October 24, 2007

Should Conservatives Show That 'We Care?'

By Christopher Chantrill

Last week President Bush successfully stopped the expansion of S-CHIP into the liberal slacker classes. So the creative children of well-to-do parents who would rather buy fancy cars than pay for health insurance will have to pause for a moment. For this important ethical and moral victory the president should be celebrated forever as one of our greatest presidents.

Meanwhile the Democrats showed once again that they "cared about the children."

Never mind that it's all just a huge bluff.

Government is there to protect us from enemies foreign and domestic. It doesn't always do that job very well, but it's better than the alternative.

Everything else is fluff., and very expensive fluff at that. The newly legislated fluff always looks wonderful. But after a while it always turns into rotting bureaucratic sludge.

Fluff? Health care and education are fluff? Let's take a look at the great heads of government spending for FY 2008 on usgovernmentspending.com. The numbers are all budgeted and estimated.

United States Federal, State, and Local Government Spending
Fiscal Year 2008
Amounts in billions of dollars

Pensions: $910.0
Health Care: $916.5
Education: $836.7
Defense: $692.0
Welfare: $436.4

We are talking about all levels of government, of course.

Here's the dirty little secret that explains why it's mostly fluff. All that money we spend on health care and education -- we don't know if it is doing any good.

You start to get the picture from Rising Life Expectancy by James C. Riley. There are six areas for reducing mortality: "public health, medicine, wealth and income, nutrition, behavior, and education," he writes. But researchers find it very difficult to separate out the significance of each area. One thing is certain; the importance of medicine has been greatly over-hyped. Needless to say, more research is needed.

Robin Hanson of CATO confirms Riley's finding. He writes that we don't have a clue about the effectiveness of health care. Although health experts know this they are nervous about telling us. Anyway we just don't believe them.

"Non-health-policy experts are probably shocked to hear my claims. Most students in my eight years of teaching health economics have simply not believed me, even after a semester of reviewing the evidence."

Here's an example of what Hanson is talking about. A RAND health insurance study in 1978-82 assigned two thousand families to various health insurance plans from free to full price. The result was inconclusive; the health of some poor families even got worse after they got free health insurance.

What is going on?

The key to understanding "health-care," Hanson suggests, comes after the hyphen. It is all about care, not health.

"[H]umans long ago evolved a tendency to use medicine to ‘show that we care,' rather than just to get healthy."

That was the point that the Democrats were trying to make over the S-CHIP expansion. It wasn't the money. They just wanted to show that they cared.

This is the brilliant idea that supports the welfare state. The welfare state doesn't actually do anything; it just shows that we care.

Look at the top three heads of government spending above. If the government didn't have its pension programs then people would just knuckle down and save some more. Families that couldn't save enough would coalesce into multigenerational compounds.

If the government didn't have its health programs, then people would be a lot more careful about their health and their medical spending, and the overall life-expectancy in the United States probably wouldn't change.

If the government didn't have its education programs then people would spend their own money on education. Does warehousing students in government high schools make more sense than allowing entry into the workforce early and learning the value of an education before it is too late for further learning?

But how would we show that "we care?"

Arthur Brooks has shown in Who ReallyCares? that government charity approximately displaces private charity one-for-one. It costs more, of course, because with government charity you have to pay for all the bureaucracy and the inefficiency, not to mention the gigantic information technology systems to keep track of all those health-and-welfare programs.

Here's an idea for young up-and-coming conservative thinkers. The current welfare state is unjust to women. It crowds out and marginalizes their natural charitable instincts and prevents them from being all they can be and demonstrating that "we care."

In the welfare state only politicians and activists get to show that they care.

Think about it. The glorious feminist revolution has pitched women out of their local face-to-face neighborhood communities. It has converted them from caring friends and neighbors into "helping professionals." In the old days they used to converse and network to help each other and show that they cared. Now they are stuck in gigantic social-service bureaucracies where their natural caring instincts and emotions are rigidly controlled by a huge rule-book.

How can anyone endure for a moment longer this monstrously unjust and unnatural system?

Christopher Chantrill is a frequent contributor to American Thinker. See his roadtothemiddleclass.com and usgovernmentspending.com. His Road to the Middle Class is forthcoming.

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