The Philosophy of Health Care Reform

The majority of members that oppose the health care bill can, non-pejoratively, be placed in the "conservative" category. Why is this? The conservative thesis is that the current system is more efficient than that which is proposed to replace it. To shed light on what it means to be called a conservative, the philosopher Michael Oakeshott states that reform opposition occurs, "when there is much to be enjoyed and when that enjoyment is combined with a sense that what is enjoyed is in danger of being lost. It is the combination of enjoyment and fear that stimulates conservatism." Surely, conservatives are enjoying themselves.

As one of the few intellectual conservatives, Edmund Burke, offered very convincing evidence for the utility of conservative views. He wasn't a Tea Partyist by any means, and has said that change is often needed; "A state without the means of some change is without the means of its conservation." However, not all change is welcomed or beneficial. Edmund Burke's Reflections on the Revolution in France is regarded as one of the most enlightened pieces of conservative apologetics ever written. Now the case for health care reform is not synonymous with the French Revolution, but the ideology is sufficiently comparable.

Burke invokes the notion of "latent function", which states that the stability and importance of an institution only becomes apparent after it is dismantled. Maybe the current health care system in the United States is better than a, possibly, failed attempt at reforming it. Maybe not. For this issue, ivory trade is an elegant historical example. To stop elephants from being killed, the ivory trade was banned. This made ivory scarce, but more importantly, expensive. The rewards for poaching subsequently became greater, so more people killed elephants than before the legality of ivory became an issue. I'm not saying that killing elephants and letting people die from lack of hospitalization are one in the same, but there's something to be taken from this analogy.

The fact of the matter is, health care reform is expensive. It could destabilize our already vulnerable economy, but it will also save lives.

This post, coming from one who approaches politics from a liberal perspective, is simply to shed light on the fact that there is a deep history tying socioeconomic reform to conservatism. What is lacking in the current approach, however, is an intellectual overture to the problem of doctrinal reform opposition. Too many analysts are caught up in perfunctory debate, and this is impeding their capacity to conceptualize the opposing philosophies. This is precisely Michael Tomasky's idea of "ideological homogeneity."

In 1957, Samuel Huntington published an article titled Conservatism as an Ideology. In it, he points out that conservatism, by definition, offers no vision of an ideal society; there is no conservative Utopia. Conservatism has no substantive institutional content and is therefor not concerned with content, but with process. Not to seem iconoclastic, but the true opposition of conservatism is not liberalism; it is radicalism. I don't mean militant radicalism, but instead defining it in terms of enthusiasm with innovation and an embrace of rapid change. Disagreeing with an opinion does not imply that you maintain a superior alternative solution, nor does it demand that you hold an individual opinion at all.

As for health reform, my opinion is that of generational partnership, which is to say that we have a fiduciary responsibility to create a state of medical philanthropy; specifically, one that is price independent. Just as in the US participation in world wars 1 and 2, we made tough decisions despite their cost, not because of it.