Health Care Fascism

The American Heritage Dictionary defines socialism as: Any of various theories or systems of social organization in which the means of producing and distributing goods is owned collectively or by a centralized government that often plans and controls the economy. The same dictionary defines fascism as: A system of government marked by centralization of authority under a dictator, stringent socioeconomic controls, suppression of the opposition through terror and censorship, and typically a policy of belligerent nationalism and racism.

Socialism and fascism are two terms that have been bandied about a lot lately as people voice their dismay with various policies being proposed or pursued by the United States government. In particular, the prospect of new health care legislation has led to outcries that the government is trying to take over our lives, and that if it is passed, the country is one step closer to socialism, if not outright Communism (the capital C is an important distinction, marking a governmental system as opposed to a traditional style of communal, cooperative living typical of small hunter-gatherer societies). I suggest, for those who fear that the new health care system is socialist, that they closely study the definition of socialism posted above. What the new legislation proposes is just about as far from socialism as you can get. For one thing, it vastly increases the market share of private insurance companies. The government mandating that all citizens purchase health insurance means a massive increase in revenue for existing insurers, whether those premiums are paid by citizens as individuals, by businesses, or by the feds. And, in any case, what the government is trying to do is make people responsible for their own health care, instead of having them wait for an emergency they can’t afford, and which the government (whether state or federal) will end up paying for anyway. But the socialist point is, if the industry is still in private hands, then in no way does this legislation constitute socialism.

Many of the people who are opposed to mandated health insurance are upset with the idea that the government can force you to do certain things. I will admit that I tend to be somewhat libertarian about the government’s role in things that should be personal choice. Philosophically, I oppose helmet laws, seat belt laws, smoking laws…. basically, if you choose to do things that are risky to your health and safety, so be it. It’s not government’s place to make me wear a helmet, etc. And I suppose I could say the same for mandated health care. The reason I support health care legislation (even though I believe the current bill is massively flawed for failing to include a public option) is because of the structural inequalities that make access to health care so difficult for so many in this country. From an economic perspective, I support the legislation because I believe that ultimately, access to care makes for a healthier population, which costs society much less and saves a lot of money in the long run.

But back to socialism/fascism. For those who are afraid of the government “taking over our lives,” let me ask you this: is the government telling you what health insurance provider to use? Is it telling you what procedures or medications you can or cannot have (answer: no – the insurance companies are the ones who still get to do that). In other areas of your life, does the government mandate what food to buy? What car to drive? What books to read? What magazines to subscribe to? What news channel to watch? What TV shows to follow? What websites to read? What sports team to root for? Who to vote for? What you can say in public, on television, on the internet? Where you can go? Who you can talk to? What job you have? And, if the government has too much control of our lives, takes too much of our money, then I guess they should stop funding schools, roads, public safety, scientific research, job training, higher education, etc. They should also stop legislating things such as sanitation standards in restaurants, truth in advertising, product and consumer safety (lead-based paint or toys, anyone?), drinking and driving, traffic laws, tracking of sex offenders (oh, except wait – the government doesn’t do enough to keep us safe from sex offenders!). After all, if we as citizens are responsible for making the right decisions, then we don’t need to legislate all those things, because people will do the right thing without having to be told (end sarcasm). This is the tragedy of the commons – we cannot assume that people or industries will police themselves, if there is no cost associated with the use of the commons (read: laws that make people behave). This is not socialism or fascism – this is the consequence of trying to maintain social order when dealing with enormous groups of people.

Requiring health insurance is, in my opinion, no more socialist than requiring car insurance. It makes people take personal responsibility (gasp!) for their own health, just like car insurance covers your liability if you are in an accident. Hmmm, personal responsibility – isn’t that a conservative value? Isn’t it worse when people don’t have health insurance and expect the government to pay if they need medical care? Frankly, this legislation is less socialist than the current system.