A reader writes:
In preparing for the impending showdown in Washington over the future of healthcare in America, I’m reminded of a passage from Michael Oakeshott’s essay "On Being Conservative," from Rationalism in Politics. I quote the relevant passage in full:
"There are, of course, numerous human relationships in which a disposition to be conservative … is not particularly appropriate: master and servant, owner and bailiff, buyer and seller, principal and agent. In these, each participant seeks some service or some recompense for service. A customer who finds a shopkeeper unable to supply his wants either persuades him to enlarge his stock or goes elsewhere; and a shopkeeper unable to meet the desires of a customer tries to impose upon him others which he can satisfy."
It seems to me that in applying this analogy to the healthcare crisis, the American people are the customer, and the private insurance industry the shopkeeper. It thus follows from Oakeshott’s argument that having exhausted an attempt to make the private industry work for the ultimate benefit of the customer–the American people–the people must thus look for a shopkeeper–the federal government perhaps–which can better fulfill the need.
As Oakeshott goes on to say, "[i]f what is sought is lacking, it is expected that the relationship will lapse or be terminated."
It would seem the time has come for us to sever our relationship with private health insurance and give a government solution a go. I trust Obama, a man who is known to have a remarkably conservative temperament given his liberal policy goals, to attempt this in a prudent way; perhaps even in a way which Oakeshott would approve of.
It’s important to note that Oakeshott’s definition of "conservative" here would fly a few miles over the balding, jowly pate of Rush Limbaugh (read the essay to understand this better). And as someone recovering from socialized medicine in the land of my birth, I will find it hard to accept the consequences of collectivizing healthcare provision without some trepidation – even via the private sector.
But I’m equally aware that our culture simply cannot tolerate, for good or ill, a vast discrepancy between healthcare for rich and poor. If that’s the case, and the private sector is unable to bear the costs of caring for the poor, and if the entire system then operates in a deeply inefficient and overly-costly fashion, some prudential adjustment might be in order.I’ve made my peace with this, even as I fear it.