CIVILIZED DEBATE

I was interested and pleased to see that my recent blog about health care and the nanny state drew a well stated comment from across the aisle.

Melemel recited the litany of benefits which are supposed to flow from the Patient Protection and Affordable Health Care Act which was signed into law this week.

Of course, debating about whether the law will accomplish the laudable goals its supporters expect is a bit like arguing about which team will win the NCAA basketball tournament.

We all have our opinions, but only time will tell.

My criticism of the health care bill was never grounded in opposition to the objectives it seeks to achieve. No one in America should doubt that health care costs have escalated to an onerous level.

The essence of my complaint is that the law attempts to nationalize an enterprise which for over 200 years has been considered properly regulated by the individual states of the union.

Every state has an insurance commissioner. Indeed, PPAHCA requires the Secretary of Health and Human Services, (who may now be called the health care czar) to consult with the National Association of State Insurance Commissioners before promulgating the many new rules the bill authorizes.

Not all the ills the law is supposed to cure are everywhere in need of curing. I know that Blue Cross of Michigan, for example, already is obligated by state statute to insure any resident of the state regardless of pre-existing condition.

The essence of insurance is the pooling of risk. At root, a health insurance company is nothing more than an agreement among a group of people to pay each others’ doctor and hospital bills.

Why should the people of Montana or Wyoming be required to share the health care risks endemic to New York or San Francisco?

The larger issue here is not health care, but constitutional democracy. When our nation was formed, a representative in Congress had a constituency of about 30,000 people. Today it is more than three quarters of a million.

Soliciting the votes of a million people costs money. Lots of money. Which is why big money people have so much clout in Washington, D.C.

The more the minutia of our daily lives is regulated by the federal government, the less control we have as individuals, the less influence we are able to exert upon those who govern us.

Should a twenty-six year old have a right to remain on his or her parents’ health insurance? Admittedly a popular provision to garner the college vote, but hardly a rule that has universal application. When I was 26, I was a lawyer, a husband and a father. I venture to say that the vast majority of people that age haven’t lived with their parents in years.

Why does the federal government have to take that decision away from the state legislatures?

The list of special treatments goes on and on. In 2,700 pages, the Congress has cobbled together a cornucopia of benefits and privileges that garnered a bare majority vote.

Its supporters expect that nationalized health care, like social security, will become a fixture in American life, such that no one will dare to suggest its repeal.

They may be right.

Sadly, de Tocqueville may also have been right.