One of the more encouraging political developments of the last few years is the acceptance of universal health care, at least in principle. Americans want to see the system changed, and they want universality to be integral to any reform measures. Politically, this is no longer just a Democratic belief — Republican governors (most notably Schwarzenegger and Romney) have also endorsed UHC with some enthusiasm.
And then there’s Rudy Giuliani, the alleged moderate whose progressive domestic policies are supposed to make him a credible general-election candidate, explaining to the Weekly Standard that he’s against a health care system that extends coverage to everyone.
“It’s a no-risk society,” Giuliani went on. “If we continue with this idea of collective responsibility, we’ll become a society that deteriorates. And it’s a battle that has to be fought now.”
He offers health care as an example. “Democrats want universal health care, collective responsibility — honestly, it’s their version of socialized medicine.” Even the recent health care reform in Massachusetts, designed by the Republican governor Mitt Romney, was tainted with collectivity, because it required every citizen to get health insurance.
“I don’t like mandates,” Giuliani says. “I don’t like mandating health care. I don’t like it because it erodes what makes health care work in this country — the free market, the profit motive. A mandate takes choice away from people. We’ve got to let people make choices. We’ve got to let them take the risk–do they want to be covered? Do they want health insurance? Because ultimately, if they don’t, well, then, they may not be taken care of. I suppose that’s difficult.” He lets the idea sink in, though it seems to bother his audience not at all. “The minute you start mandating, you always end up with more expensive government programs.”
Fascinating. Let’s unfold this a bit.
Society “deteriorates” if the nation introduces collective responsibility into the health care system. Why? Because it’s “socialized medicine.” That’s standard Republican claptrap, I suppose, and is hard to take seriously.
But Giuliani really sounds clueless when he says the “free market” and “profit motive” are what “makes health care work in this country.” Really? Work for whom? Put it this way — someone needs to ask Giuliani whether he believes the U.S. health care system is effective and efficient right now, governed only by the free market.
As Jonathan Chait put it:
Our system is far more expensive than anywhere else, denies medical services to tens of millions of people except when they have emergencies, and by most measures produces no better outcome. So is there any reason our system “works” except the tautological justification that it’s the best because it’s the most market-based?
For that matter, it’s hard not to laugh at Giuliani’s suggestion that people might prefer not having any health care coverage at all. The implication isn’t subtle — it’s fine to leave Americans behind and vulnerable, because, who knows, maybe they like it better that way.
Tell you what, Rudy, ask the 45 million Americans with no insurance whether they’re more worried about a “mandate” that would protect themselves and their families, or about being one serious illness away from bankruptcy.
And what does “It’s a no-risk society” mean, exactly? The millions of families already at risk aren’t at risk enough? Does Giuliani want to see more risk? Why?
I’m afraid Giuliani has about as much expertise on domestic policy as he does foreign policy. Which is to say, none.