A Wall Street Journal opinion column (“Big Business, Big Medicine,” October 26th) reports the “turn toward consolidation among insurance companies,” a “dynamic [that] is leading to much larger hospital systems and physician groups, and fewer insurers dominated by a handful of national conglomerates.” If this seems an anomalous result from an administration thought to represent a departure from it’s predecessors’ corporate cronyism, the blatant and contrary writing on the wall was apparently ignored.
Like all regulations declaredly subduing Big Business predominance over consumer’s lives, the new laws synthesize “public” and “private” — both of which are ultimately meaningless in our system — boosting an already corporatist economy for health services.
As we might have foreseen, the politicians’ solution nurtures a condition whereby smaller “carriers will collapse under the new mandates and higher overhead.” In the face of everything the President said about “not accept[ing] the status quo as a solution” in health care, “Obamacare” delivered for Big Insurance, a cartel that loathes competition and welcomes impenetrable regulation. The state and Big Business — adversaries only in the popular imagination — are triumphant, the coordination of the two saddling us with another shakedown scheme.
Discussions of health care policy, perhaps because they very literally implicate life and death, tend to rouse at once our most humane and most shortsighted sentiments. Assuming that the state, or any other institution, could actually deliver passable medical services through a streamlined, hierarchical plan or enactment of a statute, attacking such a system would be more problematic for libertarians.
Although the statist formula would, in any event, be vitiated by the moral interdiction against aggressive force, it would be less susceptible to ethical objections if it worked. The political process, because it relies on moral equivocations and cowardice, thrives on misleading, confusing utility calculations intended to make us believe that it is — if nothing else — the only way to achieve “the greatest good for the greatest number.” If it did engineer the hedonic equilibrium it promises, then even many with libertarian inclinations might think that it could be justified.
It would still, of course, require tangled and debased reasoning (something like: “Well, the state’s power elites swallow up so much wealth that the taxes of the rich ought to recompense the poor who can’t afford health care”), but lovers of liberty would have a more difficult time pointing out its flaws. Despite all of the state’s assurances, though, we don’t live in that reality, in a world where the state provides a useful product for the impoverished.
Instead the state, leaving aside the fact that it is just a barbarous cabal ennobled by lies, is completely ineffectual, at least for the people that state health policies are supposed to serve. Against the standard of economic utilitarianism, government is an abject catastrophe, but it couldn’t be any other way, with a profoundly immoral system somehow leading to a practicable disposition of wealth and resources. “[W]e must,” urged Murray Rothbard, “challenge the very idea of a radical separation between something that is ‘true in theory’ but ‘not valid in practice.’ If a theory is correct, then it does work in practice; if it does not work in practice, then it is a bad theory.” Contrary to anything one might hear in a White House press briefing, it is of no concern to the state whether its health care systems — before or after their latest “reform” — are economically coherent.
The United States’ health care system, a teetering house of cards that will ultimately implode, exists through economic fallacy. Even so, by the time the elites’ scheme withers, they will have already thieved more than enough from the productive class; they will, as always, leave insolvency and beggary behind, but they’ll benefit from the presumption that their hearts were in the right place in trying to give health care to everyone.
The insurance lobby is getting what it paid for with these policies and this President. We can inaccurately call this process of fraud and favoritism a free market, or we accept that such are the contours of American Capitalism and subscribe to free markets as a means of disbanding these price-fixing protection rackets.