Last weekend, Dr. Ben Carson broadcast a new campaign infomercial in 22 states titled "A Breath of Fresh Air: A New Prescription for America." Concurrent with the Armstrong Williams-produced sales pitch, Carson has finally joined the Republican Party, and lost his contributor contract with Fox News. The decision won't come until April, but Carson is running for president. So what's his selling proposition to either big-R Republicans or small-l libertarians?
Mostly, that he's a wildly successful and decorated pediatric neurosurgeon, with an inspiring rags to riches story, who became an overnight conservative sensation after using a National Prayer Breakfast in February 2013 to criticize Obamacare in President Barack Obama's presence. So a guy who warns against the national debt, preaches individual responsibility and agency, and has relevant personal experience in the one policy question that modern Republicans criticize most? What's not to like!
Well, a more thorough search of the political novice's statements quickly produces a potential conundrum for a political party running against Obamacare: Carson has even more antipathy to health insurance companies than Barack Obama does, and he has previously advocated policies that look an awful lot like death panels.
What do you need for good health? You need a patient and a health care provider. Along came a middle man to facilitate the relationship. Now, the middle has become the principal entity with the patient and the health care provider at its beck and call. The entire thing is completely out of control. The entire concept of for profits for the insurance companies makes absolutely no sense. "I deny that you need care and I will make more money". This is totally ridiculous. The first thing we need to do is get rid of for profit insurance companies. We have a lack of policies and we need to make the government responsible for catastrophic health care. We have to make the insurance companies responsible only for routine health care. The fact that a fraction of the American population has no health care insurance creates a situation in which some end up in emergency rooms, which results in even greater expenses for the US. If insurance companies are responsible only for routine health care, you are able to predict how much money they are going to need, which facilitates regulations. For instance, if we didn't regulate utilities nobody could afford electricity or water. You can't depend on the goodness of people's hearts, particularly when you're dealing with something which is essential.
Even in Carson's reputation-making National Prayer Breakfast speech, he launched into his Obamacare section (with its focus on Health Savings Accounts and consumer-driven decisions) with the throat-clearing phrase, "We've already started down the path to solving one of the other big problems, health care."
Now, Carson also said eight months later at a Value Voters Summit that "Obamacare is really I think the worst thing that has happened in this nation since slavery," so maybe his positions are evolving. (Conversely, maybe he talks more like a serially hyperbolic motivational speaker than someone prepared for the crucible of having his policy statements taken seriously.) In a June 2014 Megadiversities interview, Carson distanced himself from the slavery remark, and put his more recent positioning this way:
I would much prefer to replace the Affordable Care Act with a program that put healthcare in the hands of the people, and not the government. […] [W]ith Obamacare, we have a turning over to the government your most valuable resource, which is what Marxists said had to happen to change America from a free and open society to what they call a "utopian society" where the government controls everything, but no one suffers, at least according to them. What you do see in every society undergoing a transition of that type is the development of a small, elite class which controls everything and lives in total luxury, a rapidly-disappearing middle class, and a just as rapidly-expanding dependent class. We're witnessing the beginning of that phenomenon, and it's exactly what the neo-Marxists have prescribed for America. The reason I know about that is because I've spent a great deal of time reading and understanding what's going on. This type of transition depends on the fact that people will not be well-informed and thus easy to manipulate. What I've proposed is a system of healthcare which will cover all Americans in which no one will be a second-class citizen. Everyone will have the resources to see whomever they want to see. But more importantly, it will bring the entire healthcare system into the free market. That's what controls quality. That's what controls price.
So now we're throwing more Rules for Radicals and The Naked Communist into the mix, but are we closer to understanding a throughline on Carson's health care ideas? In his Prayer Breakfast speech, he said that his HSA-based plan would mean that "nobody is talking about death panels" anymore. Which is interesting, because one of the people in the past who was talking about concepts that sounded a lot like death panels was…Ben Carson.
Via an excellent American Thinker post, here's an excerpt from a 1996 Harvard Journal of Minority Public Health article from Carson, entitled "Health Care Reform-A Paradigm Shift":
The most natural question is, who will pay for catastrophic health care? The answer: The government-run catastrophic health care fund. Such a fund would be supported by a mandatory contribution of 10 to 15 percent of the profits of each health insurance company, including managed care operations[….]
As our general population continues to age and as our technical abilities continue to improve we will find ourselves in a position of being able to keep most people alive…well beyond their 100th birthday. The question is "Should we do it simply because we can? It is well known that up to half of the medical expenses incurred in the average American's life are incurred during the last six months of life….rather than putting them in an intensive care unit, poking and prodding them, operating and testing them ad nauseam, why not allow them the dignity of dying in comfort, at home, with an attendant if necessary?…Decisions on who should be treated and who should not be treated would clearly require some national guidelines[.]
Bolding mine (as it will be below). In his 2011 book, America the Beautiful, Carson again talks about seeking cost-efficiency in the face of human aging:
[H]ow can we provide universal health care in an efficient and cost-effective way?
