Dueling Health Plans

BACK WHEN I was on the board of Music Center of the Northwest here in Seattle, we once discussed whether to offer the faculty benefits. Good idea, said the men; we could set up a 401(k). Good idea, said the women; we could offer health insurance.

Health care is important to women. I recently listened to Ruth Messinger, CEO of American Jewish World Service, tell a fundraiser about a microloan program in the Third World. The women recipients immediately applied their earnings to the education and the health care of their children.

What kind of health care do women want? If you ask a woman, she will probably tell you about the individual health care needs of the people she knows and cares about. She wants health care that meets her needs and the needs of those she cares about.

That’s what sank HillaryCare 1.0. Women took a look at it and couldn’t tell whether it met their particular needs.

That’s why Sen. Hillary Clinton’s (D-NY) HillaryCare 2.0 is called “The American Health Choices Plan.”

But Republican presidential candidates are ready with alternative plans. In case you weren’t sure what they are, Karl Rove has laid an eight-point plan in the Wall Street Journal. A good name for Karl’s plan would be “Health Choices, Not ‘Choices.’”

For a plan with “choices” in the title Sen. Clinton’s plan seems to involve an awful lot of additional government, including expansion of Medicare, the State Children’s Health Insurance Program, and the Federal Employee Health Benefit Program.

Ol’ Fred Thompson, chatting confidentially to us on “Fred and HillaryCare” from the back seat of a limo, wondered why a plan with all those choices would demand that “you prove that you have insurance before you get a job.”

Why is it that the liberal Hillary Clinton’s health plan is full of compulsion and mandates while Karl Rove’s plan is full of health consumers spending their own money to get the health care they want?

Margaret Thatcher explained it to Woman’s Own nearly twenty years ago.

There’s no such thing as society. There are individual men and women and there are families.

There is no use in people expecting society to solve their problems, she pointed out. Society doesn’t solve problems, people do. And the way that individual men and women solve their problems is through their families.

Even Hillary Clinton can see that. “It takes a village,” she once said. But the African village of which she spoke was a village of close blood relatives—extended families that looked after each other through instinct, through the emotional bonds of love, shame, and guilt, and through unconscious tradition.

In the city the extended family breaks down, and the network of kin loyalty shrivels into the nuclear family. How did people build community in the impersonal society of the big city to replace the support of the kindred?

They invented new forms of community to replace the protection they had enjoyed as rural extended families. By the nineteenth century these new communities included self-governing Christian churches in which the emotional obligations of the extended family were instantiated in a church family. And they included labor unions and fraternal lodges in which the obligations of blood-brotherhood were instantiated in voluntary associations where men just called each other “brother.” It was an ingenious solution; the sort of thing that ordinary people do every day.

But some high-born men didn’t like the nuclear family. In particular, the post-Napoleonic war baby-boomers, a generation that came to adulthood in the 1830s and 1840s, wanted to be liberated from the oppression of the “bourgeois” family. By the middle of the twentieth century high-born women like Simone de Beauvoir decided that they wanted to be liberated too.

There are individual men and women and there are families. When you have broken the emotional bonds of family, even the bare-bones nuclear family, then you are pretty well down to individuals.

But how do individuals survive in the impersonal society of the big city? They have sundered the emotional bonds of the extended family and scorned the bonds of the bourgeois family and church family that replaced it.

If you seek the answer it is all around you. It is the administrative state and its comprehensive and mandatory programs. Individuals who “bowl alone” need to force other people to help them meet their needs.

So it makes sense that the presidential candidates of the party of married religious people with children would propose a voluntary health care program based on people choosing the health care that was best for their families. It makes sense that the presidential candidates of the party of single secular childless people would propose a mandatory health care program that was based on force.

Dueling Health Plans

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