dismal science, it is a social science and therefore not certain like chemistry or physics. There is not the exact predictably of, say, photosynthesis in demand curves or pricing models. Economics is subject to ever-changing human behavior and social conditions. Adam Smith detected an invisible hand waving about in 18th century industrializing England, not 21st century post-industrialized America. Ayn Rand’s objectivism is a strong reaction to the Soviet collectivist tyranny she escaped. It works well in fiction novels. Those who adhere so faithfully to any static economic philosophy are no less mentally calcified than those unquestioning followers of religion.

Is pure free-market capitalism always the best approach for every need or commodity? Not according to some economists, including Nobel Prize winner Kenneth Arrow. He and others contend that the free market does not work for health care. Health care is so expensive and demand so unpredictable that few can afford it or know when they will need it. Furthermore, just 5 percent of the population uses 25 percent of health care. Meanwhile, insurance companies are motivated by profit, not by the welfare of patients. They ruthlessly deny coverage to anyone whom they determine will diminish their profits.

No, health care is not broccoli.

On the other hand, is any socialist model or approach doomed to failure? Health care in America is expensive in no small part because advances in medical science have extended human life significantly. Medical science is even flirting with extending life indefinitely. Those advances cost lots of money. If the socialist model demands egalitarian health care for all, does that mean if medicine can keep folks alive forever, everyone should have that medicine, no matter the cost? How do we pay for that? Can we ethically exist with a system where the wealthy have the best available health care and everyone else is doomed to Band-Aids and aspirin?

It gets complicated, but this current “either/or” political-economic thinking hinders creative solutions and finding workable approaches to a critical, complex problem.

— Santa Barbara political observer Randy Alcorn can be contacted at .(JavaScript must be enabled to view this email address). Click here to read previous columns.

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