“We look at clouds. We dream of machines.” –Kevin Williamson
Back in college, I used to spend a few evenings a week with a set of philosophically or politically inclined peers in the constituent parties of the Yale Political Union. With wooden gavels, pedantic snark, and occasionally insightful wit, we would debate questions big and small about the nature of rights, duties, citizenship, morality, education, faith, reason, and an innumerable host of ideas about the world, its foundations, and our place in it all. While those bright college nights are long behind me, I had the recent pleasure of attending a facsimile of the old debates, when a number of my friends in the D.C. area opted to borrow from that format to explore our ongoing disagreements out in the “real world” for the edification of all involved.
The debate topic, “Every dollar spent on dog food is taken directly from the mouths of the poor,” allowed for vigorous dispute and concurrence on, among other things, the nature of ethics, duty, charity, and love, wherein even those on the same “side” of the resolution found many thoughtful occasions for profound disagreement on underlying principles. By the end, we even had some attendees rethinking their outlook on life and resources, as one should expect from a good conversation.
One particularly resounding strain of thought dealt with how profoundly difficult it is to sincerely help people. Many who fall upon hardship have not fully grasped how they stumbled into their peculiar circumstances, nor are they always aware how to identify or resolve the weight of their own affliction. Indeed, the best means to support those in need—whether the economically destitute or damaged souls in the bodies of the well-to-do—are often realized through an ongoing engagement built on persistent humility through trial and error.
Providing the love or innovation that rebuilds broken lives is, in short, an intensely personal and organic engagement, rather than a bureaucratic and mechanical one.
The value of such constructive familiarity is the ability to deliberately understand and influence the individuals and communities affected by your actions and be deliberately understood and influenced in turn. It is this dynamic rapport that allows for, as my friend (and debate attendee) Leah Libresco puts it, neighbors (in the metaphorical sense) who understand what to offer each other beyond whatever initial attempts at charity may awe or falter. Likewise, it is the inevitable lack of such rapport that consigns distant, centralized administration to its trademark unresponsiveness—i.e., the inability to adequately identify, learn from, and remedy mistakes before they become disastrous.
We can see the gangrenous limbs of this truth rotting throughout the impermeable labyrinth of ambitious public policy. The old liberal conception of the welfare state, a degraded simulacrum of communal investment in the most vulnerable of us, ravages communities unabated and still facilitates entrenched social dysfunction. The ongoing scandal with the Department of Veterans Affairs has shown that, despite the best laid schemes of donkeys and elephants, the federal government of the United States cannot even, as Kevin Williamson notes in National Review, “ensure that its own employees and contractors do not negligently kill its other employees and former employees.” This dark realization about the VA’s grotesque inadequacy is all the more unsettling against the backdrop of state governments’ inability to manage even the presumably simpler task of operating Obamacare’s online exchanges.
“If you crudely ordered America’s different health-care systems from least government control to most, it would look something like this: individual insurance market, employer-based insurance market, Medicare, Veterans Health Administration (Medicare is single-payer, but VA is actually socialized medicine, where the government owns the hospitals and employs the doctors).
If you ordered America’s different health systems worst-functioning to best, it would look like this: individual insurance market, employer-based insurance market, Medicare, Veterans Health Administration.
That symmetry should get more attention in the health-care discussion than it does.”
Given the kinship of government control between “the healthcare discussion” that produced Obamacare and the “socialized medicine” of the VA, we should certainly have that discussion Klein wants. To start, let’s glance at the federal-run healthcare exchanges in my native Florida, where Obamacare-compliant plans are facing complaints with the Office of Civil Rights at the Department of Health and Human Services for discriminating against customers with HIV. In Klein’s triumphant ranking of “America’s different health systems [from] worst-functioning to best,” where do these results fall?
Not that along ago, the critics of Obamacare pithily expressed their Big-Government skepticism by asking, “Do you want to put the folks who run the DMV in charge of your health care?” Now, in Florida and elsewhere, the more sobering realization is that the folks at the DMV may be among the best of a system that, at its worst-functioning, enables fecklessly homicidal bureaucracy in a Cabinet-level department.
(Sadly and predictably enough, the homicidal healthcare bureaucracies of “actually socialized medicine” are not unique to the United States).
Whatever your opinion of President Obama—and it is hardly a secret that I’m not a fan—the problems plaguing the VA are less about his failings (which are legion) than the flaws inherent to so vast and impersonal a would-be “neighbor” as the federal government. It is inestimably difficult to help people, especially in ways that will meaningfully better the trajectory of their lives and ennoble the good neighbors in their interdependent networks. While the recent failings of government “beneficence” naturally call to mind one of President Reagan’s more famous lines, I will instead note another insightful observation from the aforementioned (and –quoted) Kevin Williamson (emphasis his):
“It will not occur to very many of the people with a strong emotional stake in that debate that it does not matter whether we choose x or y if that is the beginning and end of the conversation. There is a prior conversation that must take precedence, one in which we answer a more fundamental question: How confident should we be that our policies will produce the desired outcomes?
Not every regulation or government program is doomed to fail. But we might consider the slightly terrifying possibility that when government does get something right, it does so by accident, temporarily, and for reasons that it cannot understand or replicate. This may be why the sheer volume of law and regulation has been climbing so rapidly: Intuiting its own inefficacy, Washington is throwing everything at the wall and seeing what sticks… We’d be far better off paying veterans’ medical bills out of the Treasury than trying to operate a network of hospitals and clinics. And no matter what Washington promises to do to solve this problem, it is a good bet that the policy enacted will not produce the result intended. Reform is a random walk.”
As much as we might like to believe otherwise, the government cannot and will not respond to us as one with a stake in our well-being. Whatever the dreams and competence of its necessarily ephemeral leaders, the Leviathan is simply too distant, labyrinthine, and self-involved to evolve with the self-interested rapidity of a private business, or the soulful agape of a longsuffering neighbor.
Thus is the eternal life of government programs.