Paul Krugman on The Immoral Republican Philosophy on Health Care

Paul Krugman‘s column today examines the philosophy behind Republican health care positions, which are a reflection of their overall view of government programs. Republicans are right more often than not when they argue that the private sector does a better job than government. The problem for them is that at times this is not true. While liberals are more willing to consider either private or public solutions to problems based upon which is best for a specific problem, conservative philosophy compels them to oppose virtually any government program, regardless of its benefits.

George Bush opposes any expansion of the State Children’s Health Insurance Program (Schip) on philosophical grounds. Krugman writes:

President Bush says that access to care is no problem — “After all, you just go to an emergency room” — and, with the support of the Republican Congressional leadership, he’s declared that he’ll veto any Schip expansion on “philosophical” grounds.

It must be about philosophy, because it surely isn’t about cost. One of the plans Mr. Bush opposes, the one approved by an overwhelming bipartisan majority in the Senate Finance Committee, would cost less over the next five years than we’ll spend in Iraq in the next four months. And it would be fully paid for by an increase in tobacco taxes.

The House plan is even worse for Bush as it would take money from Medicare Advantage plans to fund the expansion. An aspect of Bush’s Medicare bill has been to reward the insurance companies which contribute to him with subsidizes for treating Medicare patients in private plans. These Medicare Advantage plans typically cherry pick the healthiest patients but it still costs twelve percent more than it costs to care for patients under the government Medicare plan. It makes no sense, unless your goal is to privatize Medicare regardless of the cost, to fight so hard to preserve these subsidies. The money could be better spent either on improving the Medicare program itself, or on other health care programs such as Schip. Krugman looks at the underlying philosophy:

So what kind of philosophy says that it’s O.K. to subsidize insurance companies, but not to provide health care to children?

Well, here’s what Mr. Bush said after explaining that emergency rooms provide all the health care you need: “They’re going to increase the number of folks eligible through Schip; some want to lower the age for Medicare. And then all of a sudden, you begin to see a — I wouldn’t call it a plot, just a strategy — to get more people to be a part of a federalization of health care.”

Now, why should Mr. Bush fear that insuring uninsured children would lead to a further “federalization” of health care, even though nothing like that is actually in either the Senate plan or the House plan? It’s not because he thinks the plans wouldn’t work. It’s because he’s afraid that they would. That is, he fears that voters, having seen how the government can help children, would ask why it can’t do the same for adults.

And there you have the core of Mr. Bush’s philosophy. He wants the public to believe that government is always the problem, never the solution. But it’s hard to convince people that government is always bad when they see it doing good things. So his philosophy says that the government must be prevented from solving problems, even if it can. In fact, the more good a proposed government program would do, the more fiercely it must be opposed.

George Bush ran as a compassionate conservative in 2000, claiming to be different from previous conservatives who would cut useful government programs. His governing philosophy is the opposite of the views he campaigned on as he opposes government programs not because they are bad, but because they are effective and prove him wrong.

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2 Comments

  1. 1
    b-psycho says:

    Funny thing is, he’s fine with government when it does stuff that no one in their right mind would argue it should EVER be allowed to do, no matter how generally trusting of it they are otherwise.

    I’m quite the skeptic, and obviously an extremist compared to many, but at least with economics there’s a debate to be had. With warrantless wiretapping, torture, & politicizing science…not so much.

  2. 2
    Ron Chusid says:

    They certainly aren’t consistent in supporting limited government. Calling for small government is popular, so they use the rhetoric and then do the opposite if it involves a program they like.

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