Health Care: America’s Sickness or Symptom?

I suffered through a very rough batch of pneumonia five or so years ago. The experience is lodged in my memory as a rather wretched affair. I was bedridden for a month’s time, not a day passing that I did not cough up a cup of bile. Despite my misery, I was in one respect quite fortunate: I lived near a physician who happened to be a friend of my family. I knew the fellow only from Sunday meetings at the local chapel, but he seemed rather glad to help me and soon set me up with a subscription of antibiotics designed to drive the illness away.
His description of the medicine he subscribed was quite interesting. Pneumonia is not an infectious disease, as I had assumed. It is simply the inflammation of the lung’s alveoli, the respiratory sites where oxygen is delivered to the blood. This inflammation – the pneumonia – was the work of my immune system, which had begun filling the alveolis up with gunk as soon as my lungs had fallen prey to a bacterial infection. These bacteria were the real sickness. My pneumonia, as dangerous as it may have been, was just a symptom. While treatment existed to reduce the inflammation itself, it could only ever serve as a stop-gap for the real thing. If the true sickness was not destroyed, the symptom would eventually return – and with more force than before.
I believe a fitting comparison can be made between the sickness and symptoms that caused my month abed and the sickness and symptoms that plague our Republic. While the natural reaction to any disaster is to condemn it as the source of our ills, we must be wary with any such diagnosis. If what we call an illness is in reality an inflammation, we risk treating the symptom instead of its source. As with diseases of life, this is only a stop-gap solution.
Take the recently passed bill on health care reform. As did many souls of a right-wing bent, I found myself disgusted and dismayed with the bill’s passage in the House. I soon noticed a difference, however, between myself and many of the conservatives and libertarians mourning along side me. They were shocked to see such a clearly unconstitutional mess make it through the House. I was shocked to see that such a clearly unconstitutional mess could make it through the House. They were angry with a Congress willing to pass a 2,000 page behemoth no elected official had read. I was angry that Congress was capable of passing a 2,000 page behemoth no elected official had read. They were frightened by the amount of leverage and control the government will soon have over a wide swath of the private sector. I am frightened by any government that can attain this kind of control and leverage over the private sector in the first place. As I see it the danger before us comes not from one party or bill, but in the way our parties write their bills. It is a structural problem, not a partisan one.
I sympathize with those who view the bill as a great disaster brought upon the American Republic by the Democratic Party. I respectfully disagree with this position. Its advocates place a good deal more importance on the power of individual personalities than I think can be justified. Legislative majorities come and go. Parties rise and parties fall. Political philosophies go in and out of vogue. Such changes will happen in any healthy democratic republic. This cannot be helped.
With rare exception, the means by which these parties execute their vision changes at a much slower pace. Absent those few great revolutions and reformations found in our history, the rules and norms that undergird America’s government are subject only to incremental change. It is with these rules, not the parties that abide by them, that the root of the Republic’s woes can be found.
The creation of a health care regime should not have been a surprise to anyone. Its existence was foreshadowed years ago. It should be remembered that the practice of forcing under-scrutinized and liberty stripping legislation of dubious constitutionality through the House did not begin with this session of congress. And if the last party in power was unafraid to use such a contrivance in pursuit of their host of pet issues, why act surprised when the current majority followed suit?
“Give a small boy a hammer“, wrote Abraham Kaplan, “and he will find that everything he encounters needs pounding.”  This ‘Law of the Instrument’ does not discriminate between children and governments. Both can fall under its influence with incredible ease. Indeed, both have.
Be under no illusions concerning this matter. We have established a system whose automated response to adversity is imposed centralized control and bureaucratic enlargement. Public Law No. 111-148 is simply the most recent and severe manifestation of this reality.
I can only hope that the severity of this symptom has not obscured the sickness behind it.

Note: This post is a reaction to several comments – made both at the Stage and elsewhere – from various readers in response to the post “Progressives, Conservatives, and the Politics of Reconciliation.” While it is not necessary to read that post in order to benefit from this one, reading it will augment the reader’s understanding of my position.

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And yet, a person can get a cold and keep moving, contract Cancer and keep working.

But if either spreads unabated — there exists a point when the disease so serious that dramatic action is required. This bill is metastasization of indifference to liberty.

This is worse that other unfortunate legislation. It is far outside of Constitutional purview, invasive to privacy, and economically devastating enough to put us in the road to European-style socialism (yet, as I like to remind, without the really good cheese and chocolate).

"But if either spreads unabated — there exists a point when the disease so serious that dramatic action is required. This bill is metastasization of indifference to liberty."

Agreed. The question is what kind of dramatic action must be taken. Standing in opposition to the bill is not drastic action. At some point the target of attack must shift away from individual bills or personalities and towards disease itself.