April 18, 2010


A little radical thought to get to the root of the issue (Frank Wilson, 4/18/10, Philadelphia Inquirer)

Albert Jay Nock, a canny and droll observer of American folkways, points out in one of his essays that the antithesis of the word radical is not conservative, but superficial. Radical derives from the Latin radix, meaning "root." To think radically means to get at the root of the thing you are thinking about.

A good example of discourse confining itself to the topsoil of mentation would be the recent national gossip regarding health care. I call it gossip because it is hard to call something a debate when the subject of the debate - the proposed legislation - is unavailable for examination. As for superficiality, it would be hard to think of anything more superficial than legislators' voting to enact a law without actually knowing exactly what that law stipulates. Why, soon we may be able to vote for candidates whose identity will be revealed only after the election.

The funny thing about thinking radically is that it can be done without having to use big words or complicated reasoning. Those of us who were taught how to diagram sentences were introduced to it immediately: "What or whom am I talking about?" There's a perfectly radical inquiry. It gets right down to the root of the matter.

Ask it of what is being called "heath care" and you may find yourself quickly realizing that there must be some mistake. Health is a state of being in corpore sano, "sound in body," not sick. Those aren't healthy people you see lying in hospital beds.

So what we are really talking about is care of the sick or injured - medical care. Once this initial confusion is cleared up, another fundamental question immediately presents itself: Why would the state be the first place to turn to in order to deal with this problem?

The state was, of course, the last place we turned to, but the question of its proper role in making sure that the sick are cared for is the key one. And the example of other Western societies, which gave it a central role, is instructive. It seems fair to say, regardless of your politics, that the actual quality of care provided is superior in the private sector as opposed to that provided directly by government institutions (national health services). However, it is also fair to say that in societies that do not have national health there are many who do not and/or can not make provisions so that they will be able to claim that care when they require it. An "ideal" system then would maintain the private provision of care while ensuring that everyone has access to same.

Now it would be a wondrous thing is all men were ants, but instead we are mostly grasshoppers. Were it possible to fundamentally alter human nature one could live in a society where every man were industrious and parsimonious and the healthy young stockpiled cash for the eventuality of ill health. It isn't. We won't. And by the time we face our inevitable physical decline, we've reached a point where responsible private insurers ought not provide us with coverage. Insurers, after all, make money because of healthy people, not sick ones.

The proper role of government then is to require us to pay for medical care at precisely the time when we don't need it, in order that we have built up sufficient funds to access it when we do. Such is the genius of a system of universal HSA's.

This is a radical revolt against the statist approach of Big Government: In this thought-provoking essay, David Cameron elaborates on his vision for the Big Society, where Britons are freed from the 'stifling clutch of state control' and are enabled to shape their own destiny (David Cameron, 4/18/10, The Observer)

We have reached a point where the size, scope and inflexibility of our government is inhibiting, not advancing, the march of progress. Indeed, I would go further. By undermining social and personal responsibility – the building blocks of any contented community – it is making things worse. The net result is a failure to tackle entrenched social problems and the consequent diversion of funds away from other services.

This is why the Conservative programme for government is founded on such a radical revolt against the statist approach of the Big Government that always knows best. It is the culmination of years of detailed policy work by hundreds of people inside and outside my party. It is based on the best practices seen in Britain and around the world, with the potential and power to transform the lives of the least fortunate in our society. And it is in keeping with an age in which power is being diffused, the public mistrusts politicians and the internet is shattering traditional models of delivery. It is the Big Society – and it will change our nation by bringing people together to improve life for themselves, their families and their communities. The stifling clutch of state control will be replaced by the transformative power of social responsibility. We will do this by making government more transparent and accountable and by breaking open public services to new providers, unleashing the forces of innovation.

So if parents want to set up a special school to fill the void in their locality, why should we not help them? If nurses believe they can deliver a better service, why should we not encourage them to form a co-operative and do it themselves? If a pioneering social enterprise can help people escape the spiral of drug addiction and crime, why should we not let them? If a private company can get people off benefits and into jobs, why should we not allow them?

After all, the more we can solve our ingrained problems, the more harmonious our society. We are all better off if schools are improved, fewer people take drugs and there is less incivility. And the more money the state saves by cutting welfare bills and slicing out waste, the more money for frontline services in schools and hospitals.

The state, of course, will still have a pivotal role, ensuring public services are properly funded to maintain universal cover and guaranteeing standards of provision. But it will have to resist its natural instinct to command and control, loosening its grip to hand over the reins to those who might run services better or deserve a bigger say in the outcomes.

Posted by Orrin Judd at April 18, 2010 7:00 AM
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