When health care is the government’s responsibility, it becomes its principal responsibility. Because the minute you make government the provider of health care, you ensure that, come election time, the electorate identifies “health” as its number one concern. Thus, in a democracy, the very fact of socialized medicine seduces the citizenry away from citizenship. Buying health care is no more onerous than buying a car or buying a house – which, pre-Barney Frank, most Americans seemed able to manage. Indeed, most of the complications are caused by existing government interventions. If you were attempting to devise a “system” from scratch, you might opt for insurance for catastrophic scenarios and, for PAP smears and colonoscopies and whatnot, something similar to the tax breaks for a Simplified Employee Pension: C’mon, how difficult can it be? Back in the day, your grampa managed to go to the doctor without routing the admin through Washington. Matter of fact, the doctor came to grampa. That’s how crazy it was.
But the acceptance of the principle that individual health is so complex its management can only be outsourced to the state is a concession no conservative should make. More than any other factor, it dramatically advances the statist logic for remorseless encroachments on self-determination. It’s incompatible with a republic of self-governing citizens. The state cannot guarantee against every adversity and, if it attempts to, it can only do so at an enormous cost to liberty. A society in which you’re free to choose your cable package, your iTunes downloads and who ululates the best on “American Idol” but in which the government takes care of peripheral stuff like your body is a society no longer truly free.