Monday, April 5, 2010

Is ObamaCare A Pretext for Redistributing Wealth?

Byron York has pounced on Max Baucus’s offhand remark that ObamaCare "is a shift, a leveling, to help lower income, middle income Americans" as if it were a self-incriminating admission by a party to a vast liberal conspiracy (my emphasis):

“Now they tell us. For many opponents of the new legislation, the statements confirmed a nagging suspicion that for Barack Obama and Democrats in Congress, the health fight was about more than just insurance -- that redistribution played a significant, if largely unspoken, part in the drive for national health care. . . . It wasn't just about making insurance more affordable. It wasn't just about bending the cost curve. It wasn't just about cutting the federal deficit. It was about redistributing wealth.”
This is effective polemics, but it’s nonsense all the same. All public policies have redistributive effects because there can never be a perfect match between the class of people financing and otherwise contributing to a public program and the class of its intended and incidental beneficiaries. That’s true even of dollars spent on public goods that benefit everyone, like national security. Yet it’s hardly the “main aim” of national security policy is to redistribute wealth from taxpayers to bunch of a freeloaders who’ll enjoy national security without having to pay for it. It makes even less sense to say that a policy is “mainly aimed” at enriching its incidental beneficiaries, like the Code Pinkers who say that the Iraq war was “mainly aimed” at enriching Dick Cheney’s friends at Halliburton.

There’s an important ethical and political difference between programs designed to redistribute wealth and programs designed to satisfy some people’s vital interests by requiring other people to forego less-than-vital satisfactions. “Redistributing wealth” means taking a dollar that would otherwise be in a better-off person’s pocket and putting it in a worse-off person’s pocket, leaving how it’s spent to the discretion of the worse-off person. Liberals think that sometimes makes ethical and public-policy sense on the theory that, the fewer dollars you have, the more well-being you’re likely to get from spending one of them. An amount of money that Bill Gates would never miss if he left it in a pair of pants he sent to the dry cleaner might make the difference between a poorer person’s making or not making next month’s rent.

But liberals have never been notably successful at persuading other Americans that they’re right on that score. A lot of sensible people recognize that they have a duty to contribute money they would otherwise spend on superfluities so that other poor people can enjoy a decent diet or a roof over their heads. But they’re not inclined to surrender money to poorer people who might prefer spending it on superfluities to necessities themselves. That's why they insist on in-kind assistance, like food stamps rather than transfer payments that increase the transferee's discretionary income.  And that’s one of the principal reasons why welfare programs are always so unpopular and the images of “welfare queens” and “welfare Cadillacs” figured so prominently in our politics until welfare entitlements were rolled back in the 1990s.

ObamaCare  requires that mostly well-off people pay additional taxes to finance less-well-off people’s access to one good in particular, affordable health insurance. Nearly everyone across the ideological spectrum concedes that poorer people’s interest in maintaining their health should take precedence over other people’s interest in securing less-vital satisfactions; that’s why we have Medicaid and forbid private hospital emergency rooms from turning away uninsured people needing immediate medical treatment even if means higher medical costs and health insurance premiums for the rest of us. Liberals and a lot of other people see ObamaCare as a straightforward extension of that unobjectionable principle. You can disagree with that if you like, but that doesn’t make ObamaCare a mechanism for redistributing wealth.

No comments: