John Podoretz had an interesting op-ed in the New York Post on Pi Day–it was called “Freedom’s Fallen Entirely Out of the Health Care Debate.” He makes the argument that the recent CBO scoring of the AHCA has been misinterpreted; the 24 million people who will be without coverage by 2026 aren’t “losing” their healthcare. Rather, they are exercising their freedom of choice to not purchase health insurance (we’ll set aside the millions who actually will lose their health insurance as a result of lower tax credits and cuts to Medicaid). Podhoretz fears that the hysteria created by that 24 million figure will destroy the bill’s prospects in Congress and push us ever closer to a single-payer healthcare system:
That 24 million number is devastating to the political hopes of those who designed and are shepherding the bill in the House. They may be able to muscle through its passage, but what they are proposing will almost certainly be dead on arrival in the Senate. It will likely pass its own bill, and then some magic will have to happen to “reconcile” the two versions to create some final compromise President Trump can sign. If it can even get that far.
In the process, something even more devastating to the right’s argument has arisen, and that is the rise of populist critics who have decided that the left’s great desideratum is closer to their hearts than the classic conservative critique of ObamaCare and national health care.
The best example of this comes from Christopher Ruddy, the publisher of Newsmax and a close friend of the president’s. In a stunning March 13 op-ed, Ruddy argues that the private health-care system is a mirage and that Trump should ditch what he calls “Ryancare” to protect Medicare and push for a huge expansion of the Medicaid system to make it the provider for far more people than just the poorest Americans.
Ruddy’s goal is, he says, what Trump has promised: universal coverage. What’s notable here is that Medicare and Medicaid are, effectively, single-payer health-care systems run by the government. So what Ruddy is advocating is, in effect, the same long-term goal Teddy Kennedy had in 1969 when he first proposed a national health-care system.
The case for liberty is in desperate straits. The left opposes it, and now the right is splitting over it. Barack Obama and the Democrats may have lost the House in 2010, the Senate in 2014 and the presidency in 2016, but they may be winning the most important argument they’ve ever made.
I recently wrote about freedom, and how there are two kinds: liberty (which I characterize as “freedom to”) and safety (which is “freedom from”). In that article, I wrote that
A person can be in a coma, where they’re fed, cleaned, and cared for.They have no pain, no hunger, no fear, no burdens of any kind. But I think we’d all agree that they aren’t free to do anything. On the other hand, somebody running around in a Mad Max-style dystopia can do whatever they want, but they are subject to all kinds of sufferings. So there are two types of Freedom we’re working with: Freedom From (which we’ll call Safety) and Freedom To (which we’ll call Liberty).
Maybe (and I’m just running this up the flagpole now), what everyone really wants is a balance between Safety and Liberty, or rather a maximization of the two. You want to be a safe as possible while still being as free as possible. The absolute BEST world would be one in which Safety and Liberty were absolutely maxed out. So we work towards that, right? We try to get the two freedoms as expansive as possible.
I can’t disagree with Podhoretz that “the case for liberty” would be in “desperate straits” if America adopted a single-payer healthcare system (which, for the record, I think would be a bad idea–but that’s for another time). On the other hand, the case for safety is more ascendant than ever. Podhoretz, as well as everyone on the right and the left, needs to take a careful look at what would be gained with the implementation of the AHCA, as well as what would be lost–is the freedom to buy health insurance worth the loss of the freedom to not die in the streets?