"A nation of paupers with a community of goods"

Liberals talk about helping people.  They pass laws that dispossess one part of the population in order to create a bureaucracy that supposedly helps the needy but in fact has the chief effect of perpetuating and expanding neediness (and the bureaucracy that caters to it, naturally).  But what if it happens to be the case that the policies that actually (as distinct from rhetorically) help people are those that encourage economic growth and self-reliance?  What then? Such policies have the liability of providing fewer opportunities for self-congratulation as compared to policies proclaiming themselves part of a “war on poverty” or “Great Society.”  But they do at least have the effect of creating jobs instead of perpetual dependency.

Having long ago given up reading the Times, I rarely come across the emetic musings of Nicholas Kristof.  So perhaps I was more than usual susceptible to the concentrated  awfulness of his liberal sentimentality.  All those government “lifelines” — what are they but snares of  government control?

If you want a serious reflection on some of the issues Kristof pretends to conjure with, take a look at "End Medicare," Andrew McCarthy’s important essay on that gargantuan piece of fiscal incontinence and (apparently) well-intentioned effort to subject us all to government control.

McCarthy says what no politician has the guts to say: that Medicare requires not reform but abolition. It is a scam, a Ponzi scheme, that illegitimately involves the federal government in matters beyond its legitimate concern.  Responding to some defenders of Paul Ryan’s plans to reform Medicare, McCarthy asks: “why should the government be involved in setting standards for coverage, and what on earth does government know about quality when it comes to medical care? In a free society, those are matters for the market. At most, government’s job is to keep the market clean, not to dictate the inputs in the dreamy hope of controlling the outputs.”

There’s more wisdom in those few sentences than a 1000 pages of health-care legislation.  As McCarthy points out:

Medicare was a scam from the start. It had to be a scam because its ostensible purpose — providing health insurance for the elderly — was never the objective of its proponents. Instead, Medicare was a stepping stone to a utopia its champions dared not acknowledge: A compulsory universal-health-care system administered by government experts.

There followed three decades of progressive proposals, each shot down by lawmakers animated by fierce public dissent. The Left realized the dream of socializing the health-care sector was not attainable in one fell swoop, so an incremental strategy was adopted: Get a foot in the door with less ambitious proposals; establish the precedent of government control while avoiding debate over the principle of government control. . . .

Although Medicare’s architects were knowingly laying the groundwork for fully socialized medicine, they narrowly proposed to underwrite only care for the elderly — who, after all, were already benefiting from Social Security. Proponents pretended to be removing the aged from “dependency” when they were merely shifting the burden of dependency from its traditional obligors (personal responsibility, the family, and private charity) onto taxpayers. They claimed to be relieving the young of responsibility for their aging parents when they were actually burdening the young — and the young of future generations — with an ever-increasing tab for an ever-ballooning population of elderly dependents.

Demography may not be destiny, but, like the prospect of hanging in a fortnight, it does concentrate the mind.  Just take a look America’s aging population and ask yourself: who is going to be paying for grandma’s MRI?

As McCarthy notes, “if Medicare had been on the up and up, proponents could have sculpted a welfare plan for the 15 percent of seniors who arguably needed assistance.”  But helping that small group was never the object of the plan. The goal was “fully socialized medicine” — i.e., government-controlled medicine.

O what a tangled web we weave when first we practice to deceive! Proponents of Medicare pretended it was

an “insurance” program, with a “trust fund” into which working people paid “contributions” and beneficiaries paid “premiums” that would “entitle” them to claim “benefits.” In reality, there is no “trust fund.” Workers pay taxes — at levels that can no longer satisfy the pay-outs for current beneficiaries.  . . . When Medicare was enacted in 1965, the inevitability of its many adverse consequences was crystal clear. The system was grossly underfunded. The fee-for-service structure  . . .  was certain to increase costs exorbitantly with no commensurate increase in quality of care (indeed, care is mediocre, or worse). But most palpably, the fact that government was at the wheel made Medicare instantly ripe for political gaming and demagoguery.

The bottom line here is government control.  “If,” McCarthy observes, “you don’t get government out of the mix, transient politics will eventually undo any reforms you put in place.”  It happened to welfare reform. And, as night follows day,  it will happen to Medicare reform.  What we need is someone who combines the rhetorical skills of Demosthenes  and the political acumen of Cicero to make the case for what should be obvious but which our addiction to liberal sentimentality, on the one hand, and the political status quo, on the other, makes horribly difficult.  McCarthy gets it exactly right:

Medicare deserves to be destroyed, and destroying it would be better for current and future generations, young and old. So why not make that case? Other than a committed socialist ideologue, no one in his right mind would vote to implement Medicare today — not if we were on a clean slate and knew what we know now about its ruinous operation. . . . [We] can provide some sensible measure of assistance to the truly needy without giving everyone an unsustainable “entitlement” that will destroy the economy.

People like Nicholas Kristof enjoy pontificating about “lifelines” for the needy, but the actions they vote for and support threaten to turn us into, in Thomas Malthus’s phrase, “a nation of paupers with a community of goods.”