All Power to the Post Office

The U.S. government now pays for and controls half of the health care in America. That is up from less than 10 percent forty years ago. Government spending on health care has increased at a rapid rate as its share of health care has increased. Yet those who complain about the total amount of spending on health care in the United States to justify complete government control never discuss how much of the current spending is attributable to or mandated by government programs.

During a recent interview, a talk radio host told me that all private health insurance should be eliminated in order to give us all a reason to work together to make sure the government runs a good health care system.

My first reaction to that statement was to question how that approach has been working for public education. But I will come back to that. A better analogy would be that conditions in our prisons might be expected to improve if we were all required to live in them. Socialists and some Liberals would find this level of government-enforced uniformity to be a noble sacrifice to which all citizens must submit. Many Conservatives would reluctantly agree—but suggest a voucher system that would allow us each to select the prison cell of our choice.

The same reasoning would require the government to outlaw Federal Express, UPS and other private carriers, and force everyone to use the U.S. Postal Service exclusively. After all, Americans are now spending more than the citizens of any other country on package delivery. Even worse, poor people cannot afford to send anyone a FedEx package. Why allow rich people to have access to a better package delivery system? Would it not be simple social justice to require everyone to use the U.S. Postal Service? So what if it provides slower and less reliable service? Would not everyone be forced to band together to ensure that USPS does a better job?

Of course, we tried that for nearly 200 years when postmasters were politically appointed as a part of a federal spoils system. The Postal Reorganization Act of 1971 created the U.S. Postal Service as a semi-independent agency with less political interference. That plus only limited competition, in the likes of FedEx and UPS, was enough to cause the U.S. Postal Service to improve its efficiency and reliability considerably. What would be the consequences of eliminating that competition and restoring a total government monopoly? Would the U. S. Postal Service become better and cheaper?

Parents certainly have reason to band together to improve the near-monopoly of public education. They can exercise control only through politicians who often place their own interests—or those of public employee unions—ahead of those of students. Heads of unions, vying for political pull, use mandatory contributions deducted from teacher salaries to place their interests in the front of the line—ahead of students and parents. The leaders of those unions, who may spend hundreds of millions of dollars for contributions to politicians, maintain, of course, that their only concern is the welfare of the little children. Imagine for a moment what the power of a national physicians union or a national nurses union would do to health care, or imagine the prospect of a national health care strike. The only objective of these unions would be better health care for you, and for the children, right?

There are those who tell us that if we only place all of our trust in the government to control our health care, our problems will be solved. If only enlightened intellectuals ensure that each and every election puts their candidates for President and Congress in control, efficient and loving government will meet all of our medical needs. We all have surely learned that government always does a good job, and has a swell record at keeping down unnecessary expenses.

What would really happen if we had no options except government health care and no place else to go? What choice did wounded soldiers at Walter Reed Army Medical Center have? If this happened right under the nose of Congress—indeed in view of the windows of the VIP suites at the hospital reserved for Cabinet members and Congressmen—what kind of quality and oversight should the rest of us expect from a government system?

One of the things that helps curtail the inferior standards that exist in government health care is a comparison with services provided by private medical care. Such private care must be protected. Without it the 50 percent of care now paid for by the government would get much worse.

Collectivism does not work. The immoral use of government force cannot compel better health care. Putting us all in a government health care prison will not ensure better health care. Only freedom can do that.

Richard E. Ralston is Executive Director of Americans for Free Choice in Medicine.