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The moral dividend from replacing Obamacare


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A federal judge in Florida has struck down as unconstitutional Obamacare's individual mandate and along with it the whole edifice of government-controlled health insurance. "Because the individual mandate is unconstitutional and not severable, the entire act must be declared void," Judge Roger Vinson ruled.

Senate Republicans are now taking up the recent House initiative to repeal the unpopular 2010 healthcare reform law. Ron Pollack, executive director of Families USA, warns that either overturning or repealing the law "would have devastating consequences for America's families." It is hard to imagine how this could be true given that the law has been on the books for just a few months. Whether what replaces the present law leaves Americans healthier and wealthier depends on how consumer-responsive it is. But the more important benefit from such a reform would be the strengthening effect it would have on the American character.

Part of what it means to live a responsible adult life, as opposed to living in an extension of adolescence and childhood, is the willingness and effort (to the best of your abilities) to provide for yourself and for those who depend on you. It is a basic function of government to protect people's freedom to do this.

People provide all sorts of things for themselves: food, clothing, housing, transportation, education, entertainment, and even (perhaps I'm old-fashioned) savings. That's why people have jobs. But because life does not always unfold as happily as planned, people also provide for themselves with insurance: life, auto, home, and health. It spreads the risk and thus the cost of those unhappy events among similarly situated people.

But for historical reasons dating back to World War II, healthcare has found its way into a separate category of insurance. In every other insured sphere of life, we pay to spread the risk of the unusual and onerous costs associated with accidents. So we insure against traffic accidents, whether fender benders or a complete write-off of the car. We don't cover oil changes and tire replacements, much less regular maintenance visits. We insure against wind or water damage to our homes, and against break-ins and theft. We do not cover predictable maintenance, even if it is expensive, like a new roof, furnace, or water heater every 20 years or so. You're supposed to plan ahead and govern your affairs in such a way that you can save for it.

Notice: You get a job, you budget, you plan ahead, and you buy insurance. That's adult responsibility. The more government-controlled and government-provided the healthcare system becomes, the less responsible it encourages everyone to be.

Democratic lawmakers argue that healthcare is too important to leave to individual responsibility. Because some people cannot afford it, the right thing to do morally is to socialize the costs so that everyone has this basic good at public expense. But that claims a rationale for ever-greater government takeover of people's private affairs that has no limiting principle. Food is important. So are clothes. People can't get to work without a car. Why should some people have free access to these basic goods and with Cadillac-quality (literally, in the case of cars) while others go without them or get by with shoddy quality? When it comes to food, clothing, housing, and transportation, they will complain that we have a two-tier society. Ban the private car or give everyone a functional government-made, government-issued car. Why shouldn't everyone live in worker housing? Let's nationalize Nike and Tommy Hilfiger. Style for everyone!

There are better ways of helping people in need. Economically, this approach to government and the public good leads to gray, grimy, universal poverty, unless you are politically connected through the political class. But morally, it leads to infantile dependency. People lose the inclination to provide for themselves as responsible, self-governing, adult people. "I have this need! Why does the government not provide for it! It's important!" The government becomes a benevolent zookeeper, and the people are all nicely preserved. But, like the lions sunning themselves on the rocks behind the fence, no one resembles what a human being is supposed to be.


D.C. Innes

D.C. is associate professor of politics at The King's College in New York City and co-author of Left, Right, and Christ: Evangelical Faith in Politics. He is a former WORLD columnist.

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