President Bush opposes efforts in Congress and the states to expand the State Children’s Health Insurance Program (SCHIP) to include more children from middle-class families who don’t qualify for Medicaid. He says he’s against those efforts because “when you expand eligibility … you’re really beginning to open up an avenue for people to switch from private insurance to the government.” This, he says, would undermine personal responsibility.
Bush is right about that. Why should the taxpayers have to provide health insurance for people who can afford it? In a truly free society taxpayers wouldn’t be forced to provide it for anyone. The free market, unencumbered by government mandates, regulations, subsidies, and taxes, would have no trouble delivering high-quality medical care and insurance to anyone who wants it. Every serious problem facing America’s medical system is attributable to government interference. That has been documented endlessly. The claims that government-run systems — whether Canadian, British, or Cuban — are efficient and compassionate are palpable nonsense. When people need sophisticated medical care without waiting, they come to the United States. That’s true not because the United States has a free medical market, but because it has less government involvement than other countries. (That’s a very low bar.) To the extent the government is involved, the system is messed up. Government is the reason medical insurance is expensive. It’s been so distorted by the politicians that it isn’t really insurance at all, but just another wealth-transfer program.
That said, Bush’s position is not something we advocates of constraining government power can cheer. That may seem odd, but there’s a deeper political point to be made. When Bush lectures middle-class and working-class people on self-responsibility, he has no credibility whatever. This is true for most establishment conservatives today. They have violated the freedom-and-responsibility philosophy so often that when they suddenly invoke it for children’s medical care, they look cynical and callous. With friends likes these, the free-market cause hardly needs enemies.
Imagine Bush talking about responsibility and the importance of not giving people incentives to leave private insurance for the government dole. What does he think his monstrously expensive Medicare drug benefit accomplished? Economists warned of this at the time, but he was more interested in political gain than freedom and responsibility.
This only scratches the surface. His signature No Child Left Behind Act further shifted responsibility for education away from parents to distant bureaucrats in the central government. That was too much even for some conservatives.
He has supported virtually the whole constellation of corporate-welfare programs, from farm subsidies to energy-company tax preferences to ethanol privileges to Export-Import Bank favors to “defense” contracts that have nothing to do with real defense. Working people who are told to take responsibility for themselves might justifiably wonder why big corporations and agribusinesses shouldn’t do the same.
Such inconsistency — dare we say hypocrisy? — does grave damage to the cause of freedom and the free market. When politicians selectively apply the principle of self-responsibility, they discredit it. Their motives are suspect in many people’s eyes — and they should be.
This has a profound effect on the political system. Nonideological, middle-of-the-road voters, who tip the balance in many elections, are likely to think the worst when they see a politician push energy, “defense,” and farm bills that transfer huge amounts of taxpayer money to wealthy individuals and companies, while opposing health coverage for children in nonwealthy families. Voters tend not to like hypocrites, and such politicians give the free market a bad name. It begins to look like a cover for helping friends.
If the case for freedom is to win people over, it must be made clearly and consistently. Trying to shoehorn it into a program of corporate welfare is not only absurd, it is also sure to lose.