Universal Coverage vs. Universal Liberty
We conservatives can support universal health coverage. All that is necessary to do so is that we intend good for everyone, ignore the Constitution, and compromise our principles.
In his article published at National Review, "The Conservative Case for Universal Coverage," Avik Roy writes:
I argue that no Republican health-reform plan will get anywhere until Republicans come to agree that it's a legitimate goal of public policy to ensure that all Americans have access to quality health care, just as we agree that all Americans should have access to a quality education:
To credibly advance this approach, conservatives must make one change to their stance: They have to agree that universal coverage is a morally worthy goal. No conservative politicians oppose universal public education; instead, we champion reforms that improve the quality of public education that poor Americans receive.
The author thus makes the case -- asserts it twice, in fact -- that because conservatives support quality public schooling ("universal public education"), it follows that they ought also to approve of a federal universal health insurance program ("universal coverage"). This is a pernicious line of reasoning that undermines the very concept of limited government conservatives claim to champion.
I do not mean to marginalize and condemn Mr. Roy, whom I believe is sincerely trying to find a conservative response to a thorny and pressing issue, as exemplified here and here. But contrary to Mr. Roy's inference in the quote above, his argument is a liberal, not a conservative, one. Just because one believes that education and health insurance are desirable for all citizens, it does not follow that one also believes that their sweeping advancement is properly within the statutory and regulatory powers of the federal government.
First, an important distinction: conservatives, going all the way back to the Founders, have supported the concept and practice of universal education. But that support does not mean we approve of direct federal involvement in education which, until fairly recently, had been recognized as the responsibility of the states. Nor do we like the results of that federal involvement: Department of Education, anyone? Common Core? Gosh, how did we ever get a man on the moon without them? So it's probably best to avoid education as an example if one is trying to pitch universal coverage to conservatives.
Nor do we believe it is within Congress's legitimate power to create a health care law that compels universal citizen participation, especially under threat of fine -- or tax, as a man named Roberts chose to call it when he split a single hair on the back of that big, nasty beast called the Affordable Care Act, and thereby forced every American to become a ward of the state.
Mr. Roy proposes modifications to the beast because he has regrettably resigned himself to its permanent habitation in what ought to be the Land of the Free. But according to an authority higher than you, me, any of the politicians who voted for it, or the president who signed it into law, the Affordable Care Act is literally nothing more than worthless scribbles written by people who have arrogated to themselves illegitimate power.
Neither the Constitution's enumerated powers in Article I Section 8 nor any of its amendments contain a provision that allows Congress to create a compulsory universal healthcare law -- that is, unless one adopts an open-ended interpretation of the phrase "general welfare" in the preamble to those enumerated powers. But such an interpretation is clearly in conflict with the concept of limited government, against the Founders' intent, and is specifically condemned by Madison himself. This interpretation, however, has enabled progressives (with the help of 'conservative' enablers) to grow the federal government into the overbearing, coercive, and ever-enlarging behemoth that it is today.
Furthermore, powers not delegated to the federal government are retained by the states and the people, as codified in the Ninth and Tenth Amendments. Mr. Roy's position in support of universal coverage thus not only grants to Congress illegitimate powers, but, in so granting them, the states and people are robbed of rights and powers that lawfully belong to them.
The author also insists that conservatives "have to agree that universal coverage is a morally worthy goal."
No, we don't have to agree to that. Our American form of government was itself based upon a moral proposition: that only a limited government can insure our right to the Creator-endowed liberties due a free people. But when our government coerces us into universal coverage (and thereby also imposes itself as a stakeholder in what were formerly our personal health decisions) it is no longer limited and thus violates the moral purpose of its very existence.
Mr. Roy's argument, however, urges us -- on moral grounds, ironically -- to agree to a "morally worthy goal" that requires the federal government to assume powers beyond its Constitutional limits, an overreach that requires abandonment of our nation's inherently moral and foundational proposition-cum-principle. The immorality and fatal dangers inherent in such an abandonment are clear. The desire to help people can be morally worthy, but the goal one sets in order to do so is not morally justified when it requires such a lopsided tradeoff.
In his attempt to enlist conservative support to improve what he sees as the politically unconquerable ACA, Mr. Roy has (unwittingly, I believe) adopted to some degree that stance so central to liberal political thought, and which endangers our republic: if your intentions are good and your goal laudable, everything else -- including the principle of limited government that protects our divinely ordained rights -- becomes secondary, mutable, and ultimately, expendable.
Can conservatives propose solutions to the problems besetting health care in our nation? Of course we can, and as concerned citizens we ought to. But any conservative healthcare policy proposal must first comply with both the letter and spirit of the Constitution. For this reason our solutions will never be good enough for our progressive opponents who have been at work for over a century undermining the foundations of limited government, while we conservatives work for the opposite: to uphold the limits of federal power that protect our liberty and thwart statist expansionism. Our solutions will never be accepted by progressives because we are principled realists, not social idealists prepared to sell our national birthright for a mess of federal pottage.
We Americans live in the greatest experiment in freedom and self-determination in history, a true miracle of the ages. We cannot let our generation be the one that destroys it. We must insist that Constitutional limitations be faithfully adhered to. We must defend and promote the values and principles that safeguard our freedom, and have been bequeathed to us at the cost of great personal risk and sacrifice by those who came before us.
We must hold these things in trust for future generations, who -- if we don't fail -- will enjoy their birthright as we have enjoyed ours. Let's call that birthright 'universal liberty'. And that is much more precious than 'universal coverage.'
Robert Babcock writes from Lawrence, Kansas, where he ventures now and then to wrestle a few words into pleasant coherence. He recently began blogging as Michelle's Pithy Tipper, and his e-mail address is firstname.lastname@example.org.