Thursday, June 07, 2007
[W]hat Giuliani is doing is far more radical than his folksy debate answer suggests. Essentially, he is calling for the complete abolition of the current way healthcare [sic] insurance operates in the United States. It echoes the analysis of libertarian economist Arnold Kling, who argues that what Americans have right now is health insulation, not health insurance. [bold added, links dropped]This is interesting, but I'm nowhere near getting excited about it. Why? Consider: the lack of details, Giuliani's past record on economic issues, and the fact that other proposals touted as "free market" reforms have failed to challenge the basic premise behind the welfare state -- or therefore to propose getting it completely out of medicine.
And while I'm on this subject, I have just noticed something I really dislike about the way this debate over how Americans should pay medical expenses is being framed. I have long objected to (and avoided using) the phrase "health care" because I regard it as a means for leftists to be able to avoid saying "socialized medicine".
Beyond that, consider the most common name for this particular debate: "health care reform". What do politicians do when they "reform" things, anyway? They pass laws or enact new government policies. While a proper use of the term "reform" would not necessarily exclude the abolition of bad legislation, I think that current usage wrongly implies that medicine is properly the business of the government. Did "welfare reform" end welfare? Or, to take an example of something the government is properly involved in, would (or should) "tort reform" eliminate tort law? No.
While it is not possible to simply step in and change the name of this important debate, it is worth keeping in mind that those of us who want a free market in medicine will have to work harder from the outset to make others understand that the terms of this debate are broader than most people will realize.
Let's not allow the opponents of freedom to box us in to the mere tweaking they mean by the word "reform", or, for that matter, to place us in the defensive-sounding position of merely demanding that we want to get the government out of medicine (although we do).
Instead, let's proudly state that we want to further unleash the power of the free market so that America, home of the world's most advanced medical care, can do even better what it already does best: promote good health and save lives.