Compensation has to be fair…compensation cannot be determined by insurance companies, who make more money by elbowing their way in as the middleman and confiscating as much of the transaction between patient and caregiver as they can. […]
When a society faces major changes, such as drastically increased life expectancy, its people should examine the effects of such a change and make logical, appropriate adjustments…we should…devise compassionate methods of easing the burden of aging both on the individual and the family.
I can hear some people screaming after reading this that I am advocating for "death panels"….some people like to put forth terms like this because they stir up emotional responses.
Another potential sticking point among both Republicans and libertarians are Carson's stated beliefs emanating from his Seventh Day Adventist faith. Now, I for one am always pleased when a potential presidential candidate becomes part of mainstreaming a newer and frequently disfavored religion, and I generally don't care if people (let alone politicians) believe in creationism, even the strict version that Carson emphatically defends in this 2013 interview ("If they want to criticize the fact that I believe in a literal, six-day creation, let's have at it"). The man's faith certainly didn't hinder his ability to separate the craniums of conjoined infants, after all.
But what's concerning to me is Carson's prejudices against those of us who do not share his beliefs. Take this 2004 interview with Adventist Review:
Ultimately, if you accept the evolutionary theory, you dismiss ethics, you don't have to abide by a set of moral codes, you determine your own conscience based on your own desires. You have no reason for things such as selfless love, when a father dives in to save his son from drowning. You can trash the Bible as irrelevant, just silly fables, since you believe that it does not conform to scientific thought. You can be like Lucifer, who said, "I will make myself like the Most High." […]
By believing we are the product of random acts, we eliminate morality and the basis of ethical behavior. For if there is no such thing as moral authority, you can do anything you want. You make everything relative, and there's no reason for any of our higher values.
In addition to being prejudicial and factually suspect, this kind of slippery-slope-on-steroids argument–taking you from "evolutionary theory" to "Lucifer" in just 73 words!–translates far too easily into public policy that adversely affects those on the other side of his faith. Carson's opposition to gay marriage springs from an openly stated fear that the "neo-Marxists" are trying to undermine the very bedrock of America's uniquely successful project by changing the definition of family. It was not entirely a slip of the tongue when Carson told Sean Hannity in March 2013:
My thoughts are that marriage is between a man and a woman. It's a well-established fundamental pillar of society and no group, be they gays, be they NAMBLA, be they people who believe in bestiality, it doesn't matter what they are, they don't get to change the definition.
Carson is arguably a larger figure within Seventh Day Adventism than Mitt Romney has been with Mormonism. (Or at least, Carson was, until he became such a high-profile political figure, which has led to some wings of the church urging more of an arm's-length posture.) Ex-Adventist friends tell me of church gatherings where the prize at the end of the meeting was to shake the great orator's hand and get a signed copy of one his motivational books.
As Advent Truth Ministries pointed out earlier this month, the "one aspect of Dr. Carson's identity that has thus far evaded scrutiny is his religion." And what would that scrutiny reveal?
[T]here is one element of his beloved religion that would certainly pose a challenge to the electorate, and perhaps obstacle, to his presidential ambition, i.e. his church's Eschatology (View of end-time events).
According to Seventh-day Adventist theology, this very America, which Dr. Ben is so passionate about improving, will form an alliance with the Roman Catholic Papacy, one that will deprive Americans and others around the world of their highly cherished Civil and Religious Liberties. Specifically, the Seventh-day Adventist church teaches that this alliance of America and the Papacy will force the world to honor Sunday as a sacred day of rest and worship in opposition to lovingly and voluntarily allowing men and women to choose the Bible Sabbath which it believes God ordains. The church believes that this controversy will ultimately develop into a tectonic struggle of apocalyptic proportions in which millions will be killed who do not go along with the requirements of the alliance's call for Sunday sacredness (Revelation Ch. 13). Many believe that this alliance is being formed before our very eyes.
I am a religious pluralist and longtime fan of the Book of Revelations, so this kind of stuff doesn't trouble me much. But it's it at least worth asking how Carson's eschatological notions color his view of current and near-future events.
Real Clear Politics this week ran the headline "Ben Carson Making Case to Be Taken Seriously in 2016;" the Bloomberg Politics respectful cover line was "Ben Carson's Longshot Presidential Bid Suddenly Looks a Lot More Realistic." He has been given policy real estate in National Review, and had his charity hyped by Breitbart News.
In presupposing the seriousness of his candidacy, Republicans and other supporters are declaring ready for prime time a man considerably less experienced than the current naif in the White House; a man who plays fast and loose with the Nazi analogies, who has warned darkly as recently as seven weeks ago that President Obama might just cancel the 2016 elections, and who maintains a hard-to-pin view on Obamacare reform that involves open hostility to the very existence of private insurance companies. Are conservatives really ready for a 2016 presidential who, when talking about late-life health care, sounds more like Ezekiel Emanuel than Sarah Palin? The first step is to look behind the gilded oration and Iowa networking, and try to understand what the man actually thinks.