SOMEONE ONCE SAID that before there was the New Deal, there was the Wisconsin Deal. In my home state, the University of Wisconsin was an early hotbed of progressivism; its goal was to reorder society along lines other than those of the Constitution. The best known Wisconsin progressive in American politics was Robert LaFollette. "Fighting Bob," as he was called, was a Republican--as was Theodore Roosevelt, another early progressive. Today, we tend to associate progressivism mostly with Democrats, and trace it back to Woodrow Wilson, but it had its roots in both parties.
The social and political programs of the progressives came in on two great waves: the New Deal of the 1930s and the Great Society of the 1960s. Today, Pres. Barack Obama often invokes progressivism and hopes to generate its third great wave of public policy. In thinking about what this would mean, we need look no further than the health care reform program he has passed along with the leadership in Congress.
Let me say here at the beginning that even though survey after survey showed that 75% or more of Americans were satisfied with the quality of their health care, no one I know in Congress denies that health care reform was needed. Everyone understands that health care in our country has grown needlessly expensive, and that some who want coverage cannot afford it. The debate over health care, then, is not about whether there should have been reform; it is about what the principle of that reform ought to be.
Under the terms of our Constitution, individuals have a right to care for their health, just as they have a right to eat. These rights are integral to our natural right to life--and it is government's chief purpose to secure our natural fights. Yet, the right to care for one's health does not imply that government must provide health care, any more than our right to eat, in order to live, requires government to own the farms and raise the crops.
Government's constitutional obligations in regard to protecting such rights are normally met by establishing the conditions for free markets--markets that historically provide an abundance of goods and services, at an affordable cost, for the largest number. When free markets seem to be failing to meet this goal (and I would argue that the delivery of health care today is an example of where this is the case), government, rather than seeking to supply the need itself (and ramming through legislation by dubious means over the objections of most American citizens), should have looked to see if its own interventions are the root of the problem, and should have made adjustments to unleash competition and choice.
With good reason, the Constitution left the administration of public health--like that of most public goods--decentralized. If there is any doubt that control of health care services should not have been placed in the Federal government, we need only look at the history of Medicare and Medicaid--a history in which fraud has proliferated despite all efforts to stop it and failure to control costs has become a national nightmare. In 1966, the cost of Medicare to the taxpayers was about $3,000,000,000. The House Ways and Means Committee estimated that it would cost $12,000,000,000 (adjusted for inflation) by 1990. The actual cost in 1990 was $107,000,000,000. By 2009, Medicare costs reached $427,000,000,000, with Medicaid boosting that by an additional $255,000,000,000--and this does not take into account the Medicaid expansion in last year's "stimulus."
The health care reform bill that passed in March only will exacerbate this crisis. The Federal takeover of health care will subsume approximately one-sixth of our national economy. Combined with spending at all levels, government will control about 50% of total national production.
There were three basic models for health care delivery on the table: the business-government partnership of the last several years--or "crony capitalism" model in which bureaucratized insurance companies monopolize the field in most states; the progressive model passed by the Obama Administration and congressional leaders, in which Federal bureaucrats tell us which services they will allow; and the model consistent with our Constitution, in which health care providers compete in a free and transparent market, and in which individual consumers are in control. …