The GOP's purported effort to repeal and replace Obamacare appears to have reached an impasse. The maneuvering to deal with that impasse reveals (that is to say, unveils yet also hides) the fact that that effort is itself questionably sincere. The word "repeal" conveys the sense of calling back what was set forth, so that things return, insofar as possible, to what they once were. But "replace" conveys the sense of putting something new in place, not returning to the previous state of things. To its conservative opponents "repeal" means driving back Obama's salient thrust toward completing the socialist government takeover of the health sector. To their socialist leaning GOP opponents, "replace" means putting something more competent and sustainable, but still offensively socialist, in its place.
Neither understanding involves recurring to the original premises of what is supposed to be our republican, democratic, constitutional self-government. Neither involves rediscovering and applying an approach to health care that takes account of its principles and premises. Democracy refers to the strength or power of the people. But in human affairs, power involves harnessing natural forces to serve human activities, which is to say activities undertaken by human beings for purposes they understand and choose to serve.
At present, our legislators carry on the discussion of health care as if the premises and principles of our self-government have little nor nothing to do with it. True to the false assumption of the modern Administrative State, they assume that the best administration of government can be achieved without reference to any standard of good in terms of which to judge what best achieves it. This failure to clarify the basis for good judgment may seem like carelessness – but it is actually a strategic choice. Absent a common sense of good, results are most likely to be determined by the manipulation of forceful power. This abets the unchecked rule of those few who happen, at any given moment, to represent superior power.
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The return of unchecked rule by the powerful few points to the end of rising democratic self-government, epitomized, until recently, by the experience of the people of the United States. Once the present "repeal and replace" charade has reached its appointed culmination, the powerful few will have re-established themselves as the gatekeepers of life and death, reigning over masses of people enthralled by the sense of fearful expectancy, which results from being dependent on the whims of their rulers for the routine preservation of their lives and the lives of those they love.
If, as a party, the GOP were truly committed to repelling the socialist assault on our self-government, they would cast the fight over Obamacare quite simply in those terms. They would make it clear that Americans determined to retain their liberty can never agree to surrender their initiative in any personally vital economic sector to the government – much less the sector most obviously concerned with the everyday preservation of their physical lives. They would recast the debate over health care in terms that highlight the simple purpose of returning it almost exclusively to the sphere of private initiative.
They would revisit, in that regard, the real purpose of "health insurance," as an aspect of private sector welfare activity, devised to assure that the benefits of medical science are not be restricted to the persons, servants and favorites of the wealthy and powerful few. Instead of tussling over government schemes to pay for health care access for all, they would do everything possible to free individuals, and the voluntary associations they form, from tax and regulatory burdens that keep them from achieving their maximum potential. Instead of focusing mostly on subsidizing the profitability of health-care enterprises, they would look for ways to encourage and expand health care as a not-for-profit vocation, true to the premises and motives of service to humanity characteristic of true health-care professionals (in the ethical sense) from time immemorial.
Unlike the shallow rhetoric of the "repeal and replace" elitist scam, this way of thinking requires that we ponder the role that moral understanding and character must inevitably play in our economic life, especially in every activity undertaken in service to human health. Though most American agree that justice, right and rights are essential to good government, these day they shy away from the frank discussion of moral precepts without which those concepts cannot be substantiated. Perhaps they fear the intractable, deadly and destructive conflicts that have so often resulted from fundamental moral disagreements.
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But this very prospect is the main reason for preserving the primacy of private-sector initiative in our social life. Acting on their own initiative, through private, voluntary associations, people can join together with those of like mind to pursue justice and right in ways adjusted to take account of their particular moral perspectives. Aside from avoiding demands that the general public support or encourage activities it disapproves, this leads to a wealth of alternative approaches, offering individuals the choice to select the ones that best suit their particular sense of what good conscience requires.
In the health-care sector, this will not avoid all civil conflict, but it will focus attention on the need to assure that most resources are left under the control of private persons, so that:
- they can be used to second the motions that correspond to their common sense of what is best;
- private, voluntary associations are given the greatest possible responsibility and leeway to undertake welfare activities beneficial to private individuals; and
- government welfare activities are confined to those that directly serve the general welfare, defined in terms of the integrity and security of the whole body politic, not the discrete bodies of private individuals, as such.
These assurances have implications for government taxation and regulation that would result in not just repeal of Obamacare's socialist provisions. It would obviate most aspects of the programs seeded by the socialist offensives pressed forward during the "New Deal" era and its aftermath. Contrary to the ideological assumptions predominant among the elitist faction, the greatest challenge involved in this repeal is not to determine the administrative details of the socialist scheme that replaces it. It is to revisit and clarify and release for action the moral premises and character essential to preserving democratic self-government.
Just as the debate over first principles strengthened the prospects for liberty and union in the 19th century, this debate should strengthen their prospects in the 21st. We should strive to end to the moral confusion being fomented by the enemies of our constitutional self-government. We should take measures to release the common sense, initiative and moral self-confidence of individual as well as corporate persons in the private sector. And they must undertake to answer, for themselves, the question that bedevils all our discussions of social welfare issues: Who commits to assuring care for the weak, infirm and vulnerable people in our society, if the government does not? The self-motivated power of private conscience must pre-empt the coercive power of government – or else totalitarian government control will inevitably pre-empt the failed self-government of a people no longer willing to sustain it.
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Media wishing to interview Alan Keyes, please contact [email protected].