The Right-Wing Plot to Control Your Health Care
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Much has been written the past few months about the conservatives' assault on women's autonomy: the intrusive battery of new laws designed to forcibly insert the right-wing's political and religious agenda into the most intimate conversations between women and their doctors.
What's less well understood is that this same effort is also a full frontal attack on the future of government-paid healthcare, and by larger extension, on Americans' trust in their public institutions, and our confidence in government's ability to solve problems the market can't handle.
As I've written recently, busting our trust in democracy is a central goal of the Republican Party as it's currently configured. Killing our will and ability to provide good healthcare to every American is central to this enterprise: If we get the idea that we can do this much good for this many people through government, we might regain faith in our civic competence to do a whole lot of other things, too. It's the last thing they want.
So they are, quite simply, out to break the social agreements that would enable such a system to exist at all. And there's a lot in these "war-on-women" bills that achieves this other goal as well.
Who Gets to Choose?
Americans already support several government-paid healthcare systems. One, Medicare, is a single-payer system on the Canadian model. Another, the VA system, is pure British-style socialized medicine. There are a vast number of other systems as well -- child health programs, active-duty military health services, the systems that serve Native American reservations and prisons, and so on. Through these systems, we pay the bills for our seniors, troops, veterans, kids, disabled people, and others to receive healthcare.
But we've also very clearly understood, throughout the many decades of these programs' existence, that paying the bills does not give us the right to choose what care people get. Americans, by and large, stand by the idea that the fundamental right to make medical decisions should remain with us and our doctors to the greatest extent possible. There's a strong cultural belief that politicians, bureaucrats, bean-counters, well-meaning friends, religious busybodies, and your mother have no business in deciding how you should manage your health.
In fact: the thing that pisses us off the most about private insurance is the way those systems allow accountants and shareholders into the mix -- two groups of people most of us are firmly convinced have absolutely no business making decisions about our care. And we're equally suspicious when government tries to "ration" care (which is why our default has been to leave rationing to the free market, which does an ugly and brutal job of it).
We've also been pretty hostile to the idea that taxpayer-funded healthcare should ever be an open invitation for pecksniffers to run around commenting loudly on people's diets and recreational activities. Yes, we're paying their bills. And we can do what we can do -- build parks and trails, mandate good food labeling -- but beyond a point, that's it. When it comes to what any given individual does, that's between them and their doctor, and our job is to butt out.
This goes to the heart of what Americans adore most about the promise of government healthcare. We love the way it guarantees our individual freedom to pursue life, liberty and happiness, while also recognizing that we can't pursue those goals freely unless we're also covered for the very real risks that pursuit entails. If freedom means being able to quit your job to go back to school, start a business, travel the world, or raise your kids, the prospect of losing your health insurance may be the biggest obstacle there is to true American liberty, investment and self-improvement.