the realm of Asclepios: part 2a
In our last episode: our fair authoress discussed the nature of health as or as not an inalienable right and then wrangled through the idea that even if something is not an inalienable right, it may still be something society as a whole is better off insuring as many people as possible. *cue snazzy intro music to this episode*
Having thoroughly discussed (to the tune of two lengthy bog posts) my first premise, I am now moving on to the second: it is not the designated role of government to run health care.
The argument that the federal government should not involved in any way, shape, or form in the health care market/system is often predicated on the point that providing for or over-seeing health care and health coverage is not one of the 18 Constitutionally designated roles of Congress--which get applied broadly to "federal government." (The fact that this stance ignores the very broad--purposefully so, I would submit--applications of "making all laws..." notwithstanding.) I would agree that health care is not a specifically designated role of Congress or the federal government as a whole (the FG). Like the premise that health care is not an inalienable right, this premise could be hotly debated. Also like the previous premise, whether it is true or not is no reason that Congress or the FG cannot or should not get involved in an area of commerce or industry. There are five main reasons I wish to address in which government (state and federal) involvement is a positive, and largely necessary thing:
1) to facilitate simplicity of trade
2) to bolster private investment in risky/capital heavy endeavors
3) to facilitate consistency of coverage or quality
4) to protect consumers from faulty products
5) to protect consumers from unscrupulous behavior
1) Facilitating simplicity of trade
The strongest example in favor of this area on involvement is utilities. Now, a large portion of utilities (power, water, etc.) is provided by private companies. These companies, however, contract, not with individual landowners or companies but with governments. This practice has a long history dating almost back to the first electricity infrastructure. Electricity is not the only area of public works that early and consistently garnered federal oversight, regulation, or subsidy. There is a reason why this works so well: it facilitates simple trade. Consider the scenario if individual homeowners bought contracts for their electricity or sewage or water (in the cases where septic tanks and wells are not practical or possible, of course.). The confusion, the tangle of infrastructure would be crippling in most residential areas and impracticable in business and urban areas. The fact is that government purchased and regulated contracts make the public works trade not only simple but, in many areas, feasible.
2) Bolstering private investment in risky or capital heavy endeavors
There are many quite precedent-setting or socially beneficial endeavors that post significant risk or require significant capital investment to begin/complete. In these areas, government involvement can make or break the project. Various industries depend on federal grant monies to fund research and development, particularly into areas where there is a high risk of non-return on investment or into new, untested avenues. As a firm capitalist, please understand I support all private endeavors into development, into invention, into creation; as a pragmatist, I know that private investors cannot always enter new and risk-filled areas without bolstering. A major piece of the westward development and industrialization of America, the Trans-continental Railroad, was established with both FG land grants and subsidies. Governments, both state and federal, have more ability to raise and guarantee capital than most private investors. This makes their involvement in large-scale or risky endeavors positive, and often necessary.
3)Facilitating consistency of coverage and/or quality
There are three main examples that support the idea of government involvement in order to facilitate coverage and quality consistency. The first is one we have visited already: public works. Not only does government involvement simplify trade and implementation of public works, it insures that a minimum standard is adhered to by providers. Providers who fail to comply must fix the problems or they are replaced by another provider. A second example is that of interstate highways. (The interstate system is also an example of area 2, a capital heavy investment, btw.) In order to feasibly develop the most advantageous coverage and guarantee a minimum standard of safety, federal regulation and investment was necessary. This investment has been both long-term (the main impetus behind this came from a 90/10 split fed/state). Without the FG, there would likely be no interstate highway system in this country due to the extremely high overhead and big-picture planning necessary.
Before I move on to point 4 and 5, I'd like to take a moment and re-integrate education into the discussion. In my last posts I discussed the benefits of education as parallel to the benefits of widely affordable health coverage and care. I also pointed out that numerous of the founders and early colonial leaders saw the benefits of a universally accessible education, to the point that publicly funded education was discussed and proposed. Now, I'm sure the point will be raised that both ideologically and constitutionally, education was deemed at the time to be a state-by-state matter. I would agree that in application it was, and is today largely a state-by-state, or even district-by-district matter. The intervention of the federal government in education has been largely two-fold: providing necessary funds to districts and state that are in need of financial assistance, and providing minimum education standards to which state curricula and programs must accede. Of course, logically neither the Founders nor the Constitution could be expected to specifically address the role of the federal government in our current education system: when both were around, the nation was rather small and loosely bound due to the nature of communication at the time. I feel it is quite reasonable, however to infer from the expressed attitudes of the Founders toward education in general, and the necessity of a general education for the preservation of the republic, that they would understand the practical necessity of federal oversight and supplemental funding. It's just realistic. Like other areas, as this country has grown, the necessity of federal oversight and involvement has grown. In oder to simplify trade, bolster funding, and maintain a minimum consistency of coverage and quality, education must have some level of government involvement. I submit that the area of health care and coverage is at the point where a comprehensive involvement of the FG has become both positive and necessary.
And despite my endeavor to keep the discussion of this premise to a single post, this one looks long. Therefore, I will pause here and continue this episode after the break. haha.