Slate’s Dahlia Lithwick, usually a solid advocate of civil liberties against government intrusions, can’t for the life of her understand what all the fuss about the loss of economic liberties due to ObamaCare is all about. Shell shocked by the shellacking that the Solicitor General Donald Verrilli received at the hearing Tuesday, she went into a deep sulk and threw the intellectual equivalent of a hissy fit.
How dare the conservatives on the bench ask Verilli if he recognized any limiting principles on the government’s powers under the Commerce Clause to coerce activity? By simply posing this question, the conservative justices had revealed just how dark, primitive and – above all – uncompassionate their conception of freedom was. She wrote:
Until today, I couldn’t really understand why this case was framed as a discussion of “liberty.” This case isn’t so much about freedom from government-mandated broccoli or gyms. It’s about freedom from our obligations to one another, freedom from the modern world in which we live. It’s about the freedom to ignore the injured, walk away from those in peril, to never pick up the phone or eat food that’s been inspected. It’s about the freedom to be left alone. And now we know the court is worried about freedom: the freedom to live like it’s 1804.
(She had no freedom from acid reflux as she wrote this, I’m sure.)
But if she’s having trouble understanding the conservative conception of freedom, I’m having difficulty understanding her conception of compassion. So here are some questions that might help clear the cobwebs off my Neanderthal brain.
One: Liberals insist that the individual mandate forcing everyone to buy coverage is necessary to prevent freeloaders from saddling everyone else with the cost of their emergency care. One can defend this provision by appealing to individual responsibility (as the awful Mitt Romney did) or the need for a more rational health care system, or, if liberals were honest, putting in place a funding mechanism for universal coverage. But why is forcing someone to buy a product against their wishes on the threat of fines or jail compassionate?
Liberals might say that the individual mandate is not compassionate, but the system in whose service it’s being deployed – universal coverage – is because everyone will get better care. But that only raises more questions: one conceptual and one empirical:
Conceptually, if we subtract the cruelty of the means from the alleged compassion of the ends, will there be a net increase in compassion?
Empirically, if people don’t experience significant health gains under universal coverage, as there is scientific evidence to believe they won’t, does the mere intention of compassion matter?
Two: The individual mandate shows that it does not matter to Lithwick and her fellow progressives that they have to resort to conscription to enact their grand compassionate designs. But does who they are conscripting matter? In the bad old days of the draft, the fact that politically powerless minorities ended up serving disproportionally more than rich, powerful white kids made the system even more immoral.
Shouldn't that doom ObamaCare too?
In our current health care system, a mix of taxpayers; (rich) hospitals/providers and (even richer) private insurers are stuck with the tab for uncompensated care. There are many problems with this. But isn’t it at least more compassionate than ObamaCare that would force asset-poor young people – trying to pay off their college debt and hang on to some beer money – to subsidize the coverage of relatively wealthier prospective geezers? If maximizing compassion is the issue, shouldn't we stick with what we've got?
Three: In the Manichean worldview of Lithwick & Co., one can have compassion or freedom but not both. That would be news to Aristotle who, for a dead, white, male, wrote some rather lovely stuff in the Nichomachean Ethics about how freedom is a pre-requisite for genuine compassion.
If anything, the evidence that compulsion leads to more compassion is slim at best. Despite the fact that doctors and hospitals have a legal obligation to treat emergency cases, the total amount of uncompensated care provided in America adds up to only $40.7 billion annually or about 3 percent of our total health care spending (hardly the kind of problem that justifies a draconian 2,500-plus page government power grab). This is comparable to the 3 to 5 percent of billable hours in pro bono services that big law firms, that have no equivalent compulsion, aim to offer.
Why is it obvious that, absent a legal requirement, doctors would offer any less free care than lawyers? Is it at all plausible that people who have chosen healing the sick as their vocation would simply walk away as poor people “bleed out on the curb,” as Lithwick worries?
Four: Related to the above point, have liberals ever considered that freedom and compassion are not enemies, but friends? That incentivizing, rather than forcing, compassion might be a better way to go? For example, how about offering, say, Bill and Melinda Gates Foundation tax breaks to buy coverage for the uninsured?
I can already hear derisive laughter. But does that show that opponents of ObamaCare are indifferent to compassion – or that liberals have contempt for freedom?
No doubt it’s my naivety that is causing me to ask such simple-minded questions. But perhaps liberals can enlighten me – in the name of compassion, you know.