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Monday, March 22, 2010

Hayek and the Health Care Legislation

Dr. Douglas O. Walker
Robertson School of Government

I have been re-reading parts of Friedrich von Hayek's Road to Serfdom.

Hayek is so right about how government actions become increasingly demanding and outside the normal bounds of decency and law once a government starts to mandate things. We are only at the beginning of the takeover of health care in the U.S. and the Congress is already focused on the need to put in place strong measures to control everything people do in a key area of their life. One can already see some of the profound changes this legislation will cause.

Once this legislation is approved (actually, silly me, I still think -- hope springs eternal -- it may not pass), not only the nature of the government's relationship with the governed will change, but the nature of politics will change. In the first instance, health care and its demands on society will come to dominate every discussion of what the government does and does not do. This is what has happened in Britain and elsewhere and this is what will happen in the U.S. Health care will be regarded as costless to everyone who needs health care (and even many that don’t) and the constant complaint on their part will be “The government promised to give health care to me and I’m not getting what I need.” The usual concerns of government -- matters like defense and public order and maintenance of society's infrastructure -- will be seen by all those who do not pay taxes as insignificant and unimportant. Instead of seeing their role as contributing to the common support of the administrative apparatus of government and special needs of those who cannot support themselves, many will see government as the source of goods and services they regard as essential to their lives.

In the second instance, this legislation, and the accompanying education act and the cap and trade regulations to come, really do represent in some sense a march into socialism with its attendant shift in decision-making from the private sector to the public sector. Of course, many of the supporters of the health care bill cannot see this and do not understand how this causes a debasement of the political process. But it will. Slowly and inevitably, the focus of political discourse will shift from common issues of national affairs and eternal questions of international relations to the particularistic and contentious problems of satisfying the insatiable demands of special interest groups and never ending fights between those who gain benefits from government and those who carry the burdens of government. Moreover, once the public sector suppresses the market and becomes accountable for actually delivering goods and services previously allocated in the private sector, it must control not only channels of distribution, but means of production. As Hayek emphasized, each step down the road to serfdom is never seen in terms of the full set of consequences that lie ahead. Instead of discussing how the nation as a whole can prosper and how the common defense can be marshaled, once Congress usurps the decision-making functions of the private sector the nature of politics changes from promotion of the general welfare to the looting of the public purse by special interests.

An unthinking desire to engage in the large-scale engineering of the lives of people is also typical of the socialist mentality reflected in the health care bill. One Democratic congressman interviewed on TV said that, yes, it is sweeping legislation and many elements in the bill are ill-defined and less than ideal and no doubt will create problems as they are put into place. But Congress will fix the problems as we go along, he said, constantly improving how health care is delivered, once the legislation is implemented and we see the problems that arise. He did not seem to understand that implementing untested legislation of this magnitude would inevitably destroy the jobs and disrupt the lives of hundreds of thousands and perhaps millions of people as Congress “experiments” with large-scale programs that inevitably fail in unforeseeable ways. That the elements of the bill should be tested in small pilot programs first to see what impact they might have never entered this Representative’s mind. How many doctors will have their practices destroyed by bureaucrats who have absolutely no idea of what they are doing? How many patients will have health care arrangements they regard as satisfactory interrupted and adversely affected by the new rules and regulations governing who provides their health care and how it is financed? This Representative has not given one iota of thought to the recklessness and irresponsibility of what is being done and how it will affect millions of Americans.

Friedrich Hayek's great book is about the dangers of central planning and the threat administrative controls of government present to the individual liberties of a free people and their collective prosperity. One cannot help but feel that the health care bill now before Congress, with its goal of a government-directed far-reaching transformation of a critical part of the U.S. economy, represents a menace to limited government and the success Americans have enjoyed in lifting their incomes and health status over the decades. If this bill should pass the Congress, dissatisfied Americans can take solace in that an election approaches where they can express their views and reverse what many of us believe to be a dangerous step down the road to serfdom. For some of us, that election cannot come soon enough.

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