[ed. note: This is for those who do not follow the lively discussion on Facebook]
What's the difference between the moral imperative for using US resources to spread freedom, and the moral imperative to provide affordable healthcare for the poor? IMO, it's just team politics. I'm interested in seeing how [you] distinguish between using the moral imperative in foreign policy (and, for that matter, social policy), and health care.And my response:
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IIRC, I did not argue that spreading freedom ought to trump national interests full-stop, but that at a minimum, we should err on the side of freedom & democracy when in doing so we were not clearly acting against our own best interest. I think that our own best interest in the long term ought not be subordinated to unclear, debatable, potential gains to be made in the short term.
Historically speaking, the failure of detante in the middle Cold War is a pretty strong critique of realpolitik. And I'm not advancing a strictly neoconservative view of this history. This is coming from the godfather of Cold War history himself--John Lewis Gaddis.
I did not say that I felt no moral obligation or desire to help those w/o health care. I just don't translate that into wanting to tax other people to fund a government program that assuages my guilt & makes me feel better about myself.
I'm a natural rights guy.
My moral impulse to spread the "unalienable rights" is the same at home as it is abroad. I reject the cult of rights that has become progressive morality. As Folsom argues, these ever-expanding rights impose an obligation on society--an obligation which infringes on individual liberty by using the coercive power of government.
I firmly believe in the ability of market reform to drive down costs (of procedures & meds, etc. see Lasik surgery for a prime example of this), increase access, and continue medical technology innovation.
Eliminating the de facto government subsidy of employer provided healthcare & giving everyone a flat tax credit would go a long way towards accomplishing what I envision. Hell, I don't make a sufficiently compelling/persuasive argument in favor of market-based reforms, but Holman Jenkins does.
A collectivist response with fairness/equality as its main goal will not innovate. It will not drive down costs. And rather than using the amoral price mechanism allocate healthcare resources, will employ some arbitrary bureaucracy to ration care.
It may well be called "universal," but tell that to the queues of people who die waiting for cancer treatment & heart surgery. Tell that to the seniors who do not get hip replacement surgery. Tell it also to people waiting to get a friggin' MRI or colonoscopy. And don't forget about one other unintended (I'm sure) consequence of going socialist, the decline in future med tech innovation & pharmaceutical development.
Sure, Americans pay a lot of money on healthcare. So what? They are self optimizers who do so largely because they value the extension in life they believe they are receiving as a result of that care